Direct Immunofluorescence in Clinically Diagnosed Oral Lichen Planus

  • Lee, Kyung-Eun (Department of Oral Medicine, School of Dentistry, Chonbuk National University) ;
  • Suh, Bong-Jik (Department of Oral Medicine, School of Dentistry, Chonbuk National University)
  • Received : 2016.02.16
  • Accepted : 2016.03.14
  • Published : 2016.03.30


Purpose: Oral lichen planus (OLP) is relatively common mucosal disease in clinical dentistry. OLP is intractable and regarded having malignant potential. Until now, there is some debate on how far OLP can be malignant, and which characteristics can be a risk factor for malignant transformation. Clinician need to know some differences between OLP and lesions similar to OLP to manage properly and suppose prognosis correctly. Therefore, the aim of this study was to divide clinical OLP into two groups and to compare the results of direct immunofluorescence (DIF) between two groups. Methods: This study was conducted on outpatients who visited at the department of Oral Medicine in Chonbuk National University Hospital from January 2007 to November 2015. Patients with DIF result were retrospectively reviewed. The selected patients were classified 'clinical typical of OLP' (CTO) or 'clinical compatible with OLP' (CCW) by modified World Health Organization diagnostic criteria of OLP and oral lichenoid lesion. Results: DIF were classified by deposition intensity or pattern of anti-human antibody and fibrinogen. The classification of fluorescence pattern in each specimen was graded as positive, possibly positive or negative. Conclusions: Both CTO and CCW had positive and possibly positive pattern. Prevalence of positive pattern was 68.8% in CTO and 52.6% in CCW and that of possibly positive pattern was 9.4% in CTO and 5.3% in CCW. Prevalence of negative was 21.8% in CTO and 42.1% in CCW.


Supported by : Chonbuk National University Hospital


  1. Sugerman PB, Savage NW, Walsh LJ, et al. The pathogenesis of oral lichen planus. Crit Rev Oral Biol Med 2002;13:350-365.
  2. Nico MM, Fernan des JD, Lourenco SV. Oral lichen planus. An Bras Dermatol 2011;86:633-641.
  3. Farhi D, Dupin N. Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: facts and controversies. Clin Dermatol 2010;28:100-108.
  4. Ismail SB, Kumar SK, Zain RB. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci 2007;49:89-106.
  5. Parashar P. Oral lichen planus. Otolaryngol Clin North Am 2001;44:89-107.
  6. McCartan BE, Healy CM. The reported of prevalence of oral lichen planus: a review and critique. J Oral Pathol Med 2008;37:447-453.
  7. Kramer IR, Lucas RB, Pindborg JJ, Sobin LH. Definition of leukoplakia and related lesions: an aid to studies on oral precancer. Oral Surg Oral Med Oral Pathol 1978;46:518-539.
  8. Silverman S Jr, Gorsky M, Lozada-Nur F. A prospective follow-up study of 570 patients with oral lichen planus: persistence, remission, and malignant association. Oral Surg Oral Med Oral Pathol 1985;60:30-34.
  9. Murti PR, Daftary DK, Bhonsle RB, Gupta PC, Mehta FS, Pindborg JJ. Malignant potential of oral lichen planus: observations in 722 patients from India. J Oral Pathol 1986;15:71-77.
  10. Silverman S Jr, Gorsky M, Lozada-Nur F, Giannotti K. A prospective study of findings and management in 214 patients with oral lichen planus. Oral Surg Oral Med Oral Pathol 1991;72:665-670.
  11. van der Meij EH, Mast H, van der Waal I. The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective five-year follow-up study of 192 patients. Oral Oncol 2007;43:742-748.
  12. Barnes L, Eveson JW, Reichart P, Sidransky D. Pathology and genetics of head and neck tumours. Lyon: IARC Press; 1941. pp. 177-179.
  13. Laskaris G, Sklavounou A, Angelopoulos A. Direct immunofluorescence in oral lichen planus. Oral Surg Oral Med Oral Pathol 1982;53:483-487.
  14. Firth NA, Rich AM, Radden BG, Reade PC. Assessment of the value of immunofluorescence microscopy in the diagnosis of oral mucosal lichen planus. J Oral Pathol Med 1990;19:295-297.
  15. Anuradha Ch, Malathi N, Anandan S, Magesh K. Current concepts of immunofluorescence in oral mucocutaneous diseases. J Oral Maxillofac Pathol 2011;15:261-266.
  16. Raghu AR, Nirmala NR, Sreekumaran N. Direct immunofluorescence in oral lichen planus and oral lichenoid reactions. Quintessence Int 2002;33:234-239.
  17. van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med 2003;32:507-512.
  18. Kulthanan K, Jiamton S, Varothai S, Pinkaew S, Sutthipinittharm P. Direct immunofluorescence study in patients with lichen planus. Int J Dermatol 2007;46:1237-1241.
  19. Jordan RC, Daniels TE, Greenspan JS, Regezi JA. Advanced diagnostic methods in oral and maxillofacial pathology. part II: immunohistochemical and immunofluorescent methods. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:56-74.
  20. Helander SD, Rogers RS. The sensitivity and specificity of direct immunofluorescence testing in disorders of mucous membranes. J Am Acad Dermatol 1994;30:65-75.
  21. Buajeeb W, Okuma N, Thanakun S, Laothumthut T. Direct immunofluorescence in oral lichen planus. J Clin Diagn Res 2015;9:ZC34-ZC37.
  22. Watanabe C, Hayashi T, Kawada A. Immunofluorescence study of drug-induced lichen planus-like lesions. J Dermatol 1981;8:473-477.