An Association Between Serum Cortisol Levels In Erosive And Nonerosive Oral Lichen Planus Patients

Study objectives: Oral lichen planus (OLP) is a well recognized chronic mucocutaneous disorder which can manifest in the oral mucosa, whose exact pathogenic mechanisms have not been understood. Estimation of serum cortisol in patients with OLP may be helpful in understanding the pathogenesis. Therefore a study was undertaken to analyze the serum cortisol levels in OLP patients. An attempt was also made to evaluate the anxiety and depression levels in these patients. Design and key methods: A case control study was conducted on 15 cases each of non-erosive oral lichen planus (NEOLP) and erosive oral lichen planus (EOLP) and 10 controls. The serum cortisol levels of all 40 p a t i e n t s w e r e e s t i m a t e d b y u s i n g electrochemoluminiscence. Hospital Anxiety and Depression Score questionnaire was administered to evaluate the psychiatric status of all the patients. Results: The mean serum cortisol level of the OLP group showed a very highly significant difference (p=0.001) from the controls. The mean anxiety and depression scores of the OLP group showed very highly significant difference (p=0.001) from the controls. The difference in mean cortisol level between NEOLP group and control was not significant (p=0.06), whereas the difference was very highly significant between the EOLP group and controls (p=0.001). The difference between the anxiety score between the NEOLP group and EOLP group, but the depression scores between the two groups were not very significant (p=0.085). Conclusion: These findings suggest that psychiatric factors play a vital role in the pathogenesis of OLP and serum cortisol could be a possible indicator for the erosive nature of the lesion.