Clinic And Pathology Analysis Of 255 Patients With Lichen Planus

Lichen planus is a self-limiting disease,of which cause is ambiguous. It mainly appears in the skin, mucosa and genitalia. Typical lesions are purple flat polygonal papules,the surface of which is wax-like film and can be seen gloss white dots,Wickham Stria,in acute phase it appears to be Koebner phenomenon. It Often damages the mucosa,oral buccal mucosa lesion is reticular white stripes,which can be integrated and eroded. And sometimes the lesion has an atypical clinical appearance,so LP is most often confused clinically with other pigmental disease ,such as psoriasis,verruca plana,verruca plantaris,pityriasis and lichen striatus。Then the histol- ogical diagnosis is indispensible . In order to enhance the accuracy of diagnosis ,we studied retrospectively of 255cases of Lp that accepted pathological examination in our hospital from 2004 to 2009.Its etiology is unclear, in recent years, as the rapid development of immunology, molecular biology and other related basic disciplines,the pathogenesis of LP also has a deeper understanding. The pathogenesis of LP is mainly cellmediated immune response. Langerhans cells,activated by antigen of self changed or foreign change their morphology and the number and secret cytokines,which induce T cells into inflammatory sites and then will be activated .Activated T cells can kill keratinocytes through direct or indirect way,which result in a wide range of basal cell liquefaction degeneration of LP and other pathological changes. The current study shows that keratinocytes apoptosis cell,differen- tiation markers and molecular changes in neuropsychiatric factors are closely related with the pathogenesis of LP.About the participation of apoptosis in the pathogenesis of LP has became hot spots in current research.The current study showed that apoptosis and the pathogenesis of LP relationship must exist.However,apoptotic cells in the skin structure and its abnormal expression of the distribution (including apoptosis inhibition and hyperthyroidism) required further study.Apoptosis,a different cell necrosis of the cell death,is an indispensable cell self-regulating mechanisms to life processes,which leads to the survival of important cell metabolism manner throughout the entire life of biological activities. Inhibition of apoptosis can lead to biological growth and development,nervous system damage and immune function regulating etc.And apoptosis hyperthyroidism is closely related to the incidence of tissue injury and organ failure .Detecting apoptotic cells through the use of TUNEL play an important role in the study of the pathoge- nesis of many diseases and treatment All of these findings laid a theoretical foundation for the further study on the pathogenesis of LP.This study detect apoptotic cells in suprabasal and acantholysis of LP through the application of TUNEL ,and discuss the relationship between the apoptotic cells and the pathogenesis of LP.Method:We used statistic analysis in order to investigate the incidence of male and female ,average age,site difference ,clinical misdiagnosis etc.With the application of TUNEL,we chose 30 cases of paraffin-embedded specimens,which had been pathological diagnized as LP,and 10 cases of healthy skin tissue to detect apoptosis cell. Brown particles in the nucleus are apoptotic cells。Finding five typical lesions at consecutive high power field (400 x times)to count the number of positive cells,the data were statistically tested using t test。P <0.05 has statistical significance.Result:In 255 cases ,there were 111males (46%),and 144females (56%).The average age of the Lp patients was 39.6±12.69 years,and 40.56±14.05years for males , 36.5±13.5years for females .The course of disease wsa 2.5years per person .In terms of the site of leisions,it mainely occured on the Limbs and trunk.According to the standard adapted by Zxuejun and Tuping`sHistopathological diagnosis of dermatology, Lichenplanus is divided into five histological subtypes :Hypertrophic, Atrophic, Pigment type, Follicular type, Bullous type.In 255 cases,besides typical types ,the number of Hypertrophic cases was 73(28.6%), Atrophic cases was 44(17%), Pigment type cases was 5(1.9%), Follicular type cases was 2(0.9%), Bullous type cases was 5(1.9%).In our research ,33cases were misdiagnosed to the other disease ,including 8 cases (24.2%)misdianosed to psoriasis ,and others to be verruca plana,verruca plantaris,pityriasis and lichen striatus,etc.It is reported that apoptotic cells can be seen in the cortex and the lamina propria of OLP (oral lichen planus) ,in the epithelial cells of AI was significantly higher than the normal control group。However, lamina propria cell AI was significantly lower than control group。So it showed that the occurrence of OLP is related to abnormal apoptosis in LP lesions。Therefore,AI of Stratum corneum cells is expected to be higer than normal control group,AI of the cell acantholysis is lower than the control group。However, apoptotic cells were not found in the experimental group and the healthy people skin tissue。Conclusion:1.Lp can occur in any age,the majority of patients fall in the age group from 20-60 years,There are the trend of younger。2. Hypertrophic LP were more than the other types,it may be associated with dry skin, itching of the vulnerable。3.Histopathological examination is a reliable method to diagnosis of LP,the lesion resembling LP should submit for histopathological examination immediately.4.It can not conclude that apoptotic cell has nothing to do with the pathogenesis of LP,although apoptotic cells were not detected in the LP lesions. Analysis 1: The experiment has misused the process, dyeing and quality kit may also lead to negative results. 2: apoptotic cells are really involved in the pathogenesis of LP remains to be studied.