RESUMEN
Objectives: The number of patients with oral lichen planus, [OLP], increases all over the world. The treatment of this disease is not yet definitive. The correlation between OLP and chronic HCV infection is well established. However, the reported frequency of the anti-HCV antibodies in patients with OLP tends to appear quite variable and ranges from 0% to 65%. The aim of this work was to screen asymptomatic carriers in patients with OLP for anti hepatitis C antibodies and HCV-RNA detection and quantitation in seropositive cases and to assess their liver regarding chronic hepatitis through pathological study
Design and Patients: Twenty six patients diagnosed clinically as OLP and 26 normal, sex and age matched, healthy subjects, were included in this study. Blood sample of all patients and controls were tested for anti hepatitis C virus antibodies [anti-HCV Ab]. polymerase chain reaction for hepatitis C virus was done in patients with positive anti HCV Ab. Transcutaneous liver biopsy was performed in 6 patients with positive HCV-RNA. The histopathological results were evaluated. Sitting: Dermatology out-patient clinic, Menoufiya University Hospital and National Liver Institute, Menoufiya University
Results: The results of this study revealed that the frequency of positive anti HCV antibodies in OLP patients group was significantly increased [53.8%] than control group[15.4%]. Regarding the comparison of results of HCV-RNA screening, for positive anti HCV Ab cases in OLP and control groups, it was found that viral load grading of the fourteen cases of OLP patients were 3 high, 9 moderate and 2 low. While the viral load of the sero-positive four cases of the control group were 3 moderate and 1 low, On the different clinical forms of OLP regarding anti HCV antibody positivity it was found that all ulcerative forms were positive in 100%. H and E stained sections of mucus membrane biopsies from sero positive and sero negative HCV patients showed no pathological difference. Four of the liver biopsied patients were diagnosed as chronic hepatitis, with minimal to mild activity and the other two biopsied patients were diagnosed as chronic hepatitis with moderate activity
Conclusion: A significant association between OLP and HCV infection is present and HCV-RNA detection revealed dial the viral load in seropsitive cases was graded as mild, moderate and severe. So, it is prudent to screen all patients with OLP for hepatitis markers and if possible for HCV-RNA detection and quantitation. More studies are recommended to specify different prevalent genotypes of HCV in our locality and their associations with different skin diseases