What are the pathological changes of lichen planus

Lichen planus sounds like lichen, but it is not lichen. It is a chronic inflammatory disease. It is divided into three types: reticular infiltrative type and atrophic type. Oral lichen planus is relatively common, more common in women over 40 years old, but recent studies have shown that the disease can become cancerous, with a cancer rate of 1.75%. The cause is still unclear, and the medical community generally believes that it is related to mental stress and low immune function. Now let me introduce the pathological changes of lichen planus.

In the white stripes of the mucosa, the epithelium is a non-completely keratinized layer. In the red areas of the mucosa, the surface layer of the epithelium is not keratinized, and the blood vessels in the connective tissue may be dilated and congested. Generally, there are more spinous layer hyperplasia, and a few spinous layer atrophy. The epithelial pegs show irregular extension. The lower ends of a few epithelial spikes become pointed and serrated. The basal cell layer liquefies and degenerates, resulting in disordered arrangement of the basal cells and unclear boundaries of the basement membrane. Subepithelial blisters may form if basal cell liquefaction is obvious. There is a dense lymphocyte infiltration zone in the mucosal lamina propria, and the infiltration range generally does not reach the submucosal layer. Studies have shown that these infiltrating lymphocytes are mainly T cells. Round or oval colloid bodies or corpuscles can be seen in the spinous layer, basal layer or mucosal lamina propria of the epithelium. Their average diameter is about 10µm, they are homogeneous and eosinophilic, and they are rose red when positively stained with PAS. This body may be a product of cell apoptosis.

Electron microscopic observation showed that the mitochondria and rough endoplasmic reticulum in the basal cells were swollen, and vacuoles appeared in the cytoplasm. In severe cases, the vacuoles were numerous and large, and their structure disappeared. The number of hemidesmosomes between basal cells and basement membrane decreased, and proliferation, rupture and dislocation of basement membrane were observed. White blood cells can be seen in the epithelium, and there is degeneration.

Oral lichen planus has long been considered a benign lesion. In recent years, there have been more and more reports of its cancerous transformation, and there are many different opinions: one is that it is a precancerous lesion; another is that it is a precancerous state, not a precancerous lesion; and the third is that this disease does increase the risk of cancer. In conclusion, oral lichen planus does have malignant potential and has histopathological morphological changes, such as varying degrees of abnormal proliferation of the epithelium, and is therefore not a single condition.

Everyone should be vigilant about this disease, especially the erosive, ulcerative and atrophic types, and should pay more attention to follow-up observation. Once you find that you are sick, you should immediately go to the hospital for examination and treatment. You should also pay attention to a light diet and avoid spicy, raw or cold foods. Always pay attention to changes in your condition, keep a calm mind, and exercise more.