Korean J Dermatol.
2015 Jan;53(1):38-44.
Immunohistochemical Differentiation between Actinic Cheilitis and Lichen Planus of the Lips
- Affiliations
-
- 1Department of Dermatology, Ajou University School of Medicine, Suwon, Korea. maychan@ajou.ac.kr
- 2Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea.
Abstract
- BACKGROUND
It is difficult to distinguish between actinic cheilitis and lichen planus histologically, because both types of lesions exhibit variable degrees of epidermal dysplasia and dermal lichenoid inflammation. There is currently no consensus on suitable immunohistochemical markers for distinguishing these 2 conditions.
OBJECTIVE
This study aims to determine histological features and immunohistochemical markers that could be used to differentiate actinic cheilitis from lichen planus.
METHODS
Fifteen cases of actinic cheilitis and 11 cases of lichen planus of the lips were included in the study. Histological changes such as parakeratosis, hyperkeratosis, atrophy, acanthosis, ulceration, necrosis, dermal solar elastosis, degrees of epidermal dysplasia and dermal inflammatory cell infiltration were examined. Verhoeff-van Gieson stained sections were quantified for the degree of elastosis using computer software. The following immunohistochemical markers were stained for: bcl-2, Ki-67, proliferating cell nuclear antigen, indoleamine 2, 3-dioxygenase, matrix metalloproteinase-3, matrix metalloproteinase-9, CD4, CD8, c-kit, and prolyl-4-hydroxylase.
RESULTS
The only histologically appreciable difference between the diseases was the degree of epidermal dysplasia. No differences were observed with respect to solar elastosis using the Verhoeff-van Gieson stain. We found that cell proliferation markers such as proliferating cell nuclear antigen and Ki-67 were more highly expressed in actinic cheilitis than in lichen planus. In addition, the number of c-kit-positive cells observed in actinic cheilitis was significantly higher than in lichen planus. The expression levels of the other tested markers were not significantly different between the 2 diseases.
CONCLUSION
The immunohistochemical markers proliferating cell nuclear antigen, Ki-67, and c-kit may help to differentiate actinic cheilitis from lichen planus of the lips.
