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Oral lichen sclerosus expressing extracellular matrix proteins and IgG4-positive plasma cells.

Abstract
Lichen sclerosus (LS) is a mucocutaneous disease with uncommon oral involvement. The etiology is not yet well understood, but LS has been associated with autoimmune, genetic, and immunological factors. We report a 47-year-old man with LS that exhibited an asymptomatic white plaque with red patches on the maxillary alveolar mucosa extending to the labial mucosa. He had no other skin disease. Positive immunostaining for tenascin and scarcity of fibronectin suggested extracellular matrix reorganization. Elastin immunostaining indicated a reduction of elastic fibers. Immunoexpression of collagen IV in blood vessels and its absence in the epithelial basement membrane, together with diffuse MMP-9 immunoexpression, suggested altered proteolytic activity. Mast cell staining bordering areas of sclerosis indicated a possible role in the synthesis of collagen. IgG4 positivity in plasma cells suggested a role in the fibrogenesis. This is an unusual presentation of oral LS and we discuss immunohistochemical findings regarding cellular and extracellular matrix components.
AuthorsFlavia Calo De Aquino Xavier, Alisio Alves Prates, Clarissa Araujo Gurgel, Tulio Geraldo De Souza, Rodrigo Guimaraes Andrade, Eduardo Antonio Goncalves Ramos, Luciana Maria Pedreira Ramalho, Jean Nunes Dos Santos
JournalDermatology online journal (Dermatol Online J) Vol. 20 Issue 9 (Sep 16 2014) ISSN: 1087-2108 [Electronic] United States
PMID25244166 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Collagen Type IV
  • Extracellular Matrix Proteins
  • Fibronectins
  • Immunoglobulin G
  • Tenascin
  • Matrix Metalloproteinase 9
Topics
  • Collagen Type IV (metabolism)
  • Extracellular Matrix Proteins (metabolism)
  • Fibronectins (metabolism)
  • Humans
  • Immunoenzyme Techniques
  • Immunoglobulin G (metabolism)
  • Lichen Sclerosus et Atrophicus (metabolism, pathology)
  • Male
  • Matrix Metalloproteinase 9 (metabolism)
  • Middle Aged
  • Mouth Diseases (metabolism)
  • Mouth Mucosa (metabolism)
  • Plasma Cells (metabolism)
  • Tenascin (metabolism)

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