Original Article

Direct Immunofluorescence in Lichen Planus and Lichen Planus like Lesions

Reema Bhushan, Shilpi Agarwal, Ram Chander and Kiran Agarwal
World Journal of Pathology 2017, 6:4

Abstract

Background

The direct immunofluorescence examination (DIF) in lichen planus (LP) and lichen planus like lesions can show deposition of multiple immunoreactants at dermoepidermal junction (DEJ) and cytoid bodies (CB).

Patients and Methods

Fifty one cases of lichen planus and lichen planus like lesions were included in the study on the basis of clinical and histological criteria at Department of Pathology, Lady Hardinge Medical College from November 2012 to March 2014. The results of direct immunofluorescence was analysed in these cases.

Results

Among lichen planus (LP), DIF positivity at dermoepidermal junction (DEJ) was seen in 25/33 (75.6%) cases followed by deposit at cytoid bodies in 18/33 (54.5%) cases. The immunoreactivity at DEJ was most commonly seen with fibrinogen in 24/33 (72.7%) cases. DIF positivity at cytoid bodies was most commonly seen with C3 in 12/33 (36.3%) cases. Among lichen planus pigmentosus (LPP), DIF positivity was seen in 9/13 (69.2%) cases. The deposit at DEJ was noted in 2/13 (15.3%) cases while deposit at cytoid bodies was seen in 8/13 (61.5%) cases. Most common immunoreactant at cytoid bodies was C3 in 5/13 (38.4%) cases. The sensitivity of histopathology and direct immunofluorescence for the diagnosis of lichen planus including lichen planus-like lesions was found to be 100% & 74.5% (LP-87.9% and LPP-69.2%) respectively.

Conclusions

The study showed that DIF is helpful in diagnosis of LP and LP like lesions. In LP, the shaggy fibrinogen deposit alone at DEJ & C3 alone or in combination of other immunoreactants at CB was found to be most characteristic

Key words

Direct immunofluorescence, Lichen planus, skinskin, pathology,

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