الفهرس 
Chapter (1): Lichen PlanusOnly 14 pages are availabe for public view
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Abstract
Lichen planus (LP) is an inflammatory, papulosquamous disorder
that may affect the skin, mucous membranes, hair and nails. Lichen
planus is clinically characterized by faintly erythematous to violaceous,
small, flat-topped, polygonal papules, distributed mainly on the flexor
aspects of extremities, associated with intense pruritus. The oral cavity,
genitals, nails and scalp may also be involved. The exact pathogenesis is
unknown, but cell-mediatedimmunity and humoral immunity have been
implicated. The aim of the work is to evaluate the status of oxidative
stressand the antioxidant defense system in sample of Egyptian patient
with lichen planus by measuring their serum levels of nitric oxide (NO),
malondialdehyde (MDA), superoxide dismutase (SOD), and erythrocyte
catalase (CAT). This case control study was conducted on 20 patients suffering
lichen planus (11females (%) and 9 (%) males). Their age ranged from 20
to 75 years with mean 38.39 ± 11.77 years. They were age- and sexmatched
with 20 healthy individuals that served as controls with a mean
of 39.92 ± 11.79 years. The duration of the disease ranged from 3 months
to 6 years with a mean ± SD of 1.46 ± 1.33 years. Serum levels of nitric oxide (NO), malodialdehyde (MDA),
superoxide dismutase (SOD), and erythrocyte catalase (CAT) were
measured for all patient as well as the controls. Regarding marital status, 25 (75%) patients were married, 3
(15%) were single and 2 (10%) were widow or divorcied. Regarding
associated diseases in the patient group, 11 (55%) patients did not have any associated condition, 1 (5%) patients had DM, 7 (35%) patients had
hypertension, one patient (3.33%) had hypertension and liver disease, and
2 (6.66%) patients had hypertension and DM. Regarding GIT
manifestations in patient group, 7 (35%) patients did not have any
manifestations while 13 (65%) patients had GIT manifestations. Patients with negative recurrence were 16 (86.67%) patients
where positive recurrence was observed in 4 (13.33%) patients.
Regarding site of LP in the patient group, 6 (30%) patients had oral
manifestations, 2 (10%) patients had genital manifestations, 2 (10%)
patients had nail changes, 1 (5%) patients had palm involvement, 9 (45%)
patients had wrist involvement, 7 (35%) patients had feet involvement, 2
(10%) patients had generalized manifestations , 3 (15%) patients had leg involvement and 2 (10%) patients had arm involvement. involvement and 2 (10%) patients had arm involvement. and 12 (60%) patients had Guttate LP. Results of the current study showed that Mean ± SD levels of
serum NO (77.32 ± 12.133 lmol ⁄ L) and MDA (15.87 ± 3.022 lmol ⁄ L)
in patients with LP were higher than those of the control group (P
<0.0001and P =0.005, respectively). Serum SOD levels (16.1987 ± 3.012
U ⁄ mL) in patients with LP were also higher than in healthy controls
(P=0.02). In contrast, erythrocyte CAT levels (14171.47± 2788.29U)
were significantly lower in the patient group than in the control group (P
=0.005). Results of the current study showed significant higher MDA and
CAT in male patients compared to females (p=0.007, 0.01 respectively).
No statistically significant differans in NO and SOD in both sexes was
detected. Results of the current study showed higher MDA and lower CAT
in patients with oral manifistations compared to patients witout oral
manifistations (p=0.02, 0.05 respectively). No statistically significant
differans in NO and SOD in both groups was detected. Results of the current study showed a statistically significant
positive correlation between NO (r = 0.57, p = 0.005), MDA (r = 0.54, p
= 0.005), SOD (r = 0.638, p = 0.001), and the duration of illness, and a
statistically negative correlation between CAT (r = −0.48, p = 0.009) and
the duration of the disease was found. In addition, there was a significant
positive correlation between NO and SOD and CAT and MDA. In summary, we concluded that increased oxidative stress and
lipid peroxidation as well as an imbalance in the antioxidant defence
system may play a role in the pathogenesis of LP.