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KMID : 0363220150530010038
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Korean Journal of Dermatology
2015 Volume.53 No. 1 p.38 ~ p.44
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Immunohistochemical Differentiation between Actinic Cheilitis and Lichen Planus of the Lips
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Jung Soo-Eun
Jang Yong-Hyun
Kang Hee-Young
Lee Eun-So
Kim You-Chan
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Abstract
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Background: It is difficult to distinguish between actinic cheilitis and lichen planus histologically, because bothtypes of lesions exhibit variable degrees of epidermal dysplasia and dermal lichenoid inflammation. There iscurrently 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 usedto 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 solarelastosis, degrees of epidermal dysplasia and dermal inflammatory cell infiltration were examined. Verhoeff-vanGieson stained sections were quantified for the degree of elastosis using computer software. The followingimmunohistochemical 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 cellproliferation markers such as proliferating cell nuclear antigen and Ki-67 were more highly expressed in actiniccheilitis than in lichen planus. In addition, the number of c-kit-positive cells observed in actinic cheilitis wassignificantly higher than in lichen planus. The expression levels of the other tested markers were not significantlydifferent between the 2 diseases.
Conclusion: The immunohistochemical markers proliferating cell nuclear antigen, Ki-67, and c-kit may help todifferentiate actinic cheilitis from lichen planus of the lips. (Korean J Dermatol 2015;53(1):38∼44)
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KEYWORD
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Actinic cheilitis , C-kit , Ki-67 , Lichen planus , Proliferating cell nuclear antigen
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