Lupus erythematosus: clinical and histopathological study of oral manifestations and immunohistochemical profile of epithelial maturation.
BACKGROUND
Lupus erythematosus (LE) is an autoimmune disease of unknown cause. Prevalence of oral involvement in patients with LE is uncertain but may vary from 9 to 45% in patients with systemic disease and from 3 to 20% in patients with chronic cutaneous involvement.


METHODS
Incidence of oral lesions of LE and their clinical aspects were investigated. Their histopathologic features were analyzed, and the status of epithelial maturation was assessed through the expression patterns of cytokeratins.


RESULTS
Twenty-six patients (from 188 examined) presented oral lesions of LE. Most of them were females (19) with systemic disease (11). Clinical aspects of these lesions varied, and lips and buccal mucosa were most affected. Histologically, lesions revealed lichenoid mucositis with perivascular infiltrate and thickening of basement. Cytokeratins profile showed hyperproliferative epithelium, with expression of CK5/6, and CK14 on all epithelial layers, CK16 on all suprabasal layers and CK10 on prickle cell layers only.


CONCLUSIONS
Oral lesions of LE show a variety of aspects, and their microscopic features are of a lichenoid mucositis with deep inflammatory infiltrate. Cytokeratins expression patterns are of hyperproliferative epithelium, and this phenomenon must be analyzed in relation to the inflammatory cytokines for a better understanding of the mechanisms of the disease.
Lourenço
Silvia Vanessa
SV
Department of Dermatology, Medical School, University of São Paulo, São Paulo, Brazil. sloducca@usp.br
Nacagami Sotto
Mirian
M
Constantino Vilela
Maria Apparecida
MA
Rodrigues Gonçalves de Carvalho
Fabio
F
Rivitti
Evandro A
EA
Menta Simonsen Nico
Marcello
M
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000378:metabolism; D017512:Lichenoid Eruptions / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013280:Stomatitis / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*
D007633:Keratins