title: Lichen planus: a clinical and immuno-histological analysis.
abstract: BACKGROUND
  Direct immunofluorescence examination is an important technique in the diagnosis of cutaneous inflammatory disorders including lichen planus, especially in clinically and histopathological doubtful cases.
  
  
  OBJECTIVE
  To study the diagnostic utility of intensity, number, and subtypes of positive immuno-reactants found in lichen planus.
  
  
  METHODS
  A detailed analysis of clinical as well as immuno-histological features of lichen planus cases was carried out.
  
  
  RESULTS
  The male to female ratio was 1:1.1. The largest number of patients was in 31-50 year age group. Itching was the most common presenting symptom. Papular lesions were seen in 53% cases. Remaining had hypertrophic (6), follicular (3) and mucosal (9) variants. Clinico-pathological discrepancies were observed in 3 patients. The characteristic histopathological changes including basal cell vacuolization, band-like lymphocytic infiltrate at dermo-epidermal junction were seen in all the biopsies while Civatte bodies were detected in 29% cases. The overall positive yield of direct immunofluorescence microscopy was 55%. Immune deposits at Civatte bodies and dermo-epidermal junction were detected in 47% and 8% of cases, respectively. Immunoglobulin M was the most common immunoreactant followed by immunoglobulin G.
  
  
  CONCLUSIONS
  There was no correlation found between the number and intensity of Civatte bodies with clinical variants of disease and also between the number of positive immunoreactants and clinical severity of the disease. The frequency, number, and arrangement of Civatte bodies in clusters in the papillary dermis as well as multiple immunoglobulins deposition at the Civatte bodies on direct immunofluorescence of skin biopsies are important features distinguishing lichen planus from other interface dermatitis.
authors.affiliation: Department of Immunopathology, Post Graduate Institute of Medical Education and Research, PGIMER, Chandigarh, India.
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Arora
authors.affiliation: Department of Immunopathology, Post Graduate Institute of Medical Education and Research, PGIMER, Chandigarh, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Chhabra
authors.affiliation: Department of Histopathology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, PGIMER, Chandigarh, India.
authors.forename: Uma N
authors.initials: UN
authors.lastname: Saikia
authors.affiliation: Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, PGIMER, Chandigarh, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Dogra
authors.affiliation: Department of Immunopathology, Post Graduate Institute of Medical Education and Research, PGIMER, Chandigarh, India.
authors.forename: Ranzana W
authors.initials: RW
authors.lastname: Minz
keywords: Direct immunofluorescence; interface dermatitis; skin biopsy