title: Ten cases of severe oral lichen planus showing granular C3 deposition in oral mucosal basement membrane zone.
abstract: BACKGROUND
  Oral lichen planus (OLP) may show depositions of immunoglobulins and complement components in oral mucosal basement membrane zone (BMZ) in direct immunofluorescence, although these finding are not frequently seen.
  
  
  OBJECTIVE
  We collected and examined ten cases of severe OLP showing granular C3 deposition in BMZ.
  
  
  METHODS
  In addition to clinical, histopathological and direct immunofluorescence assessments, we performed various immune-serological tests, including indirect immunofluorescence of normal human skin and 1M NaCl-split skin, immunoblotting of normal human epidermal and dermal extracts, recombinant proteins of BP180 NC16a and C-terminal domains, concentrated culture supernatant of HaCaT cells and purified human laminin-332, and enzyme-linked immunosorbent assays for BP230 and BP180.
  
  
  RESULTS
  Direct immunofluorescence showed C3 deposition in BMZ exclusively of granular pattern in 7 cases and of both granular and linear patterns in 3 cases. The 10 cases showed no positive reactivity for either IgG or IgA antibodies in any immuno-serological tests. Detailed analyses of clinical, histopathological and immunological findings revealed striking female prevalence, although other parameters were in general characteristic of OLP.
  
  
  CONCLUSIONS
  Granular C3 deposition in oral BMZ may be one of the characteristic features of severe OLP, although mechanisms for C3 deposition and its pathogenic role in OLP are currently unknown.
authors.affiliation: Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan.
authors.forename: Aoi
authors.initials: A
authors.lastname: Fukuda
authors.affiliation: First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Himejima
authors.affiliation: First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan.
authors.forename: Shosuke
authors.initials: S
authors.lastname: Morita
authors.affiliation: Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tsuruta
authors.affiliation: Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koga
authors.affiliation: Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
authors.forename: Rafal P
authors.initials: RP
authors.lastname: Krol
authors.affiliation: Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Ishii
mesh_terms: D001323:Autoantibodies / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D003176:Complement C3 / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D005500:Follow-Up Studies; D006801:Humans; D015151:Immunoblotting; D017676:Lichen Planus, Oral / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; C038245:C3 protein, human; D003176:Complement C3
keywords: C3; basement membrane zone; direct immunofluorescence; granular deposition; oral lichen planus