Relevance of Herpes Simplex Virus Infection to Oral Lichen Planus

Abstract

Background: Oral lichen planus (OLP) is a chronic inflammatory disease involving the oral mucosa that induces pain and burning sensations, thus decreasing a patient's quality of life. Although its etiology has not yet been clearly defined, infection has been suggested to be associated with OLP. We tried to clarify the relevance of herpes simplex virus (HSV) infection in OLP, since HSV infection is the most common infection in the oral mucosa of adults with characteristics of recurrence due to psychological and physical stress. Methods: We enrolled thirty subjects diagnosed with OLP by clinical manifestation and pathologic findings. We tested serum IgG levels against HSV-1 and 2, and performed PCR testing of biopsy specimens for HSV. Additionally, we assessed the treatment effect of an oral anti-viral agent for OLP. Results: Serum HSV-1, 2 IgG levels were markedly elevated in the OLP subjects. HSV DNA was not found in the PCR biopsy specimens. Eight out of thirteen subjects(61.5%) who took oral acyclovir improved in subjective symptoms and objective lesion manifestations. OLP patients treated with conventional treatments showed improvement in 58.8%. Conclusions: Although we did not observe decisive findings, such as a positive HSV-PCR result, to establish a link between HSV and OLP, we did observe an increase in HSV IgG levels and a therapeutic response to oral acyclovir in subjects with OLP.