Comment on “Clinical and demographic profile of oral lichen planus in Sri Lanka: a retrospective study”

To the editor, I read the article titled ‘Clinical and demographic profile of Oral Lichen Planus in Sri Lanka: A retrospective study authored by BSM Samadarani et al. (1). I found this article enlightening and up to the minute. The distinction between Oral Lichen Planus (OLP) and Oral lichenoid reaction (OLR) is extremely difficult due to their remarkably similar clinical and histopathological features, while clinical history triggers identification and histopathological examination remain crucial, immunohistochemistry (IHC) offers more precise understanding of the underlying mechanism. Oral lichen planus are generally bilateral lesions may or may not be symmetrical (2). I reported a case of unilateral lichen planus in 2014 which was distinguished from lichenoid reaction due to the immunohistochemical positivity of CD 8+ T cell.  CD 8 + T cell often shows a stronger positive expression in OLP than OLR (3). Recently Suzuki T et al. (4) found over -expression of COX -2 by epithelial cells in OLL, that could inferred oncogenic changes, because COX -2 was described to modulate cell proliferation and apoptosis against oncogenic alterations (5). Immunohistochemistry has emerged as a valuable adjunct to traditional diagnostic methods in differentiating OLP from OLR by providing a more detailed characterization of the inflammatory infiltrate and epithelial changes.