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Medicine, Indianapolis, Indiana, USA and a unifying hypothesis of pathogenesis Chaiyarit P, Kafrawy AH, Miles DA, Zunt, SL, Van Dis ML, Gregory RL: Oral lichen planus: an immunohistochemical study of heat shock proteins (HSPs) and cytokeratins (CKs) and a unifying hypothesis of pathogenesis. J Oral Pathol Med 1999; 28: 210-5. C Munksgaard, 1999.The expression of heat shock proteins HSP60 and HSP70 and cytokeratins CK1/ 10 and CK7/18 were compared in epithelium of oral lichen planus (OLP) lesions and oral fibromas using an avidin-biotin-peroxidase complex (ABC) immunohistochemical method. An immunostaining intensity distribution (IID) index was developed to assess staining intensity and the proportion of positively stained Key words: avidin-biotin-peroxidase complex cells in different layers of the epithelium. The expression of HSP60 in the basal (ABC); cytokeratins (CKs); heat shock proteins (HSP); immunostaining intensity layer was significantly higher in OLP than in fibromas. No difference in HSP70 distribution (IID); oral lichen planus (OLP) expression was evident between OLP and fibromas. The expression of CK1/10 in the epithelial basal and suprabasal layers was significantly higher in OLP than in A. H. Kafrawy, Department of Oral Surgery, fibromas. There was no demonstrable staining for CK7/18 in either OLP or fibro-Medicine and Pathology, Indiana University School of Dentistry, 1121 West Michigan mas. A significant correlation was evident between the expression of HSP60 andStreet, Room 106, Indianapolis, Indiana CK1/10 in the basal epithelial cells in OLP. The findings support a role for HSP60 46202-5186, USA in the pathogenesis of OLP. A unifying hypothesis of the pathogenesis of OLP, involving two sequential immune reactions, is proposed.