Association of Salivary Cortisol and Anxiety Levels in Lichen Planus Patients

Abstract

Background: Oral lichen planus (OLP) is a frequently encoun tered chronic inflammatory disease of oral mucosa and skin, where the patients often relate the onset and aggravation of oral symptoms to increased levels of stress. Cortisol, also called as "stress hormone" has been used as an indicator in various stress evaluation studies. Aim:The aim of this crosssectional study was to determine any association between anxiety and salivary cortisol levels in OLP patients. Materials and Methods:A total of 20 OLP patients along with same number of age and sex matched healthy controls were included in the study. Saliva was collected from all the subjects between 9.00 to 9.15 am to avoid diurnal variations of cortisol levels. The saliva samples were analysed for cortisol levels by competitive enzymelinked immunosorbent assay (ELISA) method. Anxiety levels of 40 patients were measured by using Hamilton's anxiety scale. Student's ttest was used to compare the anxiety and salivary cortisol levels between both groups. Results:The mean salivary cortisol level of the OLP group showed highly significant difference (p<0.001) from the controls. The mean anxiety scores of the OLP group showed highly significant difference (p<0.001) from the controls. A positive correlation was found between anxiety and salivary cortisol levels in the OLP patients. Conclusion:These findings suggest that anxiety play a vital role in the pathogenesis of OLP, thus besides traditional treatment, psychological support is also needed.

Correlation between salivary cortisol levels and Hospital Anxiety and Depression scores in oral lichen planus and recurrent aphthous stomatitis

“…The mean salivary cortisol level in our group of OLP patients amounted to 0.83 ± 0.40 µg/dL which was higher than the mean of the control group, in concordance with many earlier studies [11,16,[18][19][20] , but the absolute value is lower than that reported in few of these studies [11,16,19,20] . This higher mean cortisol level could be attributed to the earlier time of saliva collection in our study as compared to other studies.…”

“…The mean rank of salivary cortisol in OLP patients was not statistically significantly higher than the control group. This insignificance is in concordance with Girardi et al [22] but dissimilar to other studies [11,16,18,19,20] .…”

“…Our study results suggest high levels of anxiety in OLP patients. This confirms the findings of several previous studies [15,18,20,24] , but contradicts that of Allen et al [12] , Pippi et al [21] and Girardi et al [22] . High levels of depression in our OLP patients contradict the findings of McCartan [15] , Pippi et al [21] and Girardi et al [22] , but is supported by the results of Shah et al [19] .…”

Stress Evaluation Using Das Scale and Salivary Cortisol in Patients With Oral Lichen Planus, Oral Submucous Fibrosis, Leukoplakia and Squamous Cell Carcinoma.

“…Salivary cortisol values in OLP group was higher than normal range 32.56 ± 14.52 ng/ml, which was in accordance with Girardi C et al 22 , Rabiei M et al2012 23 , Mohan et al 24 observed higher stress, anxiety and depression levels and higher salivary cortisol values than normal range. Nadendla LK et al 25 observed higher salivary cortisol level which was 17.0 ± 3.82 ng/ml compared to normal individual.…”

Declined hTERT expression of peripheral blood CD4+ T cells in oral lichen planus correlated with clinical parameter

“…Emerging evidences are suggesting that psychogenic factors such as anxiety, depression, and stress play important roles in the onset and progression of OLP . A high salivary cortisol level positively correlated anxiety was also showed in patients with OLP . Notably, psychological functions could have a direct impact on the telomere/telomerase system .…”