Assessment of the Relationship Between Stress and Oral Lichen Planus: A Review of Literature

Oral lichen planus (OLP) is a chronic inflammatory lesion. Psychological stress occurs when someone senses that environmental demands exceed his/her adaptive capability. Stress, anxiety, and depression have frequently been mentioned as possible factors related to the development of OLP, although this association remains controversial. In most studies, a positive correlation was found between psychological stress and OLP, although some found no significant association. In this review, we assess the possible role of psychological stress in the etiopathogenesis of OLP.
The methodological approach of this study was to search major databases from 1985-2014, using "oral lichen planus"," stress", "anxiety", "depression" and "psychological disorder” as search terms.
A total of 45 scientific papers and abstracts in English were reviewed, and 10 articles met the necessary requirements. Stress evaluation methods of these articles were questionnaire, genetic polymorphisms at DNA level, measurement of body substances like hormones, and effect of drug therapy of psychiatric disorders on OLP patients. In order to include a study, OLP in patients must have been proven by clinical and histopathological criteria. Exclusion criteria were not explicit stating the OLP diagnosis, an inadequate number of the test subject in experimental and control groups, discrepancy (inconsistency) in sex and age between the case and control groups, and unreliable method of stress measurements.
Higher levels of stress in patients with OLP were confirmed. Reducing psychological stress and well-being of patients is an important factor that should be considered in the treatment of OLP.