Oxidative Stress in Cutaneous Lichen Planus—A Narrative Review

Abstract

Lichen planus (LP) is a chronic, immune-mediated inflammatory skin condition that mainly affects the skin (cutaneous LP, CLP) and oral mucosa (oral LP, OLP). However, the mechanisms involved in the pathogenesis of the disease are not fully elucidated. Over time, several theories that could explain the appearance of LP lesions have been postulated. The key players in LP pathogenesis are the inflammatory infiltrate consisting of T cells and the proinflammatory cytokines. The cytokines stimulate the production of reactive oxygen species that induce cell apoptosis, a defining element encountered in LP. The lead inquiry triggered by this revolves around the role of oxidative stress in LP development. There are currently numerous studies showing the involvement of oxidative stress in OLP, but in terms of CLP, data are scarce. In this review, we analyze for the first time the currently existing studies on oxidative stress in CLP and summarize the results in order to assess the role of oxidative stress in skin lesions offering a fresher updated perspective.

What Are Reactive Oxygen Species, Free Radicals, and Oxidative Stress in Skin Diseases?

“…Furthermore, blood SOD activity was found to be elevated in individuals with Raynaud’s phenomenon for a long period of time, which functioned as a defense reaction [ 96 ]. Numerous studies have suggested the involvement of ROS in lichen planus based on ROS markers [ 97 ]; however, the origin and involvement of ROS in its pathogenesis remain unclear. Similarly, the accumulation of acrolein, a lipid peroxidation product, has been detected in the skin of patients with small-vessel vasculitis [ 98 ], and a relationship between ROS and the severity of vessel damage has been implied [ 99 ].…”

Modulating the Antioxidant Response for Better Oxidative Stress-Inducing Therapies: How to Take Advantage of Two Sides of the Same Medal?

“…In the chronic inflammatory autoimmune disease lichen planus (LP), it has been found that patients with oral LP present increased SOD and reduced glutathione peroxidase levels in saliva [153]. In addition, patients with cutaneous LP showed low levels of serum and tissue catalase, reduced activity of GPX, and elevated serum levels of other prooxidants [154,155]. This disbalance creates an excessive amount of H2O2 that accumulates in cells and causes damage.…”

Ischemia-Modified Albumin—A Potential New Marker of Oxidative Stress in Dermatological Diseases

“…When tissues are exposed to oxidative stress for a long time, ROS accumulate and produce tissue damage; the major molecular targets are lipids, proteins and nucleic acids. The alteration of the balance between oxidants and pro-oxidants has important consequences for the cell cycle, with implications for cell differentiation and apoptosis, and can influence and disturb many signaling pathways [ 11 , 12 ]. Antioxidants are the primary molecules that counteract the harmful effects of ROS [ 13 ].…”