Current approaches to comprehensive functional assessment of oral lichen planus

Relevance. Oral lichen planus (OLP) is a chronic immune-mediated inflammatory disease characterized by a relapsing course and clinical polymorphism. Conventional clinical examination may be insufficient to objectively assess morphologic, microvascular, and structural and functional tissue changes within lesions.

Objective. To evaluate the diagnostic capabilities of oral capillaroscopy (OC), bioimpedance spectroscopy (BIS), and dynamic electrochemical potential measurement in OLP.

Material and methods. The study included 47 participants: 20 patients aged 54–72 years with OLP and 27 controls aged 20–25 years without clinically detectable oral mucosal lesions. Participants underwent clinical examination, OC, BIS, and oral mucosal electrochemical potential measurements. Quantitative data were presented as medians and interquartile ranges (Me [Q1; Q3]); between-group comparisons were performed using the Mann–Whitney U test.

Results. In areas showing the characteristic reticular pattern, OC revealed an irregular microvascular pattern, dilation of the venous limbs of capillary loops, increased capillary tortuosity, and isolated petechiae. Areas with erosive and ulcerative lesions showed marked disorganization of the microvascular architecture, intravascular blood cell aggregation, and stasis. Quantitative OC assessment showed lower mean capillary blood flow velocity in both the arterial and venous limbs of capillary loops and increased capillary diameter in patients with OLP. BIS measurements showed that median resistance at 50 kHz (R50) was 485.5 [464.9; 492.3] Ω in the control group and 357.1 [353.4; 367.4] Ω in the OLP group (p = 0.042). Median reactance at 50 kHz (X50) was 193.4 [183.7; 220.9] and 136.5 [129.5; 139.8] Ω, respectively (p = 0.060). Median absolute electrochemical potential values did not differ significantly between groups: 142.1 [130.0; 166.4] mV in the control group vs 146.6 [139.1; 151.1] mV in patients with OLP (p = 0.606).

Conclusion. The combined use of OC, BIS, and electrochemical potential measurement enables site-specific multimodal assessment of oral mucosal morphology, microvasculature, hydration-related electrical properties, and local electrochemical characteristics in OLP. In this sample, the decrease in R50 was the most informative quantitative impedance parameter and may reflect increased tissue hydration and altered electrical conductivity at lesion sites. Electrochemical potential measurement warrants further investigation as an adjunctive tool for local functional assessment of lesional tissue in larger samples.

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