Immunohistochemical assessment of angiogenesis and vascular endothelial growth factor expression in cutaneous lichen planus: relation to the degree of inflammation.

Neo-angiogenesis is reported to be essential in the pathogenesis of oral lichen planus (LP). We aimed to investigate angiogenesis through CD34 staining and vascular endothelial growth factor (VEGF) expression in cutaneous LP lesions and to evaluate the relation of these markers with the degree of inflammation. Thirty patients with cutaneous LP and 10 healthy controls were included. Skin biopsies from all subjects were studied immunohistochemically for microvessel density (MVD) by CD34 staining and for VEGF expression. Relation of these parameters with the grade of inflammation was evaluated. The mean MVD was significantly higher in patients than controls (32.60, 95% CI: 27.71-37.49 vs. 9.60, 95% CI: 6.86-12.34; t = 5.43; P < 0.001). Positive VEGF expression was detected at a significantly higher rate in LP patients compared with controls (76.7% vs. 30.0%, OR (95% CI) 7.67(1.56-37.80), P < 0.05). Patients with positive VEGF expression showed significantly higher mean MVD compared with those having negative VEGF expression (37.39, 95% CI 32.66-42.12 vs. 16.86, 95%CI 13.59-20.12 respectively, P < 0.001). Increasing mean MVD and VEGF positivity were significantly observed with higher grades of inflammation (P < 0.05). This work confirms a role for angiogenesis and increased VEGF expression in cutaneous LP and a relation of these events with the degree of inflammation in the disease.