Significant association of deficiencies of hemoglobin, iron, folic acid, and vitamin B ₁₂ and high homocysteine level with oral lichen planus

Background/purpose: A portion of patients with oral lichen planus (OLP) may have nutritional deficiency. This study evaluated whether there was an intimate association of the deficiencies of hemoglobin (Hb), iron, vitamin B ₁₂ , and folic acid and high blood homocysteine level with OLP. Methods: The blood Hb, iron, vitamin B ₁₂ , folic acid, and homocysteine concentrations in 352 OLP patients were measured and compared with the corresponding levels in 352 age- and sex-matched healthy control participants. Results: We found that 77 (21.9%) OLP patients, 48 (13.6%) OLP patients, 25 (7.1%) OLP patients, and one (0.3%) OLP patient had deficiencies of Hb (men < 13g/dL, women < 12g/dL), iron (< 60μg/dL), vitamin B ₁₂ (< 200pg/mL), and folic acid (< 4ng/mL), respectively. Moreover, 52 (14.8%) OLP patients had abnormally high blood homocysteine level. OLP patients had a significantly higher frequency of Hb, iron, or vitamin B ₁₂ deficiency and of abnormally elevated blood homocysteine level than healthy control participants (all p<0.001). Upon further dividing OLP patients into those with major erosive OLP (MjEOLP; n=67), minor erosive OLP (n=202), and nonerosive OLP (NEOLP; n=83), we found that MjEOLP patients had a significantly higher mean homocysteine level than NEOLP patients (p=0.035). Conclusion: We conclude that there is a significant association of deficiencies of Hb, iron, folic acid, and vitamin B ₁₂ and abnormally high blood homocysteine level with OLP. There may be a close relation of high blood homocysteine level to severity of OLP.