Candida in Oral Lichen Planus Patients Undergoing Topical Steroid Therapy

Objectives: To determine the incidence, intensity and species of Candida in the oral cavity of oral lichen planus (OLP) patients who were being treated with topical steroid. Methods: The study included 30 OLP patients and 30 controls, with age- and sex-matched. The incidence of oral candida carriage and intensity were assessed by salivary and imprint cultures. Cytologic smears were used to investigate the presence of candida spores and hyphae in the OLP lesions. Candida species were identified using chlamydospore formation test and the API 20C system. Results: The salivary cultures were positive in 76.7% OLP patients and in 43.3% controls (P = 0.008) whereas the imprint cultures were positive in 76.7% OLP patients and in 40% controls (P = 0.004). The high-level candida count in saliva (³1000 cfu/ml) was frequently found in the OLP patients than in the controls (73.9% vs. 38.5%, P = 0.004). In OLP patients, the mean scores of candida growth from imprint cultures were higher than the controls (1.49±0.97 vs. 0.73±0.49, P = 0.002). The incidence of oral candida carriage increased with age. Spores and hyphae were detected in the lesions of 83.3% OLP patients. The mean scores of candida growth from imprint cultures were higher in OLP patients who took drug-induced candida growth (P = 0.038) and in OLP denture wearers (P = 0.022). Candida albicans, the most frequently isolated yeast, were found in 76.7% OLP patients and 40% controls. Conclusions: This study showed a higher incidence of candida carriage and intensity in the oral cavity of OLP patients treated with topical steroid. The results of this study indicated that topical steroid induced candida growth and the associated risk factors were age, medication use and denture wearing. This study was supported by the Dental Research Fund, Faculty of Dentistry, Chulalongkorn University