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 < 13 g/dL, women < 12 g/dL), iron (< 60 mu g/dL), vitamin B-12 (< 200 pg/mL), and folic acid (< 4 ng/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. Copyright (C) 2014, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.