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Induction of a non-encephalitogenic type 2 T helper-cell autoimmune response in multiple sclerosis after administration of an altered peptide ligand in a placebo-controlled, randomized phase II trial. Histopathological features of OLP (adapted from Eisenberg, E.Alternatively, the keratinocytes direct the CD8 cytotoxic T-cells to migrate into the epithelium by the release of cytokines that allow the lymphocytes to “home-in” on the antigen-bearing basal keratinocyte, the so called “directed migration” hypothesis.[12, 13]T-cell Activation: The lymphocytic infiltration that characterises the OLP lesion histologically, is comprised predominantly of T-cells.[4] But it was the famed British Dermatologist, Erasmus Wilson (1809-1884), who originally used the term lichen planus in his publication in 1869, noting the disorder in a group of 50 patients.

[14] In one study of testing the reactivity of lesional versus non-lesional T-cell clones from LP patients against lesional and non-lesional autologous keratinocytes, the lesional T-cells lines derived from patients with LP were significantly more active and cytotoxic against autologous lesional keratinocytes than the T-cell lines obtained from clinically normal skin.Clinicopathologic patterns of oral lichenoid lesions. Oral Maxillofac Surg Clin North Am, 1994, 6, 445.) [3] (Figures 9a, 9b and 9c) Lichen planus is a chronic systemic disease of established immune-mediated pathogenesis.[1] It most commonly, protractedly and persistently, involves the mucosa of the oral cavity, but it can involve other sites, namely the skin, the scalp (with inflammation around and affecting the hair follicles) resulting in alopecia), the nails as well as the genital area - the vulval and vaginal mucosa, and the glans penis.Other sites of involvement that are far less frequently described include the oesophagus and conjunctiva.The majority of the T-cells in proximity to the damaged and dying basal keratinocytes and within the epithelial layers are overwhelmingly activated cytotoxic CD8 T-cells.

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[14] Cytotoxic CD8 T-cells binding of antigen on the MHC Class I site of keratinocytes releases cytokines that attract other lymphocytes and immune-cells into the site of the developing OLP lesion.However, Ferdinand Ritter von Hebra used the term “lichen” to denote skin lesions which are exclusively nodular, that is characterised by a macular-papular skin eruption, hence, terms such as lichen pilaris (better known as Keratosis pilaris), and lichen nitidus are still used for other skin diseases, whose appearance differs markedly from that of lichen planus.

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