Salivary iron and Candida colonization in oral lichen planus patients undergoing topical steroid therapy

Background The most common adverse event in oral lichen planus (OLP) patients undergoing topical corticosteroid therapy is opportunistic infection with oral Candida. Oral candidiasis superimposed on OLP can worsen the patient's symptoms and obscure the true clinical appearance making the treatment of OLP more complex and difficult. The aim of this study was to investigate the salivary iron level in OLP patients undergoing topical steroid therapy with a history of oral candidiasis compared with OLP patients undergoing topical steroid therapy without a history of oral candidiasis and healthy individuals. Materials and methods The 68 OLP patients treated with a topical steroid were divided into 34 OLP patients with a history of oral candidiasis, 34 OLP patients without a history of oral candidiasis and 34 healthy individuals were enrolled in the study. Unstimulated whole saliva was collected from the participants to determine the salivary iron level and to investigate the presence of oral Candida colonization. Results The salivary iron level was significantly higher in OLP patients undergoing topical steroid therapy with a history of oral candidiasis compared with OLP patients undergoing topical steroid therapy without a history of oral candidiasis and healthy individuals (P = 0.04 and P < 0.001, respectively). Moreover, the Candida colony count in OLP patients undergoing topical steroid therapy with a history of oral candidiasis was significantly higher compared with OLP patients undergoing topical steroid therapy without a history of oral candidiasis and healthy Individuals (P < 0.001 and P < 0.001, respectively). Conclusion High salivary iron level associates with a high amount of oral Candida colonization in OLP patients undergoing topical steroid therapy with a history of oral candidiasis.