Expression of estrogen receptors in desquamative gingivitis

Background: Most cases of chronic desquamative gingivitis (CDG) are shown b y direct immunofluorescence (DIF) to be immune mediated diseases. Some pati ents present with similar clinical and microscopic findings as CDG but DIF staining is negative. It has been suggested that those cases of CDG may be hormone (estrogen) mediated and may be treated with estrogens with favorabl e results. Methods: Gingival tissue from 24 cases of CDG and one case of ordinary ging ivitis were studied for estrogen receptor (ER) expression using immunohisto chemical techniques. Twenty-four of the 25 cases were female. Using standar d DIF analysis, 11 of the CDG cases were diagnosed as benign mucous membran e pemphigoid, 10 as lichen planus or lichenoid mucositis (LP), and one as p emphigus. The remaining 3 cases were not diagnostic for a specific disorder (idiopathic). Five of the females had a history of estrogen substitute the rapy. Results: Twenty-two of 23 female CDG cases were positive for ER, although t he degree of staining varied. A 32-year-old female with ordinary gingivitis , whose gingivitis varied with her menstrual cycle, did not stain for ER. A 50-year-old male and a 76-year-old female, both with gingival LP, also had negative staining for ER. Conclusions: There appears to be no correlation between diagnosed diseases (immunological versus idiopathic) and expression of ER in CDG gingiva. ER e xpression in the gingiva is probably not related to the presence or absence of estrogen supplementation. The results of this study do not support the use of estrogen in the treatment of idiopathic CDG.