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Aim: The aim of this study was to estimate the salivary cortisol levels in patients with oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS) and to correlate it with their psychological profile using the Hospital Anxiety and Depression (HAD) scale. Methods: The study population comprised of 60 patients 20 with OLP, 20 with RAS and 20 healthy controls. Salivary cortisol levels were assessed using the chemiluminescent immuno assay technique. Anxiety and depression levels were evaluated using the HAD scale. Results: The Kruskal Wallis mean ranks of salivary cortisol level in the OLP and RAS groups were 33.45 and 33.48 respectively and were higher than the mean rank of the control group with 24.58. But this difference was not statistically significant (P = 0.178). The mean ranks of anxiety score in the OLP and RAS groups were 36.48 and 39.50. The mean ranks of depression scores were 41.88 and 35.25 in the OLP and RAS groups respectively. The control group had a statistically significant lower mean ranks for anxiety and depression (P < 0.001). Anxiety and depression scores showed strong positive correlation in both patient groups. Conclusion: The results suggest that anxiety and depression play a role in the pathogenesis of OLP and RAS. The role of salivary cortisol as a biomarker of stress remains to be validated. Patients suffering from psychosomatic diseases such as OLP and RAS need a comprehensive and holistic treatment approach to manage effectively the psychosocial factors involved in the disease process.

Correlation between salivary cortisol levels and Hospital Anxiety and Depression scores in oral lichen planus and recurrent aphthous stomatitis