Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology

Cheng, Yi; Gould, Alan R.; Kurago, Zoya B.; Fantasia, John E; Müller, Susan

doi:10.1016/j.oooo.2016.05.004

Cited by 423 publications

(598 citation statements)

References 128 publications

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“…In addition, malignant transformation is more common in women, in the sixth decade of life, and in lesions in the tongue area [26]. Although it is not recommended to perform biopsies in all patients suspected to have OLP in terms of costs and the invasiveness of the procedure, OLP in the lateral tongue is particularly difficult to diagnose since the lesions may not be obviously distinct from oral candidiasis and leukoplakia [27]. In previous studies, malignant transformation occurred from several months to more than 20 years after OLP diagnosis, although the maximum risk was observed between 3 and 6 years after diagnosis [28].…”

Section: Discussionmentioning

confidence: 99%

Factors affecting treatment outcomes in patients with oral lichen planus lesions: a retrospective study of 113 cases

Park

Lee

Kim

et al. 2018

J Periodontal Implant Sci

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PurposeOral lichen planus (OLP) is a chronic oral mucosal disease that has been recognized as an immune condition. The purpose of this study was to evaluate factors affecting the clinical outcomes of topical corticosteroid application on OLP lesions using dexamethasone gargle and ointment.MethodsThe charts of patients who were clinically diagnosed with OLP and treated with dexamethasone from July 2003 to August 2017 at the Section of Dentistry of Seoul National University Bundang Hospital were thoroughly evaluated to identify subjects who were suitable for this retrospective study. For each patient, age at the index date, gender, medical history, and dental records related to OLP lesions and dexamethasone treatment were reviewed.ResultsIn total, 113 of the 225 patients were included in the present study. Among them, 79 patients were female (69.9%) and 34 were male (30.1%), with a mean age of 57.6 years. The average duration of dexamethasone treatment was 4.7 months and the mean follow-up period was 2.24 years. Improvements were observed within 1 year after dexamethasone treatment in most cases, and 17.7% of patients had a new OLP lesion after treatment. New OLP lesions were more frequently gingival than mucosal, although mucosal OLP lesions were more common than gingival OLP lesions in all age groups. In age- and gender-adjusted multivariate logistic regression, a history of malignant disease was found to be a significant factor affecting the formation of new lesions. Gingival OLP lesions and intermittent use of dexamethasone showed near-significant associations. In Kaplan-Meier failure analysis, history of malignancy, menopausal status, age, and the site of the OLP lesion were significant factors affecting clinical outcomes.ConclusionsThe treatment outcomes of OLP were significantly influenced by age, history of malignancy, menopausal status, and the site of the OLP lesion, but not by factors related to dexamethasone treatment.

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Section: Discussionmentioning

confidence: 99%

Factors affecting treatment outcomes in patients with oral lichen planus lesions: a retrospective study of 113 cases

Park

Lee

Kim

et al. 2018

J Periodontal Implant Sci

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“…The etiology of this disease is unknown in most cases and is considered an oral potentially malignant disorder, with major controversies on its classification, its clinical and histological diagnosis, and its prognosis (1-6). …”

Section: Introductionmentioning

confidence: 99%

“…Typically, the clinical and histopathological assessments are required in all cases in order to perform a proper diagnosis of these disorders (6,8,9). An adequate clinical and histopathological analysis is crucial to reach a diagnosis and to assess the malignant potential of each case (2,6).…”

Section: Introductionmentioning

confidence: 99%

“…An adequate clinical and histopathological analysis is crucial to reach a diagnosis and to assess the malignant potential of each case (2,6). …”

Section: Introductionmentioning

confidence: 99%

“…(6,13,14). Moreover, the presence of epithelial dysplasia is a controversial datum in the histopathological analysis of these biopsies and, for some authors (6,8), it may even invalidate the diagnosis of oral lichen planus.…”

Section: Introductionmentioning

confidence: 99%

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Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data

Alberdi-Navarro¹,

Marichalar-Mendía²,

Mj³

et al. 2017

Med Oral

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BackgroundThe aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes.Material and MethodsRetrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results.ResultsThe 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from “plaque-like” lesions presented hyperkeratosis (p<0.001) and epithelial dysplasia (p=0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p=0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia.ConclusionsThe histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied. Key words:Oral lichenoid disease, histopathology, subtypes, characterization, oral lichen planus, oral lichenoid lesion, epithelial dysplasia.

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Oncological Outcomes of Patients With Oral Potentially Malignant Disorders

Villa,

Lodolo,

2024

JAMA Otolaryngol Head Neck Surg

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ImportanceUnderstanding the clinical course and malignant transformation rate of oral potentially malignant disorders (OPMDs)—including oral leukoplakia, oral erythroplakia, oral submucous fibrosis, and oral lichen planus—is crucial for early detection and improved survival rates in patients with oral cancer.ObjectiveTo evaluate the progression of oral cancer from OPMDs using a large US electronic medical database.Design, Setting, and ParticipantsThis retrospective cohort study used data from the University of California, San Francisco’s PatientExploreR database between January 1973 and March 2024. Patients with oral leukoplakia, oral erythroplakia, oral submucous fibrosis, and oral lichen planus were identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes and keywords. Demographics, tobacco and alcohol use, HIV status, and other known risk factors for oral cancer were recorded to identify factors associated with malignant transformation. Logistic regression and descriptive analyses were used.ExposureDiagnosis of oral leukoplakia, oral erythroplakia, oral submucous fibrosis, or oral lichen planus.Main Outcomes and MeasuresIncidence of oral cancer, malignant transformation rate, median time to progression, and associations between demographics and risk factors and the development of oral cancer.ResultsAmong 4 225 251 individuals in the database, 4371 were diagnosed with oral cancer (median [IQR] age, 63 [53-71] years; 2610 [59.9%] male; 0.1% of the cohort), and 110 (2.5%) had a preceding OPMD. Oral leukoplakia was found in 1124 patients, with 94 (8.4%) undergoing malignant transformation (median [IQR] time to progression, 25 [7-129] months). HIV-positive patients with oral leukoplakia were more likely to develop oral cancer (odds ratio, 3.80; 95% CI, 1.35-10.70). Of 22 patients with oral erythroplakia, 11 (50.0%) developed oral cancer (median [IQR] time to progression, 3.7 [0.2-334] months). Those who smoked tobacco with oral erythroplakia showed a higher malignant transformation rate (odds ratio, 3.75; 95% CI, 0.54-26.05). Of the 78 patients with oral submucous fibrosis, 4 (5.1%) underwent malignant transformation (median [IQR] time to progression, 36 [36-48] months). Only 1 patient with oral lichen planus developed oral cancer after 5 years.Conclusions and RelevanceThis cohort study showed that OPMDs have notable but varying propensities to progress to oral cancer. Early detection and monitoring of OPMDs are crucial for improving patient outcomes. However, the risk, etiopathogenesis, and clinical presentation vary for each OPMD and should, therefore, be considered distinct diseases.

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Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology

Cited by 423 publications

References 128 publications

Factors affecting treatment outcomes in patients with oral lichen planus lesions: a retrospective study of 113 cases

Factors affecting treatment outcomes in patients with oral lichen planus lesions: a retrospective study of 113 cases

Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data

Oncological Outcomes of Patients With Oral Potentially Malignant Disorders

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