The correlation between human papillomavirus and oral lichen planus: A systematic review of the literature

Abstract

IntroductionOral lichen planus (OLP) is a chronic inflammatory disorder with cell‐induced immunopathological responses and is considered a potential malignancy disorder in the oral cavity. Due to the high prevalence of OLP as well as the potential for malignancy, human papillomaviruses (HPVs) may play an important role in it. Although previous studies have explored the possible relationship between HPV and OLP, the findings have been conflicting and nonconclusive. This study aims to review the studies that investigated HPV‐16 and HPV‐18 in OLP.Methods and MaterialsThe research protocol followed the Preferred Reporting Items for Systematic Reviews (PRISMA2020) checklist. The online databases Pubmed, Scopus, Embase, Google Scholar, and Cochrane were searched using the following individual keywords: “OLP” OR “Oral Lichen Planus” OR “HPV” OR “Human Papillomavirus.” The search strategy resulted in the selection of 80 articles. The articles were evaluated, and after duplication removal, 53 abstracts were reviewed, resulting in the selection of 25 studies according to inclusion and exclusion criteria. The risk of bias assessment was done by using the Modified Newcastle–Ottawa quality assessment scale. The overall prevalence of HPV in OLP lesions varied from 2.7% to 70%, depending on the type of diagnostic method used.ConclusionDespite the studies conducted on the relationship between OLP and HPV infection, there is still no conclusive evidence that HPV can play a role in the etiopathogenesis of OLP, either in clinical manifestations or in the malignant transformation of lesions.

Human Papillomavirus in Oral Lichen Planus: Is There an Association? A Meta-Analysis

“…For the same reasons, the anatomic location of the oral lesions and clinical subtype of the OLP were not analyzed in correlation with the HPV status. This remains accordant with the observations of Agha-Hosseini and Hafezi Motlagh, who also concluded that the prevalence of HPV in OLP has not been widely discussed in terms of the clinical type of OLP lesions, and further investigation of this topic is definitely required [9]. The methods for the sample collection and the HPV detection used in the included studies were not uniform, which partially results from the wide timeframe of the described research, ranging from 1987 to 2023.…”

“…In our search, we did not find any results of the research on the prevalence of HPV in OLP before and after corticosteroid therapy. This issue was also pointed in a Agha-Hosseini and Hafezi Motlagh review, who emphasized the necessity to extend studies in this field [9].…”

“…All types of OLP can be pooled into two main clinical groups: erosive-atrophic forms (EA-OLP), including erosive, atrophic, bullous, and mixed EA variants, and non-erosive-atrophic forms (non-EA-OLP), comprising of reticular, plaque, and papular subtypes [1,3,[6][7][8]. A common phenomenon accompanying OLP is desquamative gingivitis [9][10][11]. Skin and mucosal lesions may develop both alone or together, as well as simultaneously or independently.…”

“…Upon histopathological examination, most characteristic findings in the OLP include lichenification of the basement layer, followed by a marked layered lymphocytic infiltrate underlying the epithelium, the presence of numerous eosinophilic colloid bodies along the epithelial-connective tissue interface (Civatte bodies), sawtooth-shaped interpapillary ridges, variable thickness of the spinous layer, and the presence of ortho-or parakeratosis [2,5,7] The OLP prevalence in the general adult population is estimated as 0.5 to 2% [2,12] with a female predilection (female: male ratio 2:1) and the age of onset between 30 and 60 years [7,9]. OLP in children has been observed only in exceptional cases [1,2].…”