What is the malignant transformation potential of oral lichen planus?

Offen, Elizabeth; Allison, James R.

doi:10.1038/s41432-022-0240-4

Cited by 10 publications

(3 citation statements)

References 6 publications

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“…According to Andreasen's classification [13], it is possible to distinguish six clinical forms of OLP (reticular, erosive, atrophic, plaque-like, bullous, and papular). These subtypes can change their clinical morphology and can occur simultaneously [13].…”

Section: Introductionmentioning

confidence: 99%

Role of Oral Microbiota Dysbiosis in the Development and Progression of Oral Lichen Planus

Lavoro,

Cultrera,

Gattuso

et al. 2024

JPM

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Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral cavity with malignant potential affecting 1.01% of the worldwide population. The clinical patterns of this oral disorder, characterized by relapses and remissions of the lesions, appear on buccal, lingual, gingival, and labial mucosa causing a significant reduction in the quality of life. Currently, there are no specific treatments for this disease, and the available therapies with topical and systemic corticosteroids only reduce symptoms. Although the etiopathogenesis of this pathological condition has not been completely understood yet, several exogenous and endogenous risk factors have been proposed over the years. The present review article summarized the underlying mechanisms of action involved in the onset of OLP and the most well-known triggering factors. According to the current data, oral microbiota dysbiosis could represent a potential diagnostic biomarker for OLP. However, further studies should be undertaken to validate their use in clinical practice, as well as to provide a better understanding of mechanisms of action and develop novel effective intervention strategies against OLP.

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Section: Introductionmentioning

confidence: 99%

Role of Oral Microbiota Dysbiosis in the Development and Progression of Oral Lichen Planus

Lavoro,

Cultrera,

Gattuso

et al. 2024

JPM

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“…14,15 The differences in transformation depend on the predisposing or risk factors. 16 Patients may develop cancer in the field of cancerization. Unfortunately, this condition is only confirmed with invasive excisional surgery.…”

Section: Introductionmentioning

confidence: 99%

Oral field cancerization: Genetic profiling for a prevention strategy for oral potentially malignant disorders

et al. 2023

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Background: Oral cancer therapy, such as radiation or surgical treatment, has pernicious long-term effects that patients suffer throughout their life, the disability being considerable with delayed diagnosis. It is well known that many oral cancers develop from oral potentially malignant disorders (OPMDs). Patients diagnosed with OPMDs may have an increased risk of developing cancer anywhere in the oral cavity. Early detection and intervention could be essential prevention strategies to inhibit oral cancer progression. OPMDs may not immediately develop into carcinoma. However, this condition provides a “field” of specific abnormalities wherein evolving altered genetic cells can be explained with the “field cancerization” concept. Purpose: This review aims to describe the “field cancerization” concept in oral cancer and OPMD, which is expected to contribute to a better clinical management strategy for oral cancer prevention. Review: “Oral field cancerization” describes oral cancers that develop in multifocal areas of pre-cancerous changes. It can be found as histologically abnormal tissue surrounding the tumor, suggesting that oral cancer often consists of multiple independent lesions. Conclusion: The oral field cancerization concept should prompt healthcare professionals to remind their patients that frequent oral examination with histological studies and molecular testing is mandatory for those at high risk of developing malignancies.

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“…Oral LP (OLP) serves as the mucosal counterpart to LP, despite the notable clinical diversity seen between the two. While skin lesions are often self-limited, OLP is characterised by a chronic nature, infrequent spontaneous remission, and a higher risk of pre-malignancy/malignancy, and increased morbidity, still being a challenge in terms of health care [12][13][14]. Isolated occurrences of OLP are often seen in dentistry settings, while 20% of OLP patients also exhibit synchronous or asynchronous cutaneous lesions [13,15].…”

Section: Introductionmentioning

confidence: 99%

Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies

Radu,

Carsote,

Nistor

et al. 2023

Biomedicines

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In this narrative review, we aimed to overview the interplay between lichen planus (LP) and thyroid conditions (TCs) from a dual perspective (dermatologic and endocrine), since a current gap in understanding LP-TC connections is found so far and the topic is still a matter of debate. We searched PubMed from Inception to October 2023 by using the key terms “lichen planus” and “thyroid”, (alternatively, “endocrine” or “hormone”). We included original clinical studies in humans according to three sections: LP and TC in terms of dysfunction, autoimmunity, and neoplasia. Six studies confirmed an association between the thyroid dysfunction (exclusively hypothyroidism) and LP/OL (oral LP); of note, only one study addressed cutaneous LP. The sample size of LP/OLP groups varied from 12–14 to 1500 individuals. Hypothyroidism prevalence in OLP was of 30–50%. A higher rate of levothyroxine replacement was identified among OLP patients, at 10% versus 2.5% in controls. The highest OR (odd ratio) of treated hypothyroidism amid OLP was of 2.99 (p < 0.005). Hypothyroidism was confirmed to be associated with a milder OLP phenotype in two studies. A single cohort revealed a similar prevalence of hypothyroidism in LP versus non-LP. Non-confirmatory studies (only on OLP, not cutaneous LP) included five cohorts: a similar prevalence of hypothyroidism among OLP versus controls, and a single cohort showed that the subjects with OLP actually had a lower prevalence of hypothyroidism versus controls (1% versus 4%). Positive autoimmunity in LP/OLP was confirmed in eight studies; the size of the cohorts varied, for instance, with 619 persons with LP and with 76, 92, 105, 108, 192, 247, and 585 patients (a total of 1405) with OLP, respectively; notably, the largest control group was of 10,441 individuals. Four clusters of approaches with respect to the autoimmunity in LP/OLP were found: an analysis of HT/ATD (Hashimoto’s thyroiditis/autoimmune thyroid diseases) prevalence; considerations over the specific antibody levels; sex-related features since females are more prone to autoimmunity; and associations (if any) with the clinical aspects of LP/OLP. HT prevalence in OLP versus controls was statistically significantly higher, as follows: 19% versus 5%; 12% versus 6%; and 20% versus 9.8%. A single study addressing LP found a 12% rate of ATDs. One study did not confirm a correlation between OLP-associated clinical elements (and OLP severity) and antibody values against the thyroid, and another showed that positive TPOAb (anti-thyroperoxidase antibodies) was more often found in erosive than non-erosive OLP (68% versus 33%). Just the reverse, one cohort found that OLP subjects had a statistically significantly lower rate of positive TPOAb versus controls (9% versus 15%). Five case-control studies addressed the issue of levothyroxine replacement for prior hypothyroidism in patients that were diagnosed with OLP (no study on LP was identified); three of them confirmed a higher rate of this treatment in OLP (at 8.9%, 9.7%, and 10.6%) versus controls. In conclusion, with regard to LP/OLP-TC, we note several main aspects as practical points for multidisciplinary practitioners: OLP rather than LP requires thyroid awareness; when it comes to the type of thyroid dysfunction, mostly, hypothyroidism should be expected; female patients are more prone to be associated with ATDs; a potential higher ratio of OLP subjects taking levothyroxine was found, thus a good collaboration with an endocrinology team is mandatory; and so far, OLP individuals have not been confirmed to be associated with a higher risk of thyroid nodules/cancer.

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What is the malignant transformation potential of oral lichen planus?

Cited by 10 publications

References 6 publications

Role of Oral Microbiota Dysbiosis in the Development and Progression of Oral Lichen Planus

Role of Oral Microbiota Dysbiosis in the Development and Progression of Oral Lichen Planus

Oral field cancerization: Genetic profiling for a prevention strategy for oral potentially malignant disorders

Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies

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