Top

Oral and Maxillofacial Surgery

Published in:

01-06-2015 | Original Article

Oral lichen planus (OLP), oral lichenoid lesions (OLL), oral dysplasia, and oral cancer: retrospective analysis of clinicopathological data from 2002–2011

Authors: S. Casparis, J. M. Borm, S. Tektas, J. Kamarachev, M. C. Locher, G. Damerau, K. W. Grätz, B. Stadlinger

Published in: Oral and Maxillofacial Surgery | Issue 2/2015

Abstract

Introduction

This 10-year retrospective study analyzed the incidence of malignant transformation of oral lichen planus (OLP). The study also included dysplasia and oral lichenoid lesion (OLL) in the initial biopsy as a potential differential diagnosis.

Material and methods

A total of 692 scalpel biopsies were taken from 542 patients (207 [38.2 %] men and 335 [61.8 %] women). Clinical and histopathological parameters were analyzed.

Results

The parameters gender (p = 0.022) and smoking behavior (p < 0.001) were significantly associated with the severity of diagnosis. Mucosal lesions with an ulcerative appearance (p = 0.006) and those located on the floor of the mouth (p < 0.001) showed significantly higher degrees of dysplasia or were diagnosed as oral squamous cell carcinoma (OSCC). Smoking and joint disease appeared to be significant risk factors. Treatment with tretinoin in different concentrations (0.005–0.02 %) significantly improved diagnosis. Twelve patients (8 female, 4 male) showed malignant transformation to OSCC within an average period of 1.58 years. The malignant transformation rate (MTR) was higher for OLL (4.4 %) than OLP (1.2 %). If the first biopsy showed intraepithelial neoplasia, the risk of developing OSCC increased (by 3.5 % for squamous intraepithelial neoplasia (SIN) II and by 6.7 % for SIN III).

Conclusion

Although we cannot rule out that OLP is a premalignant oral condition, we can confirm that OLP had the lowest MTR of all diagnoses.

Bagan-Sebastian JV, Milian-Masanet MA, Penarrocha-Diago M, Jimenez Y (1992) A clinical study of 205 patients with oral lichen planus. J Oral Maxillofac Surg 50:116CrossRefPubMed

Lodi G, Scully C, Carrozzo M et al (2005) Current controversies in oral lichen planus: report of an international consensus meeting. Part 1. Viral infections and etiopathogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:40CrossRefPubMed

Andreasen JO (1968) Oral lichen planus. 1. A clinical evaluation of 115 cases. Oral Surg Oral Med Oral Pathol 25:31CrossRefPubMed

Eisenberg E (2000) Oral lichen planus: a benign lesion. J Oral Maxillofac Surg 58:1278CrossRefPubMed

Jungell P, Konttinen YT, Nortamo P, Malmstrom M (1989) Immunoelectron microscopic study of distribution of T cell subsets in oral lichen planus. Scand J Dent Res 97:361PubMed

Khan A, Farah CS, Savage NW et al (2003) Th1 cytokines in oral lichen planus. J Oral Pathol Med 32:77CrossRefPubMed

Farthing PM, Cruchley AT (1989) Expression of MHC class II antigens (HLA DR, DP and DQ) by keratinocytes in oral lichen planus. J Oral Pathol Med 18:305CrossRefPubMed

Walsh LJ, Ishii T, Savage NW et al (1990) Immunohistologic analysis of epithelial cell populations in oral lichen planus. J Oral Pathol Med 19:177CrossRefPubMed

Ismail SB, Kumar SK, Zain RB (2007) Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci 49:89CrossRefPubMed

10.

Holmstrup P, Thorn JJ, Rindum J, Pindborg JJ (1988) Malignant development of lichen planus-affected oral mucosa. J Oral Pathol 17:219CrossRefPubMed

11.

Silverman S Jr, Gorsky M, Lozada-Nur F, Giannotti K (1991) A prospective study of findings and management in 214 patients with oral lichen planus. Oral Surg Oral Med Oral Pathol 72:665CrossRefPubMed

12.

Barnard NA, Scully C, Eveson JW et al (1993) Oral cancer development in patients with oral lichen planus. J Oral Pathol Med 22:421CrossRefPubMed

13.

Lo Muzio L, Mignogna MD, Favia G et al (1998) The possible association between oral lichen planus and oral squamous cell carcinoma: a clinical evaluation on 14 cases and a review of the literature. Oral Oncol 34:239CrossRefPubMed

14.

Mignogna MD, Lo Muzio L, Lo Russo L et al (2001) Clinical guidelines in early detection of oral squamous cell carcinoma arising in oral lichen planus: a 5-year experience. Oral Oncol 37:262CrossRefPubMed

15.

Bornstein MM, Kalas L, Lemp S et al (2006) Oral lichen planus and malignant transformation: a retrospective follow-up study of clinical and histopathologic data. Quintessence Int 37:261PubMed

16.

van der Meij EH, van der Waal I (2003) Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med 32:507CrossRefPubMed

17.

Sousa FA, Rosa LE (2008) Oral lichen planus: clinical and histopathological considerations. Braz J Otorhinolaryngol 74:284PubMed

18.

Ingafou M, Leao JC, Porter SR, Scully C (2006) Oral lichen planus: a retrospective study of 690 British patients. Oral Dis 12:463CrossRefPubMed

19.

Pakfetrat A, Javadzadeh-Bolouri A, Basir-Shabestari S, Falaki F (2009) Oral lichen llanus: a retrospective study of 420 Iranian patients. Med Oral Patol Oral Cir Bucal 14:E315PubMed

20.

Carbone M, Arduino PG, Carrozzo M et al (2009) Course of oral lichen planus: a retrospective study of 808 northern Italian patients. Oral Dis 15:235CrossRefPubMed

21.

Lodi G, Giuliani M, Majorana A et al (2004) Lichen planus and hepatitis C virus: a multicentre study of patients with oral lesions and a systematic review. Br J Dermatol 151:1172CrossRefPubMed

22.

Chainani-Wu N, Silverman S Jr, Lozada-Nur F et al (2001) Oral lichen planus: patient profile, disease progression and treatment responses. J Am Dent Assoc 132:901CrossRefPubMed

23.

Eisen D (2002) The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. J Am Acad Dermatol 46:207CrossRefPubMed

24.

Epstein JB, Gorsky M (1999) Topical application of vitamin A to oral leukoplakia: a clinical case series. Cancer 86:921CrossRefPubMed

25.

Tete S, Pappalardo S, Rubini C et al (1999) The role of apoptosis and bcl-2 protein in topical treatment of oral leukoplakia with isotretinoin. Minerva Stomatol 48:411PubMed

26.

Gorsky M, Epstein JB (2002) The effect of retinoids on premalignant oral lesions: focus on topical therapy. Cancer 95:1258CrossRefPubMed

27.

Eisenberg E, Krutchkoff DJ (1992) Lichenoid lesions of oral mucosa. Diagnostic criteria and their importance in the alleged relationship to oral cancer. Oral Surg Oral Med Oral Pathol 73:699CrossRefPubMed

28.

Zhang L, Michelsen C, Cheng X et al (1997) Molecular analysis of oral lichen planus. A premalignant lesion? Am J Pathol 151:323PubMedPubMedCentral

29.

van der Meij EH, Schepman KP, van der Waal I (2003) The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:164CrossRefPubMed

30.

Mignogna MD, Fedele S, Lo Russo L et al (2004) Immune activation and chronic inflammation as the cause of malignancy in oral lichen planus: is there any evidence? Oral Oncol 40:120CrossRefPubMed

31.

Battino M, Greabu M, Totan A et al (2008) Oxidative stress markers in oral lichen planus. Biofactors 33:301CrossRefPubMed

32.

Kawanishi S, Hiraku Y, Pinlaor S, Ma N (2006) Oxidative and nitrative DNA damage in animals and patients with inflammatory diseases in relation to inflammation-related carcinogenesis. Biol Chem 387:365CrossRefPubMed

33.

Ergun S, Trosala SC, Warnakulasuriya S et al (2011) Evaluation of oxidative stress and antioxidant profile in patients with oral lichen planus. J Oral Pathol Med 40:286CrossRefPubMed

Title: Oral lichen planus (OLP), oral lichenoid lesions (OLL), oral dysplasia, and oral cancer: retrospective analysis of clinicopathological data from 2002–2011
Authors: S. Casparis
J. M. Borm
S. Tektas
J. Kamarachev
M. C. Locher
G. Damerau
K. W. Grätz
B. Stadlinger
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: Oral and Maxillofacial Surgery / Issue 2/2015
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-014-0469-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Oral lichen planus (OLP), oral lichenoid lesions (OLL), oral dysplasia, and oral cancer: retrospective analysis of clinicopathological data from 2002–2011

Abstract

Introduction

Material and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Material and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2015

Midline upper lip sinus: a case report and review of literature

Solvent free production of porous PDLLA/calcium carbonate composite scaffolds improves the release of bone growth factors

Is there still a role for bilobed/bipaddled pectoralis major myocutaneous flap for single-stage immediate reconstruction of post ablative oncologic full-thickness defects of the cheek?

Facial trauma in the Trojan War

Accessory mental foramen: an anatomical study on dry mandibles and review of the literature

Postoperative hemostatic efficacy of gauze soaked in tranexamic acid, fibrin sponge, and dry gauze compression following dental extractions in anticoagulated patients with cardiovascular disease: a prospective, randomized study