Oral Lichen Planus: risk factors of malignant transformation and follow up. Ten years retrospective study

Introduction: Oral lichen planus (OLP) is a chronic inflammatory disease with an unknown etiology rating among oral potentially malignant disorder. The aim of the study was to determine the epidemiological and clinical characteristics of the patients with OLP and rate of malignant transformation. Patients and methods: Data were obtained from the medical records of 271 patients referred to the Oral Medicine Unit at the University Hospital in Hradec Králové diagnosed with oral lichen planus in the period of 2003–2020. The records were retrospectively analyzed. The following clinical data were retrieved from the medical charts: gender, age, systemic diseases, alcohol and tobacco consumption, localization/clinical appearance of lesions, distribution of the lesions, presence of the symptoms, treatment provided and malignant transformation. Results: A total of 271 charts of patients with confirmed diagnosis of OLP were retrospectively analyzed, of whom, 66.4% (180/271) were women and 33.6% (91/271) were men. The mean age of the patients was 56.0 (18.2–85.0) years. The median follow-up of all patients was 15.2 months. Overall, 2 patients (2/271, 0.74%) meeting the above-mentioned criteria for malignant transformation were identified during the follow-up period. Both patients suffered from erosive type OLP and developed squamous cell carcinoma of the tongue. Conclusions: This retrospective study is in concordance with other studies showing the similar profile and clinical features of the patients with OLP. Malignant transformation rate was 0.74%.

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Clinicopathological features and malignant transformation of oral lichen planus: A 12-years retrospective study

Acta Odontologica Scandinavica ◽

10.3109/00016357.2012.734407 ◽

2012 ◽

Vol 71 (3-4) ◽

pp. 834-840 ◽

Cited By ~ 24

Author(s):

Elena Bardellini ◽

Francesca Amadori ◽

Pierangela Flocchini ◽

Sara Bonadeo ◽

Alessandra Majorana

Keyword(s):

Retrospective Study ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Clinicopathological Features ◽

Oral Lichen

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Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1914 ◽

2016 ◽

Vol 17 (8) ◽

pp. 692-701 ◽

Cited By ~ 16

Author(s):

Farzaneh Agha-Hosseini ◽

Nafiseh Sheykhbahaei ◽

Maryam-Sadat SadrZadeh-Afshar

Keyword(s):

Risk Factors ◽

Literature Review ◽

Malignant Transformation ◽

Lichen Planus ◽

Potential Risk ◽

Oral Lichen Planus ◽

World Health ◽

Extensive Literature ◽

Potential Risk Factors ◽

Oral Lichen

ABSTRACT Aim Many studies have suggested that a lesion originally diagnosed as oral lichen planus (OLP) has different possibilities of undergoing malignant transformation in time, although these findings remain a controversial issue; for example, some studies reported different values of potential malignancy of OLP. Introduction World Health Organization (WHO) classifies OLP as a “potentially malignant disorder” with unspecified malignant transformation risk, and suggests that OLP patients should be closely monitored. Numerous studies have attempted to confirm the malignant transformation potential of OLP. Review results The Cochrane Controlled Trials Register, Medline and EMBASE databases, PubMed, Google Scholar, Ovid, Up To Date, BMJ Clinical Evidence, MD Consult, and Science Direct were searched for papers published between 1997 and 2015. The medical subject heading search terms were “lichen planus,” “oral lichen planus,” “erosive oral lichen planus,” “dysplasia,” “oral precancerous condition,” “oral premalignant condition,” oral cancer, oral squamous cell carcinoma (OSCC), and atrophic lichen planus. A total of 120 English language abstracts were reviewed, and 50 relevant articles identified. Because of the extensive literature on the association between OLP and SCC, we have divided the data into genetic and nongenetic factors for more accurate assessment. Conclusion In this evidence base, malignant transformation ranges from 0 to 37% with a mean of 4.59%. The highest rate of malignancy was noted in erythematosus and erosive lesions. In this way, follow-up of OLP patients could be carried out more efficiently and appropriately. Clinical significance Oral lichen planus is a premalignant lesion. All types of OLP in any site of oral mucosa must be monitored regularly. How to cite this article Agha-Hosseini F, Sheykhbahaei N, SadrZadeh-Afshar M-S. Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review. J Contemp Dent Pract 2016;17(8):692-701.

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GRINSPAN SYNDROME: THE TRIAD

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v4i10.683 ◽

2020 ◽

Vol 4 (10) ◽

Author(s):

Seema M ◽

Shruti Srinivasan

Keyword(s):

Diabetes Mellitus ◽

Early Detection ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Clinical Manifestations ◽

Prevention And Early Detection ◽

Burning Mouth ◽

Oral Lichen

Lichen Planus is a chronic immunologically mediated mucocutaneous disorder with varied clinical manifestations. The condition might be associated with multiple causative or exacerbation factors. An interesting association of Oral Lichen Planus with Diabetes Mellitus and vascular hypertension is called as Grinspan's syndrome. Since its inception has been an arena of interest. It has appeared very lucrative to many researchers as it lacks clarity and enhanced ambiguity. A 65 year female patient came with a complaint of burning mouth and difficulty in swallowing since 1 year with H/O Diabetes Mellitus since 8years and hypertension since 2 years. Malignant transformation is the most significant complication of long standing and non healing Lichen Planus. Repeated follow up and biopsies are mandatory for prevention and early detection of malignant transformation. Keywords: Grinspan Syndrome, Hypertrophic Lichen Planus, Esophageal Lichen Planus

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Photobiomodulation Therapy vs. Corticosteroid for the Management of Erosive/Ulcerative and Painful Oral Lichen Planus. Assessment of Success Rate during One-Year Follow-Up: A Retrospective Study

Healthcare ◽

10.3390/healthcare9091137 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1137

Author(s):

Samir Nammour ◽

Marwan El Mobadder ◽

Aldo Brugnera ◽

Melanie Namour ◽

Saad Houeis ◽

...

Keyword(s):

Retrospective Study ◽

Recurrence Rate ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Continuous Wave ◽

Clinical Aspects ◽

Complete Disappearance ◽

Significant Difference ◽

Oral Lichen

Photobiomodulation (PBM) therapy is a promising approach for the management of inflammatory conditions and autoimmune lesions, such as oral lichen planus (OLP). The aim of this retrospective study was to assess the effectiveness of PBM in the management of painful and erosive/ulcerative OLP and to compare it with the standard of care that is the topical application of corticosteroids. 96 patients were included with erosive and painful OLP. 48 patients received PBM therapy and 48 received corticosteroids. Data was collected retrospectively on pain using the visual analogue scale; clinical aspects of lesions were assessed with the REU score, and the recurrence rate was noted. One session of PBM therapy with a helium-neon red light (635 nm) was carried out every 48 h for 6 weeks. Treatments were mainly made in contact mode, using a fiber with a diameter of 600 µm (0.6 mm). The output power of the laser beam was calibrated by a power meter. A delivered power of 0.1 W was used for 40 s in a continuous wave (CW), corresponding to a delivered energy of 4 J. The delivered energy density related to the fiber diameter was 1415 J/cm2. Each treated point was considered as 1 cm2 of diameter. PBM therapy within these parameters was carried out on each point until the totality of the lesion was covered, including the non-erosive OLP area. Furthermore, healthy mucosa within 5 mm of the lesion was also irradiated with the same conditions. This PBM treatment was performed during 6 consecutive weeks. The topical corticosteroid treatment consisted of cortisone application to cover the OLP 3 times/day for 6 weeks. Follow-up was made at 6 weeks and at 3, 6 and 12 months. After 6 weeks, both groups showed complete absence of pain, and a complete disappearance of ulcerative/erosive areas. No significant difference was found for both groups concerning the recurrence rate of erosive OLP during the follow-up period; values were 0% at 6 weeks for both groups and 79% and 87.5% for the corticosteroid and PBM group, respectively, at 12 months of follow-up. PBM is effective for managing OLP and is significantly similar to topical corticosteroids without any need for the use of medication and with no reported side effects.

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Risk of Malignant Transformation in 3173 Subjects with Histopathologically Confirmed Oral Lichen Planus: A 33-Year Cohort Study in Northern Italy

Cancers ◽

10.3390/cancers13225740 ◽

2021 ◽

Vol 13 (22) ◽

pp. 5740

Author(s):

Paolo G. Arduino ◽

Alessandro Magliano ◽

Alessio Gambino ◽

Alessandra Macciotta ◽

Mario Carbone ◽

...

Keyword(s):

Cohort Study ◽

Oral Cancer ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Northern Italy ◽

Elderly Subjects ◽

Histopathological Diagnosis ◽

Oral Lichen

Background: Oral lichen planus (OLP) is considered an oral potentially malignant disorder. The aim of our study was to estimate the risk for oral cancer in patients diagnosed with OLP. Methods: A population-based cohort study between January 1988 and December 2020 at one hospital in Northern Italy was performed. The primary endpoint of the study was that of the histopathological diagnosis of oral cancer during the follow-up period. Results: The study population comprised 3173 patients. During the follow-up period, 32 men and 50 women developed an oral squamous cell carcinoma (2.58%), with a mean time of 103.61 months after the initial diagnosis of OLP, and 21 patients died because of oral cancer. Almost half of the deceased patients had the last follow-up visit before cancer diagnosis in a period of more than 12 months. Older age, having a red form of OLP and fewer sites of involvement, increased the risk of having cancer, while age and no treatment increased the risk of death. Conclusion: This is the largest group of OLP patients with such a long follow up ever reported. Due to the increased risk of having a malignant transformation, especially in elderly subjects, OLP patients should be regularly followed up, particularly in the Northern Italian population.

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Descoberta de carcinoma de células escamosas em lesão previamente diagnosticada como líquen plano oral: malignização ou erro de diagnóstico inicial?

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v8i4.3296 ◽

2019 ◽

Vol 8 (4) ◽

Author(s):

Adriana Caroline Leite ◽

Nathalia Torres Assay ◽

Fabio Augusto Ito ◽

Heliton Gustavo de Lima ◽

Ademar Takahama Junior

Keyword(s):

Systematic Review ◽

Retrospective Study ◽

Malignant Transformation ◽

Lichen Planus ◽

Clinical Management ◽

Oral Lichen Planus ◽

Oxidative Dna Damage ◽

Malignant Potential ◽

Oral Lichenoid Lesions ◽

Oral Lichen

O Líquen Plano Oral (LPO) é uma doença crônica imunologicamente mediada com potencial de malignização incerto. O objetivo desse artigo é relatar um caso de Carcinoma de Células Escamosas (CCE) diagnosticado em paciente com diagnóstico prévio de LPO. Paciente do sexo feminino, 69 anos, foi atendida durante uma campanha de diagnóstico precoce de câncer de boca realizada na cidade de Londrina/PR, sendo detectada uma lesão eritroplásica em língua e encaminhada para uma melhor avaliação. Na anamnese a paciente relatou que há 2 anos atrás foi diagnosticada com LPO através de biópsia em língua, não sendo proposto nenhum tratamento. Ao exame físico, observamos uma mancha eritematosa em borda lateral de língua do lado esquerdo, não apresentando nenhuma outra lesão na cavidade oral. Com a hipótese diagnóstica de eritroplasia, foi requisitada a lâmina da biópsia anterior para análise, que revelou características microscópicas incompatíveis com o diagnóstico de LPO. Optamos então por realizar uma nova biópsia e a análise histopatológica revelou ilhas de células epiteliais malignas invadindo o tecido conjuntivo, estabelecendo o diagnóstico de CCE. A paciente foi encaminhada para tratamento, sendo realizada glossectomia parcial. Em acompanhamento de 6 meses a paciente encontra-se bem e sem sinais de recidiva. A transformação maligna do LPO ainda é discutida na literatura e muitos casos relatados podem se tratar de erro no diagnóstico inicial, como no caso apresentado. O erro de diagnóstico pode levar a morbidades importantes e comprometer o prognóstico do caso.Descritores: Diagnóstico; Líquen Plano; Carcinoma de Células Escamosas.ReferênciasGiuliani M, Troiano G, Cordaro M, Corsalini M, Gioco G, Lo Muzio L et al. Rate of malignant transformation of Oral Lichen Planus: a systematic review. Oral Dis. 2019; 25(3):693-709.Bardellini E, Amadori F, Flocchini P, Bonadeo S, Majorana A. Clinicopathological features and malignant transformation of oral lichen planus: a 12-years retrospective study. Acta Odontologica Scandinavica 2013;71(3/4):834-40.Eisen D. The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. J Am Acad Dermatol. 2002;46(2):207-14.Farhi D, Dupin N. Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: facts and controversies. Clin Dermatol. 2010;28(1):100-8.Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus – a review. J Oral Pathol Med. 2010;39(10):729-34.van der Meij EH, van der Waal I. 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. 2003;32(9):507-12.Kramer IR, Lucas RB, Pindborg JJ, Sobin LH. Definition of leukoplakia and related lesions: an aid to studies on oral precancer. Oral Surg Oral Med Oral Pathol. 1978;46(4):518-39.Aghbari SMH, Abushouk AI, Attia A, Elmaraezy A, Menshawy A, Ahmed MS et al. Malignant transformation of oral lichen planus and oral lichenoid lesions: a meta-analysis of 20095 patient data. Oral Oncology. 2017;68:92-102.Eisenberg E. Oral lichen planus:a benign lesion. J Oral Maxillofac Surg. 2000;58(11):1278-85. Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res. 2016;308(8):539-51.Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: report of an international consensus meeting. Part 2. Clinical management and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(2):164-78.Sousa FACG, Paradella TC, Brandão AAH, Rosa LEB. Líquen plano bucal versus displasia epitelial: dificuldades diagnósticas. Braz J Otorhinolaryngol. 2009;75(5):716-20.Rode M, Kogoj-Rode M. Malignant potential of the reticular form of oral lichen planus over a 25-year observation period in 55 patients from Slovenia. J Oral Sci. 2002;44(2):109-11.Van der Meij EH, Mast H, Van der Waal I. The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective five-year followup study of 192 patients. Oral Oncol. 2007;43(8):742-48.Oliveira Alves MG, Almeida JD, Balducci I, Guimarães Cabral LA. Oral lichen planus: a retrospective study of 110 Brazilian patients. BMC Res Notes. 2010;3:157.Radochová V, Drˇízhal I, Slezák R. A retrospective study of 171 patients with oral lichen planus in the East Bohemia-Czech Republic–single center experience. J Clin Exp Dent. 2014;6(5):e556-61.Fitzpatrick S, Hirsch S, Gordon S. The malignant transformation of oral lichen planus and oral lichenoid lesions: a systematic review. J Am Dent Assoc. 2014;145(1):45-56.Bermejo-Fenoll A, Sánchez-Siles M, López-Jornet P, Camacho-Alonso F, Salazar-Sánchez N. A retrospective clinicopathological study of 550 patients with oral lichen planus in south-eastern Spain. J Oral Pathol Med. 2010;39(6):491-96.Chaiyarit P, Ma N, Hiraku Y, Pinlaor S, Yongvanit P, Jintakanon D et al. Nitrative and oxidative DNA damage in oral lichen planus in relation to human oral carcinogenesis. Cancer Sci. 2005;96:553-59.Georgakopoulou EA, Achtari MD, Achtaris M, Foukas PG, Kotsinas A. Oral lichen planus as a preneoplastic inflammatory model. J Biomed Biotechnol. 2012;2012:759626.Accurso BT, Warner BM, Knobloch TJ, Weghorst CM, Shumway BS, Allen CM et al. Allelic imbalance in oral lichen planus and assessment of its classification as a premalignant condition. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(3):359-66.

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