Oral lichen planus: a clinical study

Abstract

Objective: To evaluate the clinical characteristics, predisposing/aggravating factors and malignant potential of oral lichen planus (OLP).

Study design: Case series.

Place and duration of study: Department of Dermatology and Oral Pathology, Liaquat University Hospital, Hyderabad, from January 2006 to November 2007.

Methodology: Patients of either gender aged above 12 years, fulfilling the diagnostic criteria for OLP were enrolled for study. Patients not willing to participate or suspected to have drug-induced lichenoid reactions were excluded. History regarding the onset and duration, symptoms, addictions was elicited followed by oral, cutaneous and systemic examination. Biopsy was taken when the diagnosis was doubtful or malignancy was suspected. The data were analyzed using SPSS software version 11.0 for frequency and percentage.

Results: A total of 95 patients (40 male and 55 female), aged between 17 and 62 years were enrolled. Diabetes (n=05) and hypertension (n=04) were the accompanying comorbidities. Family history was positive in 3 patients only. Reticular form was the most common clinical type seen in 52 (54.7%), followed by erosive in 31 (32.6%) and atrophic/erythematous types in 12 (12.6%) patients. The disease caused pain, burning and other symptoms in 72 (75.7%) patients. Buccal mucosa was the chief site of involvement (n=31). Other sites involved were tongue (n=20), lips (n=28), palate (n=9) and floor of mouth (n=03). Stress, spicy foods and poor oral hygiene aggravated disease in most (n=77) of the patients.

Conclusion: OLP is a chronic disease with diverse clinical manifestations and multiple site involvement. Associated pigmentation of surrounding mucosa was unique finding of this study. Long-term follow up is needed to assess the malignant potential. Stress was the most important factor aggravating the disease.