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. 2020 Jul 1;25(4):e554-e562.
doi: 10.4317/medoral.23576.

Clinicopathological and prognostic characterization of oral lichenoid disease and its main subtypes: A series of 384 cases

J-M Aguirre-Urizar  1 , J Alberdi-Navarro, I Lafuente-Ibáñez de Mendoza, X Marichalar-Mendia, B Martínez-Revilla, C Parra-Pérez, A-D Juan-Galíndez, M-Á Echebarria-Goicouria
Affiliations

Clinicopathological and prognostic characterization of oral lichenoid disease and its main subtypes: A series of 384 cases

J-M Aguirre-Urizar et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: To clinicopathologically characterize the diagnosis of oral lichenoid disease (OLD) and its main subtypes: oral lichen planus (OLP) and oral lichenoid lesion (OLL), in order to correctly asses their prognosis.

Material and methods: Ambispective cohort study of 384 patients with diagnosis of OLD, based on pre-established clinical and histopathological criteria. We have analysed 272 (70.8%) women and 112 (29.2%), whose mean age was 57.1+/-11.8 years (range 21-90); minimum follow-up time was 36 months. A specific protocol was designed for this study, where we gathered the data of each patient, including malignant transformation.

Results: OLP was diagnosed in 229 cases (77.9%) and OLL in 85 (22.1%). Tobacco consumption was found in 20.3% of the patients and alcohol intake in 41.1%. Liver pathology was present in 10.7% of the cases, thyroid pathology in 11.5%, arterial hypertension in 15.6%, diabetes mellitus in 7.6%, psycho-emotional disorders in 33.3%, skin involvement in 12% and genital involvement in 4.9%. Ten patients (2.6%) developed an oral squamous cell carcinoma, 5 (1.7%) with OLP and 5 (5.9%) with OLL.

Conclusions: OLD is a potentially malignant disorder of the oral mucosa which has to be correctly diagnosed as either OLP or OLL, since the risk of malignancy of these subtypes is significantly different.

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Conflict of interest statement

Conflicts of interest Non declared.

Figures

Figure 1
Figure 1
Presence of multiple white papular lesions with reticular arrangement and atrophic-erythematous, erosive-ulcerative and plaque lesions. Bilateral and symmetric distribution. Clinical diagnosis of Oral Lichen Planus.
Figure 2
Figure 2
A) Presence of papular, atrophic-erythematous and plaque lesions located only on the tongue. Clinical diagnosis of Oral Lichenoid Lesion. B) Presence of papular, atrophic-erythematous and ulcerative lesions in the right buccal mucosa after treatment with antihypertensive medication. Clinical diagnosis of Oral Lichenoid Lesion. C and D) Presence of papular, atrophic- erythematous and ulcerative lesions in the right and left buccal mucosa in a patient undergoing bone marrow transplantation due to multiple myeloma (graft versus host disease). Clinical diagnosis of Oral Lichenoid Lesion.
Figure 3
Figure 3
A) White papular lesions with reticular disposition, fundamental for the diagnosis of Oral Lichenoid Disease. B) "Compatible” histopathology in an OLD biopsy (H&E x20). C) Papular and atrophic lesion in the buccal mucosa. D) "Compatible" histopathology of case C with epithelial atrophy, hyperkeratosis and chronic mucositis (H&E x20). E) Erythroplastic lesion of Case C 4 years after the diagnosis of OLD. F) Histopathology of case E showing a squamous cell carcinoma (H&E x100).
See this image and copyright information in PMC

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