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. 2021 Jun 10;21(1):298.
doi: 10.1186/s12903-021-01652-7.

Malignant transformation of oral lichen planus: a retrospective study of 565 Japanese patients

Fumihiko Tsushima  1 , Jinkyo Sakurai  2 , Atsushi Uesugi  2   3 , Yu Oikawa  2 , Toshimitsu Ohsako  2 , Yumi Mochizuki  2 , Hideaki Hirai  2 , Kou Kayamori  4 , Hiroyuki Harada  2
Affiliations

Malignant transformation of oral lichen planus: a retrospective study of 565 Japanese patients

Fumihiko Tsushima et al. BMC Oral Health. .

Abstract

Background: Oral lichen planus (OLP) is a chronic inflammatory oral mucosa disease that is recognized as an oral potentially malignant disorder. However, the potentially malignant nature of OLP remains unclear.

Methods: We designed this study to examine the demographic and clinical characteristics of patients with OLP and evaluate the associated malignant transformation rate. A total of 565 patients with a clinical and histopathological diagnosis of OLP who presented at our department between 2001 and 2017 were retrospectively studied. Patients who had clinical and histopathological features of oral lichenoid lesions (OLLs) classified as oral lichenoid contact lesions, oral lichenoid drug reactions and oral lichenoid lesions of graft-versus-host disease were excluded.

Results: The study population included 123 men and 442 women aged 21-93 years (mean ± standard deviation, 60.5 ± 11.8). The 565 patients were followed up for a duration of 55.9 ± 45.3 months, during which 4 (0.7%) patients developed squamous cell carcinoma (SCC). In three of these 4 patients who developed SCC, the clinical type of OLP was the red type.

Conclusions: Our results suggested that OLP was associated with a low risk of malignant transformation. We recommend regular follow-up for OLP patients and clear differentiation of oral epithelial dysplasia and OLLs to enable early detection of malignant transformation. Further investigation of the clinical risk factors associated with malignant transformation is necessary.

Keywords: Malignant transformation; Oral lichen planus; Oral squamous cell carcinoma; Retrospective study.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the patients inclusion and exclusion
Fig. 2
Fig. 2
Malignant transformation in Case 4 showing clinical pictures and correlating histopathologic features in biopsy (haematoxylin–eosin staining) at initial presentation (a, b) and malignant transformation (c, d). a She had symmetric reticular and atrophic lesions on the bilateral buccal mucosa and tongue and showed no positive to metal patch test. The lesions did not improve with removal of the metal prosthesis close to the tongue and was clinically and histopathologically diagnosed with OLP. b Biopsy revealed histopathologic features of OLP, including parakeratosis with basal cell liquefactive degeneration, a band-like predominantly lymphocytic infiltrate adjacent to basal cells. c Two years and 5 months later, the lesion had transformed into SCC. d Biopsy revealed SCC
See this image and copyright information in PMC

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