Oral lichen planus: progress in understanding its malignant potential and the implications for clinical management.
Oral lichen planus (OLP) is an inflammatory lesion that has malignant potential, but few cases of OLP progress to malignancy. A diagnosis of OLP should be confirmed on the basis of historical, clinical, and histologic data. The presence of dysplasia in an OLP-like lesion increases the risk of malignant transformation, mandating management and close follow-up. A molecular assessment of OLP may provide the best evidence of malignant risk and will likely become available for clinical use. In addition, exfoliated cells may be examined for loss of heterozygosity and may become a valuable clinical tool for patient follow-up. The treatment of OLP should include elimination of tissue irritants and recurring exposure to oral carcinogens. If OLP is symptomatic, appropriate treatment with immunosuppressive medications, particularly corticosteroids, should be undertaken. For lesions with dysplastic changes, management may include attention directed to the inflammatory change and follow-up biopsies to assess residual histologic changes that may represent dysplasia. Dysplastic OLP may be best treated as other oral dysplastic conditions; thus, regular, more frequent follow-up is required.
Epstein
Joel B
JB
Department of Dentistry, Vancouver Hospital and Division of Hospital Dentistry, University of British Columbia, Canada. jepstein@uic.edu
Wan
Laura S
LS
Gorsky
Meir
M
Zhang
Lewei
L
D002294:Carcinoma, Squamous Cell / Q000235:genetics; D002471:Cell Transformation, Neoplastic / Q000235:genetics; D016147:Genes, Tumor Suppressor; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017676:Lichen Planus, Oral / Q000188:drug therapy / Q000473:pathology*; D019656:Loss of Heterozygosity; D009062:Mouth Neoplasms / Q000235:genetics; D012306:Risk
D007166:Immunosuppressive Agents