Oral lichen planus and malignant transformation: a retrospective follow-up study of clinical and histopathologic data.
OBJECTIVE
Patients in the stomatology service of the Department of Oral Surgery and Stomatology who were clinically and histopathologically diagnosed with oral lichen planus (OLP) in the years 1995 to 2001 were examined for a possible malignant transformation of a previously biopsied OLP site.


METHODS
For the 145 patients included, the recordings were searched for initial localization and type of OLP lesion, potential noxious agents, distribution between symptomatic and asymptomatic OLP types, and for a malignant transformation of a known OLP site during the follow-up period up to December 2003.


RESULTS
The group comprised 47 men and 98 women with a mean age of 56.3 years. Of the 497 lesions, almost half were classified as reticular or papular, predominantly located on the buccal mucosa, gingiva, and borders of the tongue. Four patients did not adhere to their scheduled control visits and were dropped from the study. During the follow-up period 4 patients developed malignant transformation of OLP. In 3 of these cases, dysplasia was present at the initial diagnosis of OLP. This results in a malignant transformation rate of 2.84% among the remaining 141 patients; if the 3 patients with initial dysplasia are excluded, the rate drops to 0.71%.


CONCLUSIONS
Until further knowledge is derived from large prospective studies, the data supporting or negating a potential malignant character of OLP lesions remains inconclusive. Special emphasis has to be directed toward unified inclusion and exclusion criteria regarding clinical and histologic findings and identifiable risk factors to allow the comparison of different studies.
Bornstein
Michael M
MM
Department of Oral Surgery and Stomatology, School of Dental Medicine, Berne, Switzerland. michael.bornstein@zmk.unibe.ch
Kalas
Lucie
L
Lemp
Sandra
S
Altermatt
Hans Jörg
HJ
Rees
Terry D
TD
Buser
Daniel
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D005260:Female; D005447:Fluocinonide / Q000627:therapeutic use; D005500:Follow-Up Studies; D005882:Gingival Diseases / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D017676:Lichen Planus, Oral / Q000145:classification / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013312:Stress, Physiological / Q000150:complications; D014060:Tongue Diseases / Q000473:pathology; D014222:Triamcinolone Acetonide / Q000627:therapeutic use
D005938:Glucocorticoids; D005447:Fluocinonide; D014222:Triamcinolone Acetonide