The development of proliferative verrucous leukoplakia in oral lichen planus. A preliminary study (original) (raw)
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Advances in oral and maxillofacial surgery, 2022
Background: Was to describe 14 cases of a proliferative verrucous leukoplakia as a clinical evolution of oral lichen planus. Material and Methods: The clinical and histopathological characteristics of 14 cases of OLP that progress towards a plaque-like and verrucous form were indicated, with monitoring over a period of six to 24.3 years. Results: The female/male ratio was 11/3, (78.6 and 21.4%). The mean age when the first biopsy was undertaken was 56.4 years old. None of the patients smoked during the study. As bilateral reticular was clinically diagnostic criterion, the second most frequent clinical form was the plaque form (n=10; 71.4%), followed by the atrophic (n=6; 42.8%), and erosive forms (n=4; 28.5%). Clinically it spread towards attached gingival mucosa and the hard palate. In the histopathologic study, there were a predominance of hyperkeratosis and verrucous epithelial hyperplasia. Three of the cases progressed to a squamous cell carcinoma, and one patient developed two verrucous carcinoma. Conclusions: Further research is needed to demonstrate if proliferative multifocal oral lichen planus and proliferative multifocal oral leukoplakia are the same disorder but have different behaviour of malignancy for reasons of origin.
Collegium antropologicum, 2012
The aim of this retrospective study was to determine the frequency and malignant transformation rate of oral lichen planus and leukoplakia in a large group of oral medicine patients. Study included 12 508 patients who were referred between 1998 and 2007 to the Department of Oral Medicine. The frequency of OLP was 4.30%, leukoplakia 1.11%, and combined diagnoses 0.14%. In primary biopsies dysplasia was found in 12.96% of patients with leukoplakia and not in one with OLP and combined lesions. The highest frequency of leukoplakia was found in smokers. Women were found as predominant sufferers of both diseases and their combination. During the observed period often years malignant transformation of OLP was not detected, unlike leukoplakia where it was 0.64%. The frequency of OLP and leukoplakia in our study are comparable to other similar studies. The highest frequency of malignant transformation was observed in those patients who did not respond to our invitation to regular check-up. I...
Oral Oncology, 1998
Between 1986 and 1996, 263 patients, 156 females and 107 males, affected by oral lichen planus (OLP), were followed at the Division of Oral Medicine and Pathology, University of Naples 'Federico II', Italy, and at the Institute of Dentistry and Maxillofacial Surgery, University of Bari, Italy. During this follow-up, the possible association of OLP with oral squamous cell carcinoma (SCC), together with the possible association of OLP, oral SCC and chronic HCV-hepatitis, were investigated. 14 cases (5.32%) were known to have developed oral SCC: 10 (3.8'/) D m an area of pre-existing OLP, 3 (1.14%) in other sites, in 1 case the diagnosis of OLP and SCC was synchronous (0.38%). 3 patients were positive for anti-HCV antibody. Many carcinomas were in areas of reticular/plaque OLP. 3 patients had multiple simultaneous sites of oral involvement (21.42%); 5 patients developed oral SCC in different sites during the follow-up period (35.71%). These data, together with a clear histological evidence of progression to carcinoma within OLP lesions, suggest the probability of some cases of at least OLP having an intrinsic property predisposing to neoplastic transformation, confirming previous studies. For these reasons, the authors think that it is necessary to follow-up the patients regularly at least annually and possibly for life for the early diagnosis of a possible neoplastic degeneration.
Journal of Oral Pathology & Medicine, 2020
Background: Multiple white plaques of the oral mucosa are usually associated with potentially malignant disorders such as Oral Lichen Planus, Oral Lichenoid Lesions, and Proliferative Verrucous Leukoplakia. Previous studies in the current literature describe a potential clinical overlap in these entities. The aim of this study is to review clinicopathological and evolutive features of these Oral Potentially Malignant Disorders highlighting the dynamic changes of diagnoses. Discussion: It was previously hypothesized that a subset of patients with Oral Lichen Planus or Oral Lichenoid diagnosis, could develop multiple white plaques during the natural history of the disease, fulfilling diagnostic criteria for Proliferative Verrucous Leukoplakia. Consequently, these entities could, under certain conditions, obey a continuum of the same precancerous condition in the context of the field cancerization theory, increasing the risk of malignant transformation. Nevertheless, there is limited scientific evidence concerning this issue. Conclusion: Further studies are needed to understand the biological and evolutive features of the link between these Oral Potentially Malignant disorders. Regardless of its diagnosis, these patients with multifocal white lesions must be carefully monitored to detect early malignant transformation.
Drugs of Today, 2002
Oral lichen planus affects 1-2 per cent of the general adult population and is the most common noninfectious oral mucosal disease in patients referred to oral medicine and oral pathology clinics. According to clinical features and histopathologic analysis, there are several variants including linear, hypertrophic, bullous, erosive, palmoplantar, nodular, annular, atrophic, follicular, ulcerative, plaque-like, reticular, papular. The aim of this communication is to provide an update of the clinical and histological features of OLP, process of OLP diagnosis, causes of OLP, management of OLP patients and medical treatment of OLP lesions. The malignant potential of OLP is discussed and practical steps to reduce the risk of oral cancer in OLP patients are presented. The need for OLP patient education is highlighted.
Incidence rates for oral leukoplakia and lichen planus in a Japanese population
BACKGROUND: Data on the incidence rates of potentially malignant diseases of the oral cavity in different populations is meagre. This is the first study to report on the age-specific incidence of oral leukoplakia and oral lichen planus from an industrialized country. METHODS: Annual screening for oral cancer and precancer was undertaken in Municipal Health Centres in Tokoname city, Japan from 1995 to 1998. A total of 9536 volunteers aged 40-95 years participated in this programme. A cohort of 6340 (67%) subjects attended annual mouth examinations following a negative screen result at entry, allowing 13 072 person-years of observations. Some associated risk factors (tobacco and alcohol misuse) and health-related variables were also evaluated. RESULTS: Over a 4-year follow-up period, 18 new oral leukoplakias (all homogenous; 11 idiopathic and seven tobacco-associated) and 24 oral lichen planus (22 reticular, one erythematous and one ulcerative) were detected at screening and confirmed by re-examination at specialist units. The age-adjusted incidence rate for leukoplakia was 409.2 (95% CI: 90.6-727.9) in male and 70.0 (95% CI: 17.9-121.8) in female per 100 000 personyears observations. For lichen planus, the corresponding rates were 59.7 (95% CI: 7.4-112.1) and 188.0 (95% CI: 96.0-280.1). The age-adjusted incidence rate for tobaccoassociated leukoplakia in males was almost 12 times compared with female (560.3 vs. 45.2 per 100 000). Agespecific incidence rates for oral leukoplakia varied by age groups. New oral leukoplakias were more prevalent on gingival/alveolar ridge (33.3%) than in other oral sites, and lichen planus at buccal site (33.3%). Prevalence of smoking habits among those positive for leukoplakia (38.9%) was higher compared with the screen-negatives (26.4%) but these differences did not reach statistical significance (P ΒΌ 0.232). Regular drinking was not related to occurrence of either oral leukoplakia or oral lichen planus. In cases with diabetes mellitus, relative risk for oral lichen planus adjusted by logistic regression was 6.4 (95% CI: 2.4-17.6), suggesting an association. CONCLUSIONS: The reported incidence rates for oral leukoplakia in this Japanese population are somewhat higher to those reported from India, the risk habits of the two groups being markedly different. The reported rates for oral leukoplakia and lichen planus allow estimation of service needs in specialist oral medicine clinics and for the training of primary care dentists. A high incidence of idiopathic leukoplakia found in this study raises challenges to the strategy of screening high-risk populations aimed at conserving resources. J Oral Pathol Med (2005) 34: 532-9
BACKGROUND: The aim of this study was to determine the correlation of histopathology and clinical OLP and OLL diagnosis and which histopathologic criteria could best distinguish the OLP and OLL. MATERIALS AND METHODS: The retrospective study group comprised 60 patients who were referred to the Department of Oral Medicine Govt. dental college Srinagar. Diagnosis was based on clinical examination and medical and dental history, intake of drugs, and duration of the lesions. Only patients who underwent biopsy were included in the study. The clinical diagnosis of OLP was established in 50 patients (34 females; 16 males; ratio f/m = 2.12:1), while in 10 patients OLL was diagnosed (4 females; 6 males, ratio f/m = 0.66:1). Clinical diagnosis of OLL was established due to the presence of hyperkeratotic lesions adjacent to amalgam fillings with asymmetric and mainly unilateral distribution and patient medical history related to drugs, which provoke lichenoid changes in oral mucosa. RESULTS: In 56% (28/50) of patients, clinical diagnosis of OLP was histopathologically confirmed, while in 6%(3/50) of cases there was a partial confirmation and only some criteria were fulfilled. In 14%(7/50) of OLP patients, both clinical and histopathologic diagnosis were concordant, while in 24% (12/50) of patients histopathologic diagnosis was nonspecific, being described as inflammation and keratosis. Clinical and histopathological diagnoses coincide in 50% (5/10) of OLL patients. In clinically diagnosed OLL, in one case the diagnosis of OLP was established, and 3 (30%)cases had inflammation and keratosis, while in 1(10%) cases squamous cell carcinoma(OSCC) was diagnosed histopathologically.
Oral lichen planus: Epidemiology, clinical characteristics, and associated diseases
Seminars in Cutaneous Medicine and Surgery, 1997
Oral lichen planus (OLP) is a chronic inflammatory disease, the cause of which remains unknown. In the last few years, significant advances have been made in understanding the mechanisms involved in the pathogenesis of the disease. Data on HLA markers for OLP vary depending on the population studied. OLP is a disease primarily of adults (50 to 55 years of age) and predominantly affects women. Any site in the oral cavity may be involved, but the buccal mucosa and gingiva are the most common sites. OLP can have different clinical presentations, with the reticular, erosive, and atrophic types being the most commonly reported. OLP has been reported to be associated with different medical conditions such as diabetes, hepatitis C infection, liver disease, and oral cancer. With the exception of oral cancer, there are not good data to support such associations. The question that remains to be answered is why we see a higher prevalence of oral carcinoma in patients with OLP. The relative prevalence from our series was 1.2%. Therefore, we believe patients with OLP have a higher risk for oral cancer and should be monitored for malignant transformation once a year.
Journal of the Korean Association of Oral and Maxillofacial Surgeons, 2017
Lichen planus (LP) is a relatively common mucocutaneous disease with autoimmune etiology. Considering its malignancy potential, it is important to define the correct diagnosis, treatment, and clinical follow-up for patients with LP so that the disease is not diagnosed late, thus hindering the chances of curing the disease. This study aims to describe a clinical case of oral squamous cell carcinoma, potentially originated from LP. The patient is undergoing clinical and histopathological follow-up. A 64-year-old Caucasian male patient presented with a proliferative verrucous lesion on the tongue and sought treatment at the School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, Brazil. He claimed the lesion had been present since 1988, and had been initially diagnoses as "oral lichen planus." The physical exam presented three diagnostic hypotheses: plaque-like oral LP, verrucous carcinoma, and squamous cell carcinoma. After incisional biopsy and histopathological ...