Clinicopathologic Correlation of Oral Lichen Planus and Oral Lichenoid Lesions: A Preliminary Study

Abstract

Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are clinically and histologically similar lesions but their treatment planning and prognosis are different. The review of the literature indicates numerous criteria to distinguish these two lesions; however there is a lot of inconsistency. Thus, the aim of this study was to determine the correlation of histopathology and clinical OLP and OLL diagnosis and to clarify which histopathologic criteria could best distinguish these two diagnoses. A retrospective study showed that clinically diagnosed 92 OLPs and 14 OLLs have been confirmed histopathologically in 52.2% and 42.9% of cases, respectively. In addition, histopathology showed statistically significant more eosinophils (P < 0.0005), plasma cells (P < 0.0005), and granulocytes (P < 0.05) in OLL than OLP. To establish histopathological diagnosis of OLP and OLL it should be mandatory to define the type of cells in mononuclear infiltrate, which can be associated more accurately with clinical feature and patient history. Therefore, currently accepted diagnostic criteria for OLP and OLL should be modified and validated on a larger number of patients taking into account particular distinguishing histopathological features.

The Role of Dental Metal Allergy in Oral Lichen Planus

“…(8) For example, an article by Silverman, 1991, our results may contradict several other studies as stated earlier. (7,12,48) This similarity between allergy rates in OLP and OLL patients found in our study can be explained in three ways.…”

“…(7,12) Direct immunofluorescence (DIF) is the best study that oral pathologists have been able to use To obtain a confirmed diagnosis of OLP and to rule out dysplasia or malignancy, a biopsy is necessary.…”

“…(7,15) cells and eosinophils appears in lamina propria and superficial submucosa, without increased vascularity. (7,12) In the UWMC OMCS, the certified Oral Pathologist, Doctor Dolphine Oda, uses specific criteria to differentiate OLL from OLP. These criteria include: …”

“…(8) However, it may also challenge a few other studies that consider OLL and OLP as two separate conditions where only OLL is associated with allergy. (7,12,48) One of these studies include a comprehensive review of the literature [7] which attempted to highlight the distinguishing features between OLP and OLL clinically and histologically.…”

“…Allergy to dental metals have been reported as an inciting factor for OLL (7,12) and less commonly with OLP.…”