Oral Lichen Planus and Its Association With Squamous Cell Carcinoma: An Update on Pathogenesis and Treatment Implications

Abstract

Lichen planus of the oral mucosa (OLP) is characterized by lymphocytic mucositis, basal cell lysis, and lymphocyte transmigration into the epithelial compartment. Some reports have suggested a high incidence of oral squamous cell carcinoma (OSCCA) in OLP patients and have implicated OLP as a premalignant lesion. We describe five cases of OSCCA arising in patients with preexisting OLP. At our institution, the incidence of OSCCA in patients with OLP approximates that reported in other series. The immunopathologic basis for OLP, its potential association with malignancy, and the variable clinical picture of OSCCA in patients with OLP are reviewed. Specific recommendations are given for treatment and follow-up of lesions, including the role of future testing with viral and oncogene markers.

Head and Neck Squamous Cell Carcinoma in the Young: A Spectrum or a Distinct Group? Part 1

“…As regards younger patients, Llewellyn [6] noted a slight but not significant risk for female cannabis smokers. Malignant transformation in lichen planus occurs mainly in association with the atrophic and erosive forms that typically occur in older rather than younger patients [13]. Poor dental hygiene has long been associated with oral cancer.…”

Oral Lichen Planus and Malignant Transformation: Is a Recall of Patients Justified?

“…S everal prospective Silverman et al, 1991) and retrospective studies (Warin, 1960;Altman and Perry, 1961;Janner et al, 1967;Abramova, 1968;Andreasen, 1968;Cawson, 1968;Shklar, 1972;Fulling, 1973;Kovesi and Bánóczy, 1973;Holmstrup and Pindborg, 1979;Vas'kovskaia and Abramova, 1981;Silverman et al, 1985;Murti et al, 1986;Salem, 1989;Sigurgeirsson and Lindelof, 1991;Voute et al, 1992;Barnard et al, 1993;Brown et al, 1993;Moncarz et al, 1993;Duffey et al, 1996;Markopoulos et al, 1997;Silverman and Bahl, 1997;Lo Muzio et al, 1998;Rajentheran et al, 1999) as well as case reports (Faraci et al, 1975;Marder and Deesen, 1982;Pogrel and Weldon, 1983;Fowler et al, 1987;Katz et al, 1990;Massa et al, 1990;Harland et al, 1992;Porter et al, 1997;Camisa et al, 1998;Chainani-Wu et al, 2001) have reported oral lichen planus (OLP) as having an increased potential for malignant development. The reported transformation rates vary from 0 to 9%.…”

Expression of intermediate filament proteins in benign lesions of the oral mucosa

“…Lymphocytic mucositis and lymphocyte transmigration into the epithelial compartment associated with keratinization characterize LPR [7]. Most these lesions comprise a benign hyperkeratosis and only incidentally undergo malignant transformation.…”