Rate of malignant transformation of oral lichen planus: A systematic review

Giuliani, Michele; Troiano, Giuseppe; Cordaro, Massimo; Corsalini, Massimo; Gioco, Gioele; Muzio, Lorenzo Lo; Pignatelli, Pamela; Lajolo, Carlo

doi:10.1111/odi.12885

Cited by 196 publications

(206 citation statements)

References 75 publications

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“…Within our cohort of OLP patients, only 1/206 patient underwent malignant transformation, generating an overall MT rate of 0.49% which is within the range of 0%‐5.4% established in the literature, but somewhat lower than the rates calculated in recent meta‐analyses of approximately 1.1%‐1.4% …”

Section: Discussionsupporting

confidence: 56%

“…The reported rate of MT across different studies ranges from 0% to 5.4% . A recent systematic review calculated a combined MT rate of 1.4% with an annual transformation rate of 0.2% which was comparable with other recent meta‐analyses which obtained combined values of 1.09% and 1.1%, respectively . Interestingly, when a sub‐group analysis was performed utilising only studies adhering to the updated 2003 WHO criteria, which specifically excludes lesions with dysplasia, Aghbari et al obtained an MT rate of 0.9%.…”

Section: Introductionmentioning

confidence: 69%

“…Oral lichenoid lesions have been studied less extensively than OLP in the literature, however, recent studies have recorded MT rates of 1.2%, 3.2% and 4.4% . Interestingly, in two of these studies, the rate of MT in OLL was higher than in OLP and this was also the case in a systematic review where the OLL MT rate was 2.43% vs 1.37% for OLP . Patient characteristics in the OLL group were comparable to the OLP and OLD groups and demonstrated a higher rate of known OSCC risk factors including smoking and alcohol use.…”

Section: Discussionmentioning

confidence: 91%

“…Factors which increase the risk of MT in OLP patients include smoking and infection with the hepatitis C virus, although this has been investigated in only a few studies . Lesions on the tongue and female patients are also at higher risk of MT . While the exact mechanisms by which OLP undergoes malignant transformation have not yet been determined, it is thought that chronic immune stimulation and inflammation can cause growth signal dysregulation and this combines with oxidative stress to induce DNA damage .…”

Section: Discussionmentioning

confidence: 99%

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Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Shearston

Fateh

Tai

et al. 2019

J Oral Pathology Medicine

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Objectives Oral potentially malignant disorders (OPMD) include a variety of mucosal lesions such as oral lichen planus (OLP), oral lichenoid lesions (OLL) and oral lichenoid dysplasia (OLD). Their rate of malignant transformation ranges from 0% to 34% and is dependent on OPMD type, lesion site and a range of risk factors. This study seeks to determine the proportion of oral lichenoid conditions that transform into oral squamous cell carcinoma (OSCC) in an Australian population. Methods The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLP, OLL or OLD using clinical and histopathological data between 2006 and 2014. Patients were cross‐matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation determined. Results OLP and OLL patients displayed a low risk of malignant transformation; 0.49% (1/206) for OLP and 0% (0/31) for OLL. In contrast, OLD patients, all of whom presented clinically as OLP, were at much higher risk with 6.81% (3/44) developing OSCC over an average time of 4.6 years (±2.4 SD). Rates of smoking and alcohol consumption were no higher in OLD patients compared to others. Conclusions Compared with other oral lichenoid conditions, OLD lesions are at a particularly high risk of malignant transformation and should be managed based on the presence of dysplasia and not the lichenoid inflammatory infiltrate. OLP demonstrates a relatively low rate of malignant transformation. Diagnostic histopathology is important for discriminating OLP from OLD.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Shearston

Fateh

Tai

et al. 2019

J Oral Pathology Medicine

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“…It affects the skin and mucosa, with oral lichen planus (OLP) being the most frequent of its manifestations. It has characteristic clinical and histological features and a benign progression, although it can sometimes undergo malignant transformation (Aghbari et al, ; Blanco Carrión, Otero Rey, Peñamaría Mallón, & Diniz Freitas, ; Gándara‐Rey et al, ; Giuliani et al, ).…”

Section: Introductionmentioning

confidence: 99%

Psychological disorders and quality of life in oral lichen planus patients and a control group

et al. 2019

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Objectives Oral lichen planus (OLP) is a common disease whose aetiopathogenesis is linked to psychological disorders. This study aims to determine the influence of anxiety and depression in OLP patients, define the perception of quality of life in these patients and check for potential differences between atrophic/ ulcerative and reticular lesions. Materials and Methods A group of 48 OLP patients and a control group of 40 patients were selected. In order to assess anxiety, depression and quality of life, Hospital Anxiety and Depression Scale (HADS) and Oral Health Impact Profile 14 (OHIP‐14) tests were completed. Results OLP patients showed higher scores on HADS (anxiety p < 0.01, depression p < 0.05) and OHIP‐14 (physical pain p < 0.05, psychological discomfort p = 0.001). Patients with reticular lesions obtained higher scores in HADS (anxiety p = 0.001, depression p < 0.001), whereas patients with atrophic/ ulcerative lesions obtained higher scores in OHIP‐14 (p = 0.02). Conclusions Psychological disorders play an important role as a trigger for OLP and are responsible for many relapses. Psychological support would be advisable in order to improve their mental health, as this would have a positive impact on their quality of life and would lead to a better progression of the disease.

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Oral Acitretin Plus Topical Triamcinolone vs Topical Triamcinolone Monotherapy in Patients With Symptomatic Oral Lichen Planus

Vinay,

Kumar,

Dev

et al. 2024

JAMA Dermatol

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ImportanceSymptomatic oral lichen planus (OLP) can be challenging to treat.ObjectiveTo compare the efficacy of oral acitretin plus topical triamcinolone acetonide (TAC), 0.1%, with TAC monotherapy in patients with symptomatic OLP.Design, Setting, and ParticipantsThis monocentric, investigator-initiated, placebo-controlled, investigator- and patient-blinded randomized clinical trial was conducted from December 2018 to June 2020 at the Postgraduate Institute of Medical Education and Research, a tertiary referral center in Chandigarh, India. Sixty-four patients 18 years or older with symptomatic OLP were recruited by consecutive sampling. Data were analyzed from July to December 2020.InterventionThe patients were randomized to receive either a combination of oral acitretin (25-35 mg/d) and TAC (treatment group) or TAC in combination with placebo (placebo group) for 28 weeks, with an additional 8 weeks of treatment-free follow-up after the end of treatment (36 weeks of total study duration).Main Outcomes and MeasuresThe disease severity and treatment response were assessed using Oral Disease Severity Score (ODSS), Oral Health Impact Profile 14 (OHIP-14), and visual analog scale (VAS). The primary aim was to assess the number of patients achieving ODSS-75 (75% reduction in ODSS compared with baseline) in both groups at 28 weeks and at the end of 36 weeks.ResultsAmong 64 patients, 31 in the treatment group and 30 in the placebo group completed the study (mean [SD] age, 50.6 [15.2] years vs 49.2 [14.4] years; male-female ratio, 13:19 vs 16:16). Baseline ODSS, visual analog scale, and Oral Health Impact Profile 14 scores were comparable in both groups. In the intention-to-treat analysis, there was a statistically significant higher number of patients achieving 75% or higher reduction in ODSS in the treatment group compared with the placebo group at the end of 28 weeks (28 [88%] vs 15 [47%], a 41 [95% CI, 20-61] percentage point difference between groups; P &lt; .001; Cramér V = 0.47) and 36 weeks (27 [84%] vs 13 [41%], a 43 [95% CI, 23-67] percentage point difference between groups; P &lt; .001; Cramér V = 0.47). Relapses during the posttreatment follow-up of 8 weeks were low among patients in both treatment and placebo groups (1 [3%] vs 2 [6%], a 3 [95% CI, −13 to 7] percentage point difference between groups; P &gt; .99; Cramér V = 0.07).Conclusion and RelevanceIn this randomized clinical trial, the combination of oral acitretin and TAC was more effective than TAC monotherapy in patients with symptomatic OLP.Trial RegistrationClinical Trial Registry of India Identifier: CTRI/2018/11/016448

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Rate of malignant transformation of oral lichen planus: A systematic review

Cited by 196 publications

References 75 publications

Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Psychological disorders and quality of life in oral lichen planus patients and a control group

Oral Acitretin Plus Topical Triamcinolone vs Topical Triamcinolone Monotherapy in Patients With Symptomatic Oral Lichen Planus

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