The natural history of oral mucosal lesions with both lichenoid and epithelial dysplastic features: a systematic review

Abstract

Background Assessing the natural history of oral mucosal lesions with both lichenoid and epithelial dysplastic features through a systematic review of published literature. Methods Scopus, PubMed, and Web of Science were searched for oral mucosal lesions showing both lichenoid and epithelial dysplastic features from original studies using the keywords “oral lichenoid dysplasia; oral epithelial dysplasia (OED) with lichenoid features; oral lichen planus (OLP) with dysplastic features; oral lichenoid lesions (OLL) with dysplastic features”. Results The search yielded 152 articles (PubMed-84, Scopus-32, Web of Science-36). Among these only 5 studies complied with the selection criteria including the provision of sufficient clinical and histopathological data. Out of these 5 studies, 181 cases were described to exhibit both lichenoid and epithelial dysplastic features. The most common diagnostic criterion employed was of van der Meij et al. Although some studies accepted the presence of epithelial dysplasia in OLL, most rejected the notion of epithelial dysplasia in OLP and designated such lesions as an OLL or oral lichenoid dysplasia. The few studies which accepted the presence of epithelial dysplasia in OLP rendered a diagnosis of OLP with dysplasia. Conclusions The review shows that several diagnoses were used for lesions with similar clinicopathological features and distinct clinicopathological entities were designated similar diagnosis. These diagnostic variations are the primary cause for the discrepancies in the prevalence and malignant transformation rates of these enigmatic entities which in turn often leads to erroneous treatment.

Lichenoid dysplasia- report of 2 cases and review of literature

“…Presence of atypical cells with basal cell degeneration implies OLP/OLL with secondary dysplasia. [ 5 ] No evidence of basal cell degeneration was reported in our case series.…”

“…Literature suggests that the inflammatory response in LD is non-specific, non-diagnostic and secondary to epithelial dysplasia. [ 5 ]…”

“…Although OLP and OLL can have any one of the above patterns, presence of some amount of reticular striations is a mandate for their clinical diagnosis. [ 4 5 ] Zimbrao et al stressed on clinic-histopathological algorithm for proper diagnosis of these lesions. [ 6 ]…”

Preface to the series on oral pre-cancer and cancer

“…The WHO has provided clear definitions for the majority of OPMDs along with their etiopathogenesis and diagnostic criteria. Despite these clear delineations, there are few entities such as the oral lichenoid dysplasia (OLD), whose natural history remains to be elusive ( 9 ). By definition, OLD is a primary epithelial dysplasia with secondary lichenoid (stromal inflammatory) features.…”

“…The series on oral pre-cancer and cancer included articles analyzing the etiopathogenesis, the tumor micro-environment, diagnostic markers, and therapeutic innovations for oral cancer ( 1 - 4 , 7 , 8 , 10 ). The natural history of enigmatic entities such as oral lichenoid dysplasia has been explored in-depth ( 9 ). Also, the series includes articles assessing the quality of life of oral cancer patients both during anti-cancer treatment and during prosthetic rehabilitation ( 5 , 6 ).…”