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RESEARCH PRODUCT

Oral lichen planus – retrospective study of 563 Croatian patients

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Objectives were to evaluate sociodemographic and clinical data of oral lichen planus (OLP) patients attending our Department from 2006.-2012. Retrospective chart review was performed. Data regarding age, gender, medical history, drugs, smoking, alcohol, chief complaint, clinical type, localization, histology, treatment and malignant transformation were registered for 563 patients. Majority of patients were female (414 ; 73.5%) and median age was 58 (range 11-94). Majority of patients did not smoke (408 ; 72.5%) and did not consume alcohol (392 ; 69.6%). Chief complaint was oral soreness (242 ; 43.3%) followed by mucosal roughness (39 ; 7%), xerostomia (17 ; 3%), gingival bleeding (11 ; 2%) and altered taste (3 ; 0.5%). Nearly half of the patients were symptom-free (247 ; 44.2%). Reticular type of OLP was most common (365 ; 64.8%) followed by erosive (129 ; 22.9%), plaque-like (32 ; 5.7%) atrophic/erythemtous (24 ; 4.3%) and bullous (13 ; 2.3%). Buccal mucosa was most commonly affected site (82.4%) followed by gingiva (19.7%) and tongue (16.3%). Biopsy was performed in 214 (38%) patients. In 156 patients (73.9%) histological diagnosis was consistent with OLP. Other histological diagnoses were non-specific chronic inflammation (43 ; 20%), lichenoid reaction (10 ; 4.1%) and leukoplakia (5 ; 2%). Treatment was not necessary in 210(39.8%) patients. Topical steroids were used in 271(43.1%) patients, intralesional corticosteroids in 30(5.7%) patients and systemic steroids in 5(0.9%) patients. Malignant transformation occurred in 4 (0.7%) female patients (2 with erosive OLP, one with atrophic and one with plaque-like OLP). One patient was smoker, one was non-smoker and two were ex- smokers. Conclusions: OLP is chronic mucosal disease affecting mainly non-smoking middle-aged women. OLP mostly affects buccal mucosa but all oral regions can be affected. Lesions are symptom- free in nearly half of the cases. Women with erosive/atrophic form of OLP are at greater risk for malignant transformation. Due to low but present risk of malignant transformation all patients with OLP should be regularly followed.