Oral lichen planus: a retrospective study of 690 British patients

This is the largest UK patient group with oral lichen planus (OLP) to be studied in terms of the demographic and clinical characteristics.

Data were taken from the medical records of 690 consecutive patients referred to Oral Medicine subsequently found to have clinical, and usually histopathological confirmatory features of OLP. Over two-thirds (68.7%) of the patients were Caucasians.

Eighty-two per cent of the patients had been referred to a specialist Oral Medicine service by general dental practitioners, 62% of the patients being referred as a consequence of oral mucosal and/or gingival pain. Reticular OLP was the most common intra-oral presentation, but 60% of such lesions were accompanied by other clinical types of OLP. 95% of lesions were bilateral. About 13% of patients reported symptoms or signs, or had a known history of lichen planus or possible lichen planus affecting non-oral epithelia. In only 13% of patients did all signs and symptoms of OLP resolve within 12-246 months (median 35 months). A malignant transformation rate of 1.9% was observed in the present group.

Oral lichen planus in UK persons almost always gives rise to bilateral reticular OLP, rarely resolves spontaneously, and has a low rate of malignant transformation.