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Oral lichenoid dysplasia: a clinicopathologic analysis
J G Lovas1, B B Harsanyi, A K ElGeneidy
1Department of Oral Biology, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada.
Oral Surgery, Oral Medicine, and Oral Pathology
|July 1, 1989
Summary
Oral lichen planus (OLP) may mimic early epithelial dysplasia. Three women diagnosed with OLP developed carcinoma, suggesting OLP lesions can be dysplastic from onset.
Area of Science:
- Oral pathology
- Oncology
- Dermatology
Background:
- Oral lichen planus (OLP) is a chronic inflammatory condition affecting oral mucosa.
- Distinguishing OLP from early epithelial dysplasia can be challenging due to overlapping clinical and histological features.
Observation:
- Three women with OLP presented with persistent burning pain and large mucosal lesions.
- Lesion appearance varied unpredictably and showed poor response to topical corticosteroids.
- One patient was a smoker with recurrent candidiasis; one non-smoker was a denture wearer.
Findings:
- All three patients developed carcinoma within 32-63 months.
- Retrospective analysis revealed lichenoid dysplasia in two initial biopsies and lichenoid mucositis in one.
- Speckled erythroplakia indicated invasive carcinoma, while some dysplasias showed inflammatory responses and temporary regression.
Implications:
- Apparent malignant transformation of OLP may represent lesions that were dysplastic from the outset.
- Mucosal erythema with regression could be common to both OLP and early epithelial dysplasia.
- Clinical and histological mimicry necessitates careful evaluation to differentiate OLP from premalignant lesions.