Understanding Oral Lichen Planus and Its Malignant Potential in the Saudi Arabian Population: A Systematic Review

Oral lichen planus (OLP) is a chronic inflammatory disorder recognised as a potentially malignant disorder of the oral cavity. This review aimed to synthesize available evidence from Saudi Arabia regarding OLP prevalence, clinical presentation, associated factors, and risk of malignant transformation.

A systematic search was conducted across several electronic databases (e.g., PubMed, Scopus, Saudi Digital Library) up to February 2024. Eligible studies were original clinical investigations on OLP in Saudi Arabia, reporting at least one of the following: prevalence, clinical presentation, treatment, or malignant transformation. Study quality was appraised using the Joanna Briggs Institute (JBI) checklists.

Eleven studies - eight cross-sectional and three case-control - met the inclusion criteria. Reported prevalence of OLP across Saudi Arabian populations ranged from 0.35% to 11.08%. Clinical forms most often included the reticular variant, followed by erythematous and erosive forms. Topical corticosteroids were the most frequently applied treatment. Reported associations included diabetes mellitus, hypertension, thyroid disease, and hepatitis C virus infection. Histopathological confirmation was not consistently applied across studies. Dysplastic changes were noted in up to 12% of cases, while malignant transformation rates ranged from 0.2% to 5.6%.

Prevalence estimates of OLP in Saudi Arabia are highly variable, reflecting methodological and diagnostic inconsistencies. There is a possible relationship with systemic comorbidities, particularly hepatitis C infection. Multi-center, prospective studies with standardized diagnostic and follow-up protocols are needed to accurately determine epidemiology and malignant potential.