Research Article
BibTex RIS Cite

Clinical and demographic profile of oral lichen planus in Sri Lanka: a retrospective study

Year 2025, Volume: 59 Issue: 1, 1 - 6, 29.01.2025
https://doi.org/10.26650/eor.20241331423

Abstract

Purpose: Several relatively large series from developed countries have extensively described the demographic and clinical characteristics of oral lichen planus (OLP). However, such descriptions from developing countries are rare. This study aimed to investigate the differences in these aspects within a cohort of Sri Lankan patients affected by OLP.

Materials and Methods: Cases diagnosed with OLP between 1999 and 2019 were retrieved. Demographic data, clinical presentation, main complaints, age, sex, lesion sites, and histological information, were collected from the database. Cases with lichenoid reactions and incomplete data were excluded. Instances with multiple biopsies were treated as single cases. Frequencies were compared using chi-square statistics.

Results: The database identified a total of 3734 cases. The male-to-female ratio was 1:1.6, indicating an overall female predominance. The youngest patient reported was 1 year and 2 months old, presenting with brownish pigmentations on the right side of the buccal mucosa. The highest number of cases were observed in the 41-50 year age group, followed by the 51-60-year age group. The most common clinical type was the reticular type, followed by atrophic and erosive types. 200 patients presented with blackish pigmentations in the oral mucosa, experiencing a burning sensation without evidence of the typical reticular background. The plaque type was more common on the dorsal surface of the tongue, showing a statistically significant association (p<0.05). Ninety cases exhibited dysplastic changes ranging from mild to moderate degrees, accounting for 2.4% of the total sample.

Conclusion: While the malignancy rate is not significantly high enough to reduce morbidity and mortality from cancer arising on OLP lesions, regular follow-up and examinations are recommended for early diagnosis of malignant transformation.

Supporting Institution

None

Project Number

None

References

  • Andrea E, Reyes E, Kamal E. Oral Lichen Planus: A review of clinical features, etiologies, and treatments, Dentistry Review 2022; 22: 100007 [CrossRef] google scholar
  • Al-Hashimi I, Schifter M, Lockhart PB, Wray D, Brennan M, Migliorati CA, et al. Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103 Suppl: S25.e1-12. [CrossRef] google scholar
  • Li C, Tang X, Zheng X, Ge S, Wen H, Lin X, et al. Global Prevalence and Incidence Estimates of Oral Lichen Planus: A Systematic Review and Meta-analysis. JAMA Dermatol 2020; 156:172-81. [CrossRef] google scholar
  • Pritam KM, Jayanti GH, Mandakini SM, Jyoti DB. Clinical profile of 108 cases of oral lichen planus. J Oral Sci 2016; 58: 43-7. [CrossRef] google scholar
  • Fumihiko T, Jinkyo S, Atsushi U, Yu O, Toshimitsu O, Yumi M, et al. Malignant transformation of oral lichen planus: a retrospective study of 565 Japanese patients. BMC Oral Health 2021; 21 :298. [CrossRef] google scholar
  • Idrees M, Kujan O, Shearston K, Farah CS. Oral lichen planus has a very low malignant transformation rate: A systematic review and meta-analysis using strict diagnostic and inclusion criteria. J Oral Pathol Med 2021; 50: 287-98. [CrossRef] google scholar
  • Lauritano D, Arrica M, Lucchese A, Valente M, Pannone G, Lajolo C, et al. Oral lichen planus clinical characteristics in Italian patients: a retrospective analysis. Head Face Med 2016; 26: 18 [CrossRef] google scholar
  • Munde AD, Karle RR, Wankhede PK, Shaikh SS, Kulkurni M. Demographic and clinical profile of oral lichen planus: A retrospective study. Contemp Clin Dent 2013; 4: 181-5. [CrossRef] google scholar
  • Bermejo-Fenoll A, Sanchez-Siles M, Lopez-Jornet P, Camacho-Alonso F, Salazar-Sanchez N. A retrospective clinicopathological study of 550 patients with oral lichen planus in south-eastern Spain. J Oral Pathol Med 2010; 39: 491-6 [CrossRef] google scholar
  • Xue JL, Fan MW, Wang SZ, Chen XM, Li Y, Wang L. A clinical study of 674 patients with oral lichen planus in China. J Oral Pathol Med 2005; 34: 467-72. [CrossRef] google scholar
  • Gönül M, Gül U, Kaya I, Koçak O, Cakmak SK, Kılıç A, et al. Smoking, alcohol consumption and denture use in patients with oral mucosal lesions.J Dermatol Case Rep 2011; 5: 64-8. [CrossRef] google scholar
  • Ingafou M, Leao JC, Porter SR, Scully C. Oral lichen planus: A retrospective study of 690 British patients. Oral Dis 2006; 12: 463-8. [CrossRef] google scholar
  • Shikha, Gupta S, Mahajan A, Ambika, Garg R, Ghosh S. Childhood oral lichen planus: a case series with review of literature. Eur Arch Paediatr Dent 2022; 23: 341-53. [CrossRef] google scholar
  • Andreasen JO. Oral lichen planus. 1. A clinical evaluation of 115 cases. Oral Surg Oral Med Oral Pathol 1968; 25: 31-42. [CrossRef] google scholar
  • Gandolfo S, Richiardi L, Carrozzo M, Broccoletti R, Carbone M, Pagano M, et al. Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: A follow-up study in an Italian population. Oral Oncol. 2004;40:77-83. [CrossRef] google scholar
  • Carbone M, Arduino PG, Carrozzo M, Gandolfo S, Argiolas MR, Bertolusso G, et al. Course of oral lichen planus: A retrospective study of 808 northern Italian patients. Oral Dis 2009; 15: 235-43. [CrossRef] google scholar
  • Cawson RA and Odel EW. Essentials of Oral Pathology and Oral Medicine. 9th ed. Churchill Livingstone. Edinburgh. 2017 google scholar
  • Anjum R, Singh J, Kudva S. A Clinicohistopathologic Study and Probable Mechanism of Pigmentation in Oral Lichen Planus. World J Dent 2012; 3: 330-4. [CrossRef] google scholar
  • Chitturi RT, Sindhuja P, Parameswar RA, Nirmal RM, Reddy BV, Dineshshankar J, et al. A clinical study on oral lichen planus with special emphasis on hyperpigmentation. J Pharm Bioallied Sci 2015; 7: S495-8. [CrossRef] google scholar
  • Mergoni G, Ergun S, Vescovi P, Mete Ö, Tanyeri H, Meleti M. Oral postinflammatory pigmentation: an analysis of 7 cases. Med Oral Patol Oral Cir Bucal 2011; 16: e11-4. [CrossRef] google scholar
  • Gonzalez-Moles MA, Warnakulasuriya S, Gonzalez-Ruiz I, Ayen A, Gonzalez-Ruiz L, Ruiz-Avila I, et al. Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper. Med Oral Patol Oral Cir Bucal 2021; 26: e541-8. [CrossRef] google scholar
  • Medawela RMS, Ratnayake DRDL, Jayasooriya PR, Siriwardena BSMS, Tilakaratne WM, Jayasinghe RD. Malignant transformation of Oral Lichen Planus: The first two cases reported in Sri Lanka and literature review. SLDJ 2017; 47: 29-37. google scholar
Year 2025, Volume: 59 Issue: 1, 1 - 6, 29.01.2025
https://doi.org/10.26650/eor.20241331423

Abstract

Project Number

None

References

  • Andrea E, Reyes E, Kamal E. Oral Lichen Planus: A review of clinical features, etiologies, and treatments, Dentistry Review 2022; 22: 100007 [CrossRef] google scholar
  • Al-Hashimi I, Schifter M, Lockhart PB, Wray D, Brennan M, Migliorati CA, et al. Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103 Suppl: S25.e1-12. [CrossRef] google scholar
  • Li C, Tang X, Zheng X, Ge S, Wen H, Lin X, et al. Global Prevalence and Incidence Estimates of Oral Lichen Planus: A Systematic Review and Meta-analysis. JAMA Dermatol 2020; 156:172-81. [CrossRef] google scholar
  • Pritam KM, Jayanti GH, Mandakini SM, Jyoti DB. Clinical profile of 108 cases of oral lichen planus. J Oral Sci 2016; 58: 43-7. [CrossRef] google scholar
  • Fumihiko T, Jinkyo S, Atsushi U, Yu O, Toshimitsu O, Yumi M, et al. Malignant transformation of oral lichen planus: a retrospective study of 565 Japanese patients. BMC Oral Health 2021; 21 :298. [CrossRef] google scholar
  • Idrees M, Kujan O, Shearston K, Farah CS. Oral lichen planus has a very low malignant transformation rate: A systematic review and meta-analysis using strict diagnostic and inclusion criteria. J Oral Pathol Med 2021; 50: 287-98. [CrossRef] google scholar
  • Lauritano D, Arrica M, Lucchese A, Valente M, Pannone G, Lajolo C, et al. Oral lichen planus clinical characteristics in Italian patients: a retrospective analysis. Head Face Med 2016; 26: 18 [CrossRef] google scholar
  • Munde AD, Karle RR, Wankhede PK, Shaikh SS, Kulkurni M. Demographic and clinical profile of oral lichen planus: A retrospective study. Contemp Clin Dent 2013; 4: 181-5. [CrossRef] google scholar
  • Bermejo-Fenoll A, Sanchez-Siles M, Lopez-Jornet P, Camacho-Alonso F, Salazar-Sanchez N. A retrospective clinicopathological study of 550 patients with oral lichen planus in south-eastern Spain. J Oral Pathol Med 2010; 39: 491-6 [CrossRef] google scholar
  • Xue JL, Fan MW, Wang SZ, Chen XM, Li Y, Wang L. A clinical study of 674 patients with oral lichen planus in China. J Oral Pathol Med 2005; 34: 467-72. [CrossRef] google scholar
  • Gönül M, Gül U, Kaya I, Koçak O, Cakmak SK, Kılıç A, et al. Smoking, alcohol consumption and denture use in patients with oral mucosal lesions.J Dermatol Case Rep 2011; 5: 64-8. [CrossRef] google scholar
  • Ingafou M, Leao JC, Porter SR, Scully C. Oral lichen planus: A retrospective study of 690 British patients. Oral Dis 2006; 12: 463-8. [CrossRef] google scholar
  • Shikha, Gupta S, Mahajan A, Ambika, Garg R, Ghosh S. Childhood oral lichen planus: a case series with review of literature. Eur Arch Paediatr Dent 2022; 23: 341-53. [CrossRef] google scholar
  • Andreasen JO. Oral lichen planus. 1. A clinical evaluation of 115 cases. Oral Surg Oral Med Oral Pathol 1968; 25: 31-42. [CrossRef] google scholar
  • Gandolfo S, Richiardi L, Carrozzo M, Broccoletti R, Carbone M, Pagano M, et al. Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: A follow-up study in an Italian population. Oral Oncol. 2004;40:77-83. [CrossRef] google scholar
  • Carbone M, Arduino PG, Carrozzo M, Gandolfo S, Argiolas MR, Bertolusso G, et al. Course of oral lichen planus: A retrospective study of 808 northern Italian patients. Oral Dis 2009; 15: 235-43. [CrossRef] google scholar
  • Cawson RA and Odel EW. Essentials of Oral Pathology and Oral Medicine. 9th ed. Churchill Livingstone. Edinburgh. 2017 google scholar
  • Anjum R, Singh J, Kudva S. A Clinicohistopathologic Study and Probable Mechanism of Pigmentation in Oral Lichen Planus. World J Dent 2012; 3: 330-4. [CrossRef] google scholar
  • Chitturi RT, Sindhuja P, Parameswar RA, Nirmal RM, Reddy BV, Dineshshankar J, et al. A clinical study on oral lichen planus with special emphasis on hyperpigmentation. J Pharm Bioallied Sci 2015; 7: S495-8. [CrossRef] google scholar
  • Mergoni G, Ergun S, Vescovi P, Mete Ö, Tanyeri H, Meleti M. Oral postinflammatory pigmentation: an analysis of 7 cases. Med Oral Patol Oral Cir Bucal 2011; 16: e11-4. [CrossRef] google scholar
  • Gonzalez-Moles MA, Warnakulasuriya S, Gonzalez-Ruiz I, Ayen A, Gonzalez-Ruiz L, Ruiz-Avila I, et al. Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper. Med Oral Patol Oral Cir Bucal 2021; 26: e541-8. [CrossRef] google scholar
  • Medawela RMS, Ratnayake DRDL, Jayasooriya PR, Siriwardena BSMS, Tilakaratne WM, Jayasinghe RD. Malignant transformation of Oral Lichen Planus: The first two cases reported in Sri Lanka and literature review. SLDJ 2017; 47: 29-37. google scholar
There are 22 citations in total.

Details

Primary Language English
Subjects Dentistry (Other)
Journal Section Original Research Articles
Authors

Samadarani Siriwardena 0000-0002-5178-5026

Kalani Hettiarachchi 0000-0003-2618-5050

Ruwan Jayasinghe 0000-0002-8054-4301

Project Number None
Publication Date January 29, 2025
Submission Date July 23, 2023
Published in Issue Year 2025 Volume: 59 Issue: 1

Cite

EndNote Siriwardena S, Hettiarachchi K, Jayasinghe R (January 1, 2025) Clinical and demographic profile of oral lichen planus in Sri Lanka: a retrospective study. European Oral Research 59 1 1–6.