Evaluation of the classification and clinical characteristics of oral lichen planus and its treatment effect in different clinical types: A retrospective study

Abstract

Purpose: Oral lichen planus (OLP) is an intractable chronic inflammatory disease associated with dyskeratosis. This study aimed to investigate the clinical features of OLP at the initial diagnosis and classified it using the clinical visual examination type classification. Furthermore, we evaluated whether the clinical characteristics and effectiveness of symptomatic treatment differ between the typical reticular type and other types of OLP. Methods: We evaluated the age, sex, chief complaints, clinical morphological forms, lesion sites, cytological and histopathological findings, therapeutic strategies, and therapeutic responsiveness of 132 patients with OLP. Results: Of 132 patients, there were 42 men and 90 women (mean age, 66.4 ± 13.0 years). The buccal mucosa was the most affected site (n = 95). The reticular form was the most common clinical morphological form (n = 124). Biopsy was performed in 48 patients. The erosive form was the most common among the biopsied lesions. Regarding therapeutic strategies, topical steroids were prescribed to 85 patients, 47 of whom experienced symptomatic relief and 38 showed no changes in symptoms. The rates of symptomatic relief following topical steroid use were 70.4% and 15.9% for the reticular and erosive forms, respectively. In patients with erosive and plaque-like forms, symptomatic relief with topical steroid use was difficult to achieve, whereas in those with other forms, a moderate response was observed. Conclusion: Topical steroids are often ineffective in patients with erosive or mixed forms, and these clinical morphological forms are associated with a higher risk of malignant transformation than the other forms. Therefore, early histological examination is important.

Keywords

• Oral lichen planus
• Clinical classification
• Oral potentially malignant disorders
• Oral mucosa