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Keywords:
Malignant transformation, oral lichen planus, oral squamous cell carcinoma, potentially malignant condition
Abstract
One of the most common encountered cancers in India is oral cancer comprising for nearly 30% of all cancer and among these cases, oral squamous cell carcinoma accounts for a vital portion. It seems important to screen and recall patients with any potentially malignant lesions/conditions to detect dysplastic changes in early stage. This article attempts to briefly review the current literature for malignant potential of oral lichen planus.
Introduction
In 1869, Erasmus Wilson introduced the term lichen planus to write down a condition that had been formerly called leichen ruber Hebra. The word lichen is obtained from Greek term "leichen" meaning "treemoss." The term planus is derived from Latin which means smooth, level or even.[1]
Lichen planus is a chronic inflammatory mucocutaneous condition with no definite etiology. It usually involves the oral cavity and sometimes skin with characteristic clinical and histopathologic features though not completely diagnostic.® It is said to be a T-cell-mediated autoimmune disease with triggering of oral epithelial cell apoptosis by autocytotoxic CD8+ T-cell. It affects 0.5-1.9% of population.®4
Oral lichen planus (OLP) commonly involves individuals of middle to old aged. It occurs more commonly in women than men with ratio of 3:1.® These lesions are typically seen with episodes of remission and exacerbation and may even persist for many years. However, complete remission is rare.®4 The lesion commonly occurs on the buccal mucosa. Sometimes, it can also involve other sites like gingiva and dorsal surface and/ lateral borders of the tongue.® Traditionally, these lesions tend to occur bilaterally and even symmetrical.
A classic presentation of white interweaving thin long lace like lesions (Wickham's striae) giving a spider web like reticular pattern usually confirms the clinical diagnosis of OLP. The surrounding mucosa can be erythematous and/ulcerative with white lines but sometimes with associated blisters. Patients may sometimes have a metallic taste. However, it may be often difficult to diagnose cases with asymmetric (atypical) lesions especially in oral cancer-prone areas like the floor of mouth, lateral or ventral surface of the tongue, retromolar areas and soft palate.®4
OLP can present in six different forms clinically. They are reticular, papular, plaque-like, ulcerative, erosive and bullous forms among which the reticular...