Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data

  1. Javier Alberdi Navarro 1
  2. Xabier Marichalar Mendia 1
  3. María José Lartitegui Sebastián 1
  4. María Luisa Gainza Cirauqui 2
  5. María Ángeles Echebarria Goicouria 1
  6. José Manuel Aguirre Urizar 1
  1. 1 Oral Medicine and Oral and Maxillofacial Pathology Units, Dental Clinic Service. Department of Stomatology II. UFI 11/25. University of the Basque Country/ EHU
  2. 2 Department of Dental Surgery, Faculty of Dental Surgery, University of Malta
Journal:
Medicina oral, patología oral y cirugía bucal. Ed. inglesa

ISSN: 1698-6946

Year of publication: 2017

Volume: 22

Issue: 3

Pages: 8

Type: Article

DOI: 10.4317/MEDORAL.21730 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Medicina oral, patología oral y cirugía bucal. Ed. inglesa

Abstract

The aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes. Retrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results. The 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from “plaque-like” lesions presented hyperkeratosis (p<0.001) and epithelial dysplasia (p=0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p=0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia. The histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied.

Bibliographic References

  • Aguirre-Urizar, JM. (2008). Letter to Editor: oral lichenoid disease. A new classification proposal. Med Oral Patol Oral Cir Bucal. 13. 224
  • van der Meij, EH, Mast, H, van der Waal, I. (2007). The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective five-year follow-up study of 192 patients. Oral Oncol. 43. 742
  • González-Moles, MA, Scully, C, Gil-Montoya, JA. (2008). Oral lichen planus: controversies surrounding malignant transformation. Oral Dis. 14. 229
  • Fitzpatrick, SG, Hirsch, SA, Gordon, SC. (2014). The malignant transformation of oral lichen planus and oral lichenoid lesions: a systematic review. J Am Dent Assoc. 145. 45-56
  • Khudhur, AS, Di Zenzo, G, Carrozzo, M. (2014). Oral lichenoid tissue reactions: diagnosis and classification. Expert Rev Mol Diagn. 14. 169
  • Cheng, YS, Gould, A, Kurago, Z, Fantasia, J, Muller, S. (2016). Diagnosis of oral lichen planus: a position paper of the American Academiy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 122. 332
  • van der Meij, EH, Schepman, KP, van der Waal, I. (2003). The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 96. 164
  • van der Meij, EH, van der Waal, I. (2003). Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently avariable diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 32. 502
  • Cortés-Ramírez, DA, Gainza-Cirauqui, ML, Echebarria-Goikouria, MA, Aguirre-Urizar, JM. (2009). Oral lichenoid disease as a premalignant condition: the controversies and the unknown. Med Oral Patol Oral Cir Bucal. 14. 118
  • Mravak-Stipetić, M, Lončar-Brzak, B, Bakale-Hodak, I, Sabol, I, Seiwerth, S, Majstorović, M. (2014). Clinicopathologic correlation of oral lichen planus and oral lichenoid lesions: a preliminary study. ScientificWorldJournal. 2014. 746874
  • Hiremath, S, Kale, AD, Hallikerimath, S. (2015). Clinico-pathological study to evaluate oral lichen planus form the establishment of clinica and histopathological diagnostic criteria. Turk Patoloji Derg. 31. 24
  • Rad, M, Hashemipoor, MA, Mojtahedi, A, Zarei, MR, Chamani, G, Kakoei, S. (2009). Correlation between clinical and histopathologic diagnoses of oral lichen planus based on modified WHO diagnostic criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107. 796-800
  • Ismail, SB, Kumar, SK, Zain, RB. (2007). Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci. 49. 89-106
  • Thornhill, MH, Sankar, V, Xu, XJ, Barrett, AW, High, AS, Odell, EW. (2006). The role of histopathological characteristics in distinguishing amalgam-associated oral lichenoid reactions and oral lichen planus. J Oral Pathol Med. 35. 233
  • Al-Hashimi, I, Schifter, M, Lockhart, PB, Wray, D, Brennan, M, Migliorati, CA. (2007). Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 103.
  • Sousa, FA, Rosa, LE. (2008). Oral lichen planus: clinical ad histopathological considerations. Braz J Otorhinolaryngol. 74. 284
  • van der Waal, I. (2009). Oral lichen planus and oral lichenoid lesions; a critical appraisal with emphasis on the diagnostic aspects. Med Oral Patol Oral Cir Bucal. 14. 310
  • Karatsaidis, A, Schreurs, O, Helgeland, K, Axéll, T, Schenck, K. (2003). Erythematous and reticular forms of oral lichen planus and oral lichenoid reactions differ in pathological features related to disease activity. J Oral Pathol Med. 32. 275
  • Fernández-González, F, Vázquez-Álvarez, R, Reboiras-López, D, Gándara-Vila, P, García-García, A, Gándara-Rey, JM. (2011). Histopathological findings in oral lichen planus and their correlation with the clinical manifestations. Med Oral Patol Oral Cir Bucal. 16. 641
  • Kaplan, I, Ventura-Sharabi, Y, Gal, G, Calderon, S, Anavi, Y. (2012). The dynamics of oral lichen planus: a retrospective clinicopathological study. Head Neck Pathol. 6. 178
  • García-García, V, Bascones-Martínez, A, Martinelli-Kläy, CP, Álvarez, Fernández, Lombardi, T, Küffer, R. (2012). New perspectives on the dynamics behavior of oral lichen planus. Eur J Dermatol. 22. 172
  • Bagan, J, Sarrion, G, Jimenez, Y. (2010). Oral cancer: clinical features. Oral Oncol. 46. 414
  • Ho, MW, Risk, JM, Woolgar, JA, Field, EA, Field, JK, Steele, JC. (2012). The clinical determinants of malignant transformation in oral epithelial dysplasia. Oral Oncol. 48. 969
  • Warnakulasuriya, S, Reibel, J, Bouquot, J, Dabelsteen, E. (2008). Oral epithelial dysplasia systems: predictive value, utility, weaknesses and scope for improvement. J Oral Pathol Med. 37. 127
  • Krutchkoff, DJ, Eisenberg, E. (1985). Lichenoid displasia: a distinct histopathologic entity. Oral Surg Oral Med Oral Pathol. 60. 308
  • Öhman, J, Magnusson, B, Telemo, E, Jontell, M, Hasséus, B. (2012). Langerhans cells and T cells sense cell dysplasia in oral leukoplakias and oral squamous cell carcinomas-evidence for immunosurveillance. Scand J Immunol. 76. 39-48
  • Óhman, J, Mowjood, R, Larsson, L, Kovacs, A, Magnusson, B, Kjeller, G. (2015). Presence of CD3-positive T-cells in oral premalignant leukoplakia indicates prevention of cancer transformation. Anticancer Res. 35. 311
  • Lopez, MA, Feio, P, Santos-Silva, AR, Vargas, PA. (2015). Proliferative verrucous leukoplakia may initially mimic lichenoid reactions. World J Clin Cases. 16. 861
  • Chainani-Wu, N, Purnell, DM, Silverman, S Jr. (2015). Oral leukplakia development in patients with pre-existing oral lichen planus. J Calif Dent Assoc. 43. 35
  • García-Pola, MJ, Llorente-Pendás, S, González-Garcia, M, García-Martín, JM. (2016). The development of proliferative verrucous leukoplakia in oral lichen planus. A preliminary study. Med Oral Patol Oral Cir Bucal. 21. 328