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ORAL LICHEN PLANUS AND MALIGNANT TRANSFORMATION: IS A RECALL OF PATIENTS JUSTIFIED?

¹ Clinic of Oral and Maxillofacial Surgery and Hospital Dental Care, Central Hospital, Karlstad; ² Clinic of Oral Medicine, Faculty of Odontology, Göteborg University, Sweden; and ³ Department of Periodontology, School of Dentistry, University of Copenhagen, Denmark;

* corresponding author, ph{at}odont.ku.dk

CONTROVERSY Lichen planus is a dermatological disorder that can have oral manifestations prior to skin involvement. The pre-malignant potential of oral lichen planus has been a controversial issue for the past several decades. Some of the controversy can be attributed to the fact that several studies have focused on the development of oral cancer in cohorts of patients with oral lichen planus diagnosed on the basis of different criteria and followed for various periods of time. This article by Mattsson, Jontell, and Holmstrup is a critical evaluation of the pre-malignant potential of oral lichen planus and its consequences for the clinical management of this disorder. –Olav Alvares, Editor

 

There has been a continuous debate regarding the possible malignant potential of oral lichen planus (OLP). Based on the results from follow-up studies, OLP is regarded by several authors as a pre-malignant condition, and patients with OLP have been recommended to have their lesions monitored two to four times annually. This recommendation needs reconsideration, because a recall system of all patients with OLP requires substantial economic resources. In a reality where such resources are limited, a recall system must be weighed against other benefits and the fact that the malignant potential of OLP is most likely very low. The present review focuses on the diagnostic criteria for OLP, the pre-malignant potential of OLP, and the extent to which the available information can be used to reduce morbidity and mortality of oral cancer related to OLP.

Key words. Oral cancer, lichenoid dysplasia, diagnostic criteria, prognosis, oral mucosa, lichen planus, prevention