A study on risk factors affecting the course of oral lichen planus

Keywords: Oral lichen planus, epithelial dysplasia, chronic persistent irritation        
The non reticular forms of oral lichen planus (OLP) are currently considered potentially malignant lesions of the oral mucosa. Dysplasia is a structural and cytologic alteration of the epithelium, and is often an indication of malignant transformation. To our knowledge there are no reports in the literature evaluating the risk factors for dysplastic transformation of non-reticular lichen planus. The aim of the present work was to evaluate risk factors, including tobacco (To) and alcohol (Al) use and chronic traumatic irritation (CTI), for dysplastic transformation of non-reticular lichen planus lesions. Materials and methods: A total 29 cases with clinical and histopathological diagnosis of OLP were studied; 51.7% (15) presenting histopathological evidence of varying degrees of epithelial dysplasia were considered study cases and 48.3% (14) presenting no degree of dysplasia served as control. The relative risk (RR) of the presence of To, Al, and CTI was calculated. Results: Tobacco use was found in 41% of lichen planus cases and in 21% of cases showing dysplasia; RR= 0.18. Alcohol use was detected in 24% of OLP and 17% of dysplasia cases; RR= 0.63. CTI was present in 37% of OLP and 38% of dysplasia cases; RR = 1.3. Conclusions: The results obtained herein show the importance of considering chronic, persistent irritation as a risk factor that dentists must take into account in patients with oral lichen planus. Grant: UBACyT O013