Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Kate Shearston, Behrooz Fateh, Shixiong Tai, Dzikamai Hove, Camile S. Farah

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: Oral potentially malignant disorders (OPMD) include a variety of mucosal lesions such as oral lichen planus (OLP), oral lichenoid lesions (OLL) and oral lichenoid dysplasia (OLD). Their rate of malignant transformation ranges from 0% to 34% and is dependent on OPMD type, lesion site and a range of risk factors. This study seeks to determine the proportion of oral lichenoid conditions that transform into oral squamous cell carcinoma (OSCC) in an Australian population. Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLP, OLL or OLD using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation determined. Results: OLP and OLL patients displayed a low risk of malignant transformation; 0.49% (1/206) for OLP and 0% (0/31) for OLL. In contrast, OLD patients, all of whom presented clinically as OLP, were at much higher risk with 6.81% (3/44) developing OSCC over an average time of 4.6 years (±2.4 SD). Rates of smoking and alcohol consumption were no higher in OLD patients compared to others. Conclusions: Compared with other oral lichenoid conditions, OLD lesions are at a particularly high risk of malignant transformation and should be managed based on the presence of dysplasia and not the lichenoid inflammatory infiltrate. OLP demonstrates a relatively low rate of malignant transformation. Diagnostic histopathology is important for discriminating OLP from OLD.

Original languageEnglish
JournalJournal Of Oral Pathology and Medicine
DOIs
Publication statusE-pub ahead of print - 7 Jun 2019

Fingerprint

Oral Lichen Planus
Squamous Cell Carcinoma
Oral Medicine
Alcohol Drinking
Registries
Smoking

Cite this

@article{7e6b257a9a1f4901b9cae012e99d049d,
title = "Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates",
abstract = "Objectives: Oral potentially malignant disorders (OPMD) include a variety of mucosal lesions such as oral lichen planus (OLP), oral lichenoid lesions (OLL) and oral lichenoid dysplasia (OLD). Their rate of malignant transformation ranges from 0{\%} to 34{\%} and is dependent on OPMD type, lesion site and a range of risk factors. This study seeks to determine the proportion of oral lichenoid conditions that transform into oral squamous cell carcinoma (OSCC) in an Australian population. Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLP, OLL or OLD using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation determined. Results: OLP and OLL patients displayed a low risk of malignant transformation; 0.49{\%} (1/206) for OLP and 0{\%} (0/31) for OLL. In contrast, OLD patients, all of whom presented clinically as OLP, were at much higher risk with 6.81{\%} (3/44) developing OSCC over an average time of 4.6 years (±2.4 SD). Rates of smoking and alcohol consumption were no higher in OLD patients compared to others. Conclusions: Compared with other oral lichenoid conditions, OLD lesions are at a particularly high risk of malignant transformation and should be managed based on the presence of dysplasia and not the lichenoid inflammatory infiltrate. OLP demonstrates a relatively low rate of malignant transformation. Diagnostic histopathology is important for discriminating OLP from OLD.",
keywords = "Australia, malignant transformation, oral lichen planus, oral lichenoid dysplasia, oral lichenoid lesion, oral squamous cell carcinoma",
author = "Kate Shearston and Behrooz Fateh and Shixiong Tai and Dzikamai Hove and Farah, {Camile S.}",
year = "2019",
month = "6",
day = "7",
doi = "10.1111/jop.12904",
language = "English",
journal = "Journal of Oral Pathology & Medicine",
issn = "0904-2512",
publisher = "Wiley-Blackwell",

}

Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates. / Shearston, Kate; Fateh, Behrooz; Tai, Shixiong; Hove, Dzikamai; Farah, Camile S.

In: Journal Of Oral Pathology and Medicine, 07.06.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

AU - Shearston, Kate

AU - Fateh, Behrooz

AU - Tai, Shixiong

AU - Hove, Dzikamai

AU - Farah, Camile S.

PY - 2019/6/7

Y1 - 2019/6/7

N2 - Objectives: Oral potentially malignant disorders (OPMD) include a variety of mucosal lesions such as oral lichen planus (OLP), oral lichenoid lesions (OLL) and oral lichenoid dysplasia (OLD). Their rate of malignant transformation ranges from 0% to 34% and is dependent on OPMD type, lesion site and a range of risk factors. This study seeks to determine the proportion of oral lichenoid conditions that transform into oral squamous cell carcinoma (OSCC) in an Australian population. Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLP, OLL or OLD using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation determined. Results: OLP and OLL patients displayed a low risk of malignant transformation; 0.49% (1/206) for OLP and 0% (0/31) for OLL. In contrast, OLD patients, all of whom presented clinically as OLP, were at much higher risk with 6.81% (3/44) developing OSCC over an average time of 4.6 years (±2.4 SD). Rates of smoking and alcohol consumption were no higher in OLD patients compared to others. Conclusions: Compared with other oral lichenoid conditions, OLD lesions are at a particularly high risk of malignant transformation and should be managed based on the presence of dysplasia and not the lichenoid inflammatory infiltrate. OLP demonstrates a relatively low rate of malignant transformation. Diagnostic histopathology is important for discriminating OLP from OLD.

AB - Objectives: Oral potentially malignant disorders (OPMD) include a variety of mucosal lesions such as oral lichen planus (OLP), oral lichenoid lesions (OLL) and oral lichenoid dysplasia (OLD). Their rate of malignant transformation ranges from 0% to 34% and is dependent on OPMD type, lesion site and a range of risk factors. This study seeks to determine the proportion of oral lichenoid conditions that transform into oral squamous cell carcinoma (OSCC) in an Australian population. Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLP, OLL or OLD using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation determined. Results: OLP and OLL patients displayed a low risk of malignant transformation; 0.49% (1/206) for OLP and 0% (0/31) for OLL. In contrast, OLD patients, all of whom presented clinically as OLP, were at much higher risk with 6.81% (3/44) developing OSCC over an average time of 4.6 years (±2.4 SD). Rates of smoking and alcohol consumption were no higher in OLD patients compared to others. Conclusions: Compared with other oral lichenoid conditions, OLD lesions are at a particularly high risk of malignant transformation and should be managed based on the presence of dysplasia and not the lichenoid inflammatory infiltrate. OLP demonstrates a relatively low rate of malignant transformation. Diagnostic histopathology is important for discriminating OLP from OLD.

KW - Australia

KW - malignant transformation

KW - oral lichen planus

KW - oral lichenoid dysplasia

KW - oral lichenoid lesion

KW - oral squamous cell carcinoma

UR - http://www.scopus.com/inward/record.url?scp=85067896550&partnerID=8YFLogxK

U2 - 10.1111/jop.12904

DO - 10.1111/jop.12904

M3 - Article

JO - Journal of Oral Pathology & Medicine

JF - Journal of Oral Pathology & Medicine

SN - 0904-2512

ER -