Oral lichen planus and epithelial dysplasia
Keywords:
oral lichen planus, epithelial dysplasia, pre-malignant character.Abstract
Introduction: oral lichen planus is an inflammatory, chronic and recurrent disease which is considered an abnormal T- cell mediated immune response. One of the most important aspects is its possible pre-malignant character and the role of epithelial dysplasia.
Objective: to describe cellular disorders characteristic of dysplasia in lesions in the oral lichen planus and their relation with clinical forms and other histopathological variables
Method: the universe was composed of the registration of 14 977 patients who underwent an anatomopathological study in the Department of Pathology of the Faculty of Stomatology of Havana during the period 1970-2008, from which a sample composed of 115 patients with histopathological diagnosis of oral lichen planus was taken. The records of biopsies were reviewed, taking those requests with enough clinical data in which the presence of bilateral lesions were recorded or, in its absence, more than one lesion spread through one or more than one anatomic region. The clinical variables were: reticular, atrophic, erosive and hypertrophic types of lichen planus, and the histopathological variables were: type of keratinization, epithelial thickness, presence of epithelial dysplasia. Microscope observation of the lamina obtained from the records was performed. Photomicrographs were obtained. For qualitative variables, absolute frequency and percentages were calculated. For analytical statistics, the Chi-square test was used, applying, if needed, the Yates´ correction or Fisher's exact test.
Results: signs of mild epithelial dysplasia were found in 25 cases (21.73 %) of which a total of 17 cases (14.78 %) corresponded to a reticular type, and 8 cases (6.95 %) to the erosive type. A significant association between the clinical type and epithelial dysplasia was observed, finding that the 42.1 % of the erosive type cases presented this alteration, regarding the 17.7 % of the reticular type cases.
Conclusions: the presence of mild dysplasia is a possible finding in the oral lichen planus, which is more frequent in the erosive type and, until proven otherwise, the oral lichen planus should have a short-term, medium-term and long-term follow-up.
Key words: oral lichen planus, epithelial dysplasia, pre-malignant character.
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