RT Journal Article
T1 Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper
A1 González-Moles, Miguel Ángel
A1 Warnakulasuriya, Saman
A1 González-Ruiz, Isabel
A1 Ayén, Ángela
A1 González-Ruiz, Lucía
A1 Ruiz-Ávila, Isabel
A1 Ramos-García, Pablo
K1 Oral lichen planus
K1 Epithelial dysplasia
K1 Oral cancer
K1 Hyperplasia
K1 Biopsy
K1 Epithelium
K1 Liquen plano oral
K1 Amaurosis congénita de Leber
K1 Neoplasias de la boca
K1 Hiperplasia
K1 Biopsia
K1 Epitelio
AB BackgroundPatients with oral lichen planus (OLP) have an increased risk of oral cancer. For this reason, OLP is classified as an oral potentially malignant disorder. However, the precise personal (or individual) risk is unknown. Recent meta-analytical studies have reported that dysplastic OLP may transform to cancer in around 6% of cases, while the rate of transformation is lower (<1.5%) in non-dysplastic cases. The presence of epithelial dysplasia has emerged as the most powerful indicator for assessing cancer risk in oral potentially malignant disorders in routine practice. However, the general acceptance of epithelial dysplasia as an accompanying histologic feature in OLP is subject to great controversy. Many pathologists consider the presence of dysplasia as a criterion to exclude OLP when routinely reporting on this disease. This practice, widespread among oral pathology professionals, has resulted in the underestimation of the potential for malignancy of OLP.Material and MethodsA review of the literature was carried out in order to critically analyze the relevance, controversies and challenges encountered across the diagnosis of epithelial dysplasia in OLP.Results12 studies have been published examining dysplastic changes in OLP, reporting Figures ranging from 0.54% to 25% of cases with dysplasia in the first diagnostic biopsy. The diagnosis of dysplasia in the OLP poses an additional difficulty due to the fact that the affected oral epithelium per se develops changes related to autoimmune aggression. Among the most frequent histological features of OLP that develops dysplasia are basal cell hyperplasia with basaloid appearance, loss of basal cells polarity, cellular and nuclear pleomorphism and irregular stratification.ConclusionsEpithelial dysplasia should not be considered an exclusion criterion for OLP; its evaluation requires experienced pathologists in this field.
PB Medicina Oral SL
SN 1698-4447
YR 2021
FD 2021-07-01
LK http://hdl.handle.net/10668/4468
UL http://hdl.handle.net/10668/4468
LA en
NO González-Moles MÁ, Warnakulasuriya S, González-Ruiz I, Ayén Á, González-Ruiz L, Ruiz-Ávila I, et al. Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper. Med Oral Patol Oral Cir Bucal. 2021 Jul 1;26(4):e541-e548
DS RISalud
RD Apr 10, 2025