Oral lichen planus: a retrospective study of 690 British patients

OBJECTIVE: This is the largest UK patient group with oral lichen planus (OLP) to be studied in terms of the demographic and clinical characteristics. MATERIALS AND METHODS: Data were taken from the medical records of 690 consecutive patients referred to Oral Medicine subsequently found to have clinical, and usually histopathological confirmatory features of OLP. Over two-thirds (68.7%) of the patients were Caucasians. RESULTS: Eighty-two per cent of the patients had been referred to a specialist Oral Medicine service by general dental practitioners, 62% of the patients being referred as a consequence of oral mucosal and/or gingival pain. Reticular OLP was the most common intra-oral presentation, but 60% of such lesions were accompanied by other clinical types of OLP. 95% of lesions were bilateral. About 13% of patients reported symptoms or signs, or had a known history of lichen planus or possible lichen planus affecting non-oral epithelia. In only 13% of patients did all signs and symptoms of OLP resolve within 12-246 months (median 35 months). A malignant transformation rate of 1.9% was observed in the present group. CONCLUSIONS: Oral lichen planus in UK persons almost always gives rise to bilateral reticular OLP, rarely resolves spontaneously, and has a low rate of malignant transformation.