Assessment of compatibility of clinical diagnosis with histopathological diagnosis of oral lichen planus

Oral Lichen Planus (OLP) is a chronic inflammatory disease of the stratified squamous epithelia of unknown etiology. The lesion can appear as a combination of clinical subtypes. As there is a controversy about the necessity of taking biopsy in the various types of OLP، the assessment of compatibility of clinical diagnosis with histopathological diagnosis and also the necessity of biopsy could be a guide to this matter. In this cross-sectional descriptive study، the files of 162 patients with clinical diagnosis of OLP from Oral Medicine Department of Dental Faculty of Tehran University of Medical Sciences (2002 to 2008) were reviewed. These files were categorized based on the results of histopathological diagnosis: 1. OLP، 2. Oral Lichenoid Lesion (OLL)، and 3. Other lesions (nonspecific keratosis، SCC …). From the total of 162 subjects، 25 were with only clinically keratotic type and 137 were with other clinical types (atrophic، erosive …). The mean age of patients was 48. 85± 13. 69 (19 to 77 years). Also 60. 5 percent of cases were women and 39. 5 percent men. The histopathological diagnosis was OLP in 123 patients، OLL in 11 patients، and other lesions in 28 patients. Ten patients from 123 with diagnosis of OLP revealed dysplastic changes. Regarding to the sufficiency of clinical diagnostic criteria، especially about the keratotic type of OLP that has little or no chance of dysplastic transformation، it seems that taking biopsy is not mandatory، while atrophic or/and erosive forms are suggested to be biopsied because of potential of malignant transformation.