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      Malignización del liquen plano oral (LPO) Translated title: Malignization of oral lichen planus (OLP)

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          Abstract

          El carácter maligno del Liquen Plano Oral (LPO) ha sido discutido por diversos autores desde hace unas décadas. La determinación del potencial de malignización puede ser afectada por las dificultades que se presentan en el diagnóstico clínico e histopatológico de estas lesiones. Por este motivo, el objetivo de esta revisión sistemática es evaluar la evidencia disponible en relación a la transformación maligna del LPO, determinando su incidencia y prevalencia y los tipos de lesiones de LPO asociados. La búsqueda principal se realizó en la base de datos PubMed; y como complemento, se hizo una búsqueda manual. Se obtuvo un total de 3.221 artículos, que tras aplicar los criterios de inclusión y exclusión, se seleccionaron 19. Los resultados demostraron una incidencia de malignización <1% en la mayoría de casos y los subtipos de LPO que predominaron fueron atrófico/erosivo. Sin embargo, estudios prospectivos siguen siendo necesarios para confirmar estos resultados.

          Translated abstract

          The malignant nature of Oral Lichen Planus (OLP) has been discussed by various authors a few decades ago. The determination of the malignant potential may be affected by the difficulties encountered in the clinical and pathological diagnosis of these lesions. Therefore, the aim of this review is to evaluate the available evidence regarding its malignant transformation, determining the incidence, prevalence, and types of injuries associated OLP. The main search was performed in PubMed´s database, and to support this, a manual search was also done. A total of 3,221 articles were obtained, and 19 met the inclusion criteria. The results showed an incidence of malignancy <1% in most of the cases, and the predominant subtypes in malignant transformation of the lesions were of atrophic/erosive nature. Nonetheless, prospective studies are still needed to confirm these results.

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          Most cited references39

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          Nomenclature and classification of potentially malignant disorders of the oral mucosa.

          At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Precancer in the UK issues related to terminology, definitions and classification of oral precancer were discussed by an expert group. The consensus views of the Working Group are presented here. The term, 'potentially malignant disorders', was recommended to refer to precancer as it conveys that not all disorders described under this term may transform into cancer. Critically evaluating all definitions proposed so far for oral leukoplakia, the Working Group agreed that the term leukoplakia should be used to recognize 'white plaques of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer'. An outline was proposed for diagnosing oral leukoplakia that will prevent other oral white disorders being misclassified as leukoplakia. The Working Group discussed the caveats involved in the current use of terminology and classification of oral potentially malignant disorders, deficiencies of these complex systems, and how they have evolved over the past several decades. The terminology presented in this report reflects our best understanding of multi-step carcinogenesis in the oral mucosa, and aspires to engender consistency in use.
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            Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: facts and controversies.

            Lichen planus (LP) is an inflammatory disease of the stratified squamous epithelia of unknown etiology. LP affects most frequently the oral mucosa, but it may also involve other mucosa and the skin. Oral LP (OLP) most frequently affects woman aged between 30 and 60 years. Histopathologic examination typically shows orthokeratotic hyperkeratosis, basal cell degeneration, and a dense well-defined infiltrate of lymphocytes in the superficial dermis. OLP lesions may result from the induction of keratinocytes apoptosis by cytotoxic CD8+ T cells stimulated by a yet unidentified self-antigen on a genetically predisposed patient. The association of OLP with hepatitis C virus (HCV) has been more consistently demonstrated in the Mediterranean area. Although HCV RNA and HCV-specific CD4+ and CD8+ T cells have been retrieved in the mucosal lesions of patients with chronic HCV infection and OLP, the eventual pathophysiology of HCV in OLP lesions remains unclear. Available treatments of OLP are not curative, and many have potentially prominent side effects. The objectives of OLP management should be to prevent and screen for malignant transformation and alleviate symptoms on the long-term. Avoidance of potential precipitating drugs, tobacco, alcohol, and local trauma, as well as strict oral hygiene, is essential. The first-line pharmacologic treatment relies on topical steroids. Systemic steroids should be limited to the short-term cure of severe refractory OLP. Life-long clinical follow-up, at least annually, is fundamental. Copyright 2010 Elsevier Inc. All rights reserved.
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              Oral lichen planus. 1. A clinical evaluation of 115 cases.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                odonto
                Avances en Odontoestomatología
                Av Odontoestomatol
                Ediciones Avances, S.L. (Madrid, Madrid, Spain )
                0213-1285
                2340-3152
                October 2015
                : 31
                : 5
                : 323-329
                Affiliations
                [01] orgnameUniversidad Complutense de Madrid
                Article
                S0213-12852015000500005
                10.4321/S0213-12852015000500005
                e11c60c2-11d0-4d00-8c1d-2d61ff85f150

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 22 October 2014
                : 18 January 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 7
                Product

                SciELO Spain


                Liquen plano oral,malignización,premalignización,Oral Lichen Planus,malignant,premalignant

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