Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2021) – 132.50
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CiteScore (2021) – 2.0
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Average rejection rate (2022) – 79.69%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2017, vol. 54, nr 2, April-June, p. 205–208

doi: 10.17219/dmp/70528

Publication type: clinical case

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Squamous cell carcinoma arising in plaque-like oral lichen planus: A case report

Powstanie raka płaskonabłonkowego w przebiegu płytkopodobnej postaci liszaja płaskiego w jamie ustnej – opis przypadku

Chanwit Prapinjumrune1,A,B,C,D,E,F, Risa Chaisuparat2,D,E,F, Thongprasom Kobkan1,A,B,C,D,E,F

1 Oral Medicine Department, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand

2 Oral Pathology Department, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand


Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa that commonly occurs in middle-aged or elderly women. In this paper, we describe a case of a 64-year-old woman who presented with red and white lesions in the oral cavity. Intraoral examination revealed a white plaque and white lines with a mild erythematous area on the right buccal mucosa, however, the left buccal mucosa showed only white striae and a mild erythematous area. Biopsy specimens taken twice from the right buccal mucosa demonstrated OLP characteristics. After 7-years of follow-up, an irregularly shaped ulcer was observed on the plaque lesion of the right buccal mucosa. A biopsy was performed again and the final diagnosis of superficially invasive squamous cell carcinoma was made. OLP is classified as a potentially malignant disorder (PMD) of the oral mucosa. Histopathological examination is mandatory to confirm the diagnosis and to exclude dysplasia and malignancy. Due to the malignant potential of OLP, long-term follow-up is strongly recommended, particularly in elderly patients with plaque-like OLP.

Key words

the elderly, lichen planus, squamous cell carcinoma, potentially malignant disorders

Słowa kluczowe

osoby starsze, liszaj płaski, rak płaskonabłonkowy, zmiany przednowotworowe

References (20)

  1. Farhi D, Dupin N. Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: Facts and controversies. Clin Dermatol. 2010;28,100–108.
  2. Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: Report of an international consensus meeting. Part 1. Viral infections and etiopathogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:40–51.
  3. Thornhill MH. Immune mechanisms in oral lichen planus. Acta Odontol Scand. 2001;59:174–177.
  4. McCartan BE, Healy CM. The reported prevalence of oral lichen planus: A review and critique. J Oral Pathol Med. 2008;37:447–453.
  5. Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36:575–580.
  6. Gonzalez-Moles MA, Scully C, Gil-Montoya JA. Oral lichen planus: Controversies surrounding malignant transformation. Oral Dis. 2008;14:229–243.
  7. Eisen D, Carrozzo M, Bagan Sebastian JV, Thongprasom K. Number V Oral lichen planus: Clinical features and management. Oral Dis. 2005;11:338–349.
  8. Scully C, Carrozzo M. Oral mucosal disease. Lichen planus. Br J Oral Maxillofac Surg. 2008;46:15–21.
  9. Sugerman PB, Savage NW, Walsh LJ, et al. The pathogenesis of oral lichen planus. Crit Rev Oral Biol Med. 2002;13:350–365.
  10. van der Meij EH, Reibel J, Slootweg PJ, van der Wal JE, de Jong WF, van der Waal I. Interobserver and intraobserver variability in the histologic assessment of oral lichen planus. J Oral Pathol Med. 1999;28:274–277.
  11. Laskaris G, Sklavounou A, Angelopoulos A. Direct immunofluorescence in oral lichen planus. Oral Surg Oral Med Oral Pathol. 1982;53:483–487.
  12. Firth NA, Rich AM, Radden BG, Reade PC. Assessment of the value of immunofluorescence microscopy in the diagnosis of oral mucosal lichen planus. J Oral Pathol Med. 1990;19:295–297.
  13. Qari H, Villasante C, Richert J, Rees T, Kessler H. The diagnostic challenges of Separating chronic ulcerative stomatitis from oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120:622–627.
  14. Helander SD, Rogers RS. The sensitivity and specificity of direct immunofluorescence testing in disorders of mucous membranes. J Am Acad Dermatol. 1994;30:65–75.
  15. Kulthanan K, Jiamton S, Varothai S, Pinkaew S, Sutthipinittharm P. Direct immunofluorescence study in patients with lichen planus. Int J Dermatol. 2007;46:1237–1241.
  16. van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003;32:507–512.
  17. Thongprasom K, Prapinjumrune C, Kanjanabuch P, Youngnak-Piboonratanakit P, Preuksrisakul T. Correlation of serum ANA and direct immunofluorescence studies in elderly Thai patients with red and white oral lesions. J Oral Pathol Med. 2016;45:797–802.
  18. Prucktrakul C, Youngnak-Piboonratanakit P, Kanjanabuch P, Prueksrisakul T, Thongprasom K. Oral lichenoid lesions and serum antinuclear antibodies in Thai patients. J Oral Pathol Med. 2015;44:468–474.
  19. Morita M, Asoda S, Tsunoda K, et al. The onset risk of carcinoma in patients continuing tacrolimus topical treatment for oral lichen planus: A case report. Odontology. 2017;105:262–266.
  20. Mattsson U, Magnusson B, Jontell M. Squamous cell carcinoma in a patient with oral lichen planus treated with topical application of tacrolimus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:19–25.