Dysplasia in Oral Lichen Planus in a Sample of Egyptians Attending 2 Tertiary Care Centers in Cairo

Abstract

The present retrospective study aimed to evaluate dysplastic changes in oral lichen planus (OLP) lesions and related risk factors in a sample of Egyptians. The records of patients with histological diagnosis of OLP, who attended the Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, and Faculty of Dentistry, the British University in Egypt, in the period from 2020 to 2023 were used. The study included records of patients diagnosed with OLP which contained detailed histopathologic descriptions, with documented grades of dysplasia and complete demographic data. Dysplastic changes were diagnosed and graded according to the latest WHO classification (Neville et al. 2016) by 2 pathologists as documented in the records. Patients with oral lichenoid lesions or coexisting tobacco-associated lesions were excluded, along with those under 18 years of age. Ethical approval was acquired from the Research Ethics Committee at the British University in Egypt (24-034). All the archives included patients' consent for the use of data in published research. The records that met the inclusion criteria in the years 2020–2023 were 206. Table 1 demonstrates the results. The proportion of patients with both buccal mucosa and tongue lesions was 39.81%. Palatal lesions were all accompanied by lesions in the buccal mucosa. 11 (5.34%) 80 (38.83%) The frequency of dysplasia was 10.19% (21 out of 206 cases) and was statistically not associated with age, gender or smoking. The frequency results are in accordance with a previous study in Iran (Irani, Esfahani, and Ghorbani 2016), where a rate of 10.7% was revealed, whereas Czerninski et al. (2015) showed a figure of 12.9% dysplasia, which is quite close. According to González-Moles et al. (2021), some previously reported OLP dysplasia values were within the same range, despite the variation in studied populations. Previous results of increased frequency of dysplasia with ageing (Ghalwash 2020; Kakoei et al. 2022) were not supported by the present study. A recent meta-analysis proves that smoking is an important factor that increases malignant transformation risk in OLP (González-Moles and Ramos-García 2023). However, the results of our investigation did not show an influential effect of smoking on dysplasia occurrence which is following other research (Giuliani et al. 2019). In our study, the high prevalence of females could be the cause of blurring smoking as a risk factor, as females from certain Egyptian socioeconomic levels find it embarrassing to confess the habit of smoking. Our results showed that the erosive type registered the highest rate (p < 0.001), followed by atrophic, whereas papular type did not show dysplasia. Also, the most common site for dysplasia was the buccal mucosa and tongue (p < 0.001 and p = 0.001, respectively), then gingiva, lips, and floor of the mouth. Thus, results are in accordance with Aghbari et al. (2017) regarding type and site of lesions. However, others found no difference between different types of OLP in potential malignant transformations (Kakoei et al. 2022). Given the importance of OLP, among the Egyptian population seeking care in our clinics, more research should be conducted to create a database of statistical information. Fat'heya M. Zahran: conceptualization, investigation, supervision, writing – review and editing, data curation. Basma Elsaadany: methodology, writing – original draft, data curation. Noha Adel Azab: writing – original draft, methodology, data curation. Ayman El-Gawish: methodology, writing – original draft, data curation. Dalia Ghalwash: conceptualization, writing – original draft, writing – review and editing, supervision, data curation. The authors declare no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.