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Clinicopathological Correlation in Patients with Oral Lichen Planus

Mahesh Mathur, Ayush Jha, Neha Thakur, Gautam Das, Swati Shah, Sunil Jaiswal, Srijana Maharjan, Supriya Paudel, Anjali Shrestha

Background: Oral Lichen Planus is a chronic immunological mucosal disorder. Histopathological evaluation of oral biopsy is necessary because of varied clinical manifestations that might mimic other disease and its premalignant potential. However, a lack of universally accepted diagnostic criteria leads to a very low clinic-pathological correlation.
Methodology: The current prospective hospital based observational study was carried from 2016 to 2022 at Department of Dermatology, College of Medical Sciences, Bharatpur. All patients with oral lesions suspicious of Oral Lichen Planus were included in our study and routine histopathological evaluation was carried as per standard protocols. Clinical and histopathological diagnosis were made as per World Health Organization criteria.
Results: The average age of patients in our study was 41.14 years and majority of them were females (68.8%).Areca nut and tobacco chewing habbit was present in 24.4% and 16.7% patients respectively. Majority of patients were asymptomatic while 41.1% patients complained of burning sensation upon intake of food, especially in erosive form of disease. Involvememt of buccal mucosa (55.6%) followed by tongue (7.8%) and labial mucosa (7.8%) were observed. Reticular Oral Lichen Planus (53.3%) was the most common morphological type followed by erosive OLP (23.3%). Clinicopathological correlation was achieved in 65.6% of cases. Band like stromal infiltrate (100%) and basal layer vacuolization (100%) were the most consistent histopathological findings.
Conclusion: There is low clinicopathological correlation in cases of Oral Lichen Planus using World Health Organization criteria and a universally accepted diagnostic criteria is the need of hour.