School of Dentistry, University of Granada, Granada, Spain.
Biohealth Research Institute (IBS), Granada, Spain.
Oral Dis. 2021 May;27(4):813-828. doi: 10.1111/odi.13323. Epub 2020 Apr 2.
The objective was to assess the global oral lichen planus prevalence. We searched PubMed, EMBASE, Web of Science, and Scopus for studies published before September 2019. We evaluated the quality of studies and carried out several meta-analyses. The global pooled prevalence was 1.01%, with a marked geographical difference (p < .001). The highest prevalence was reported from Europe (1.43%) and the lowest in India (0.49%), where tobacco-associated keratosis appears to mask oral lichen planus resulting in attenuation of its prevalence. From the age of 40 years, the prevalence increases significantly and progressively (OR = 3.43, 95% CI = 2.48-4.73, p < .001). Studies that define diagnostic criteria report a higher prevalence (1.31% vs. 0.70%, p = .03), although the application of the WHO criteria (year 1978-2007) does not increase the ability to diagnose the disease compared with other criteria (p = .11). The studies performed by oral medicine/oral pathology specialists report significantly higher prevalence (1.80%) than dentists (0.61%) and dermatologists (0.33%; p < .001). In conclusion, we propose that reliable diagnostic criteria should be defined, which should include a set of essential criteria including the presence of white reticular lesions in any location of the oral mucosa. The impact of histopathological confirmation with defined diagnostic criteria must be researched in the future, although its main use should be to determine the presence or absence of epithelial dysplasia. The necessity to improve the knowledge of oral lichen planus among dentists and dermatologists through continuing education is apparent in the results of this meta-analysis.
目的是评估全球口腔扁平苔藓的患病率。我们在 PubMed、EMBASE、Web of Science 和 Scopus 上搜索了截至 2019 年 9 月之前发表的研究。我们评估了研究的质量，并进行了多次荟萃分析。全球汇总患病率为 1.01%，存在明显的地域差异（p<0.001）。患病率最高的地区是欧洲（1.43%），最低的是印度（0.49%），在印度，烟草相关性角化病似乎掩盖了口腔扁平苔藓，从而降低了其患病率。从 40 岁开始，患病率显著且逐渐增加（OR=3.43，95%CI=2.48-4.73，p<0.001）。定义诊断标准的研究报告的患病率更高（1.31%比 0.70%，p=0.03），尽管应用 WHO 标准（1978-2007 年）与其他标准相比并没有提高诊断疾病的能力（p=0.11）。口腔医学/口腔病理学专家进行的研究报告的患病率显著更高（1.80%），而牙医（0.61%）和皮肤科医生（0.33%；p<0.001）。总之，我们建议应定义可靠的诊断标准，该标准应包括一组基本标准，包括在口腔黏膜的任何部位存在白色网状病变。在未来，必须研究使用定义明确的诊断标准进行组织病理学确认的影响，尽管其主要用途应是确定是否存在上皮异型增生。通过继续教育提高牙医和皮肤科医生对口腔扁平苔藓的认识，这在本次荟萃分析的结果中显而易见。
