Boffano Paolo, Neirotti Francesca, Nikolovska Valeria, Brucoli Matteo, Ruslin Muhammad, Pechalova Petia, Pavlov Nikolai, Sapundzhiev Angel, Uchikov Petar, Rodríguez Juan Carlos de Vicente, Santamarta Tania Rodríguez, Meyer Christophe, Louvrier Aurelien, Michel-Guillaneux Alexandre, Bertin Eugenie, Starch-Jensen Thomas, Gusic Ivana, Bajkin Branislav V, López-Pintor Rosa Maria, González-Serrano José, Dugast Sophie, Bertin Helios, Corre Pierre, Bán Ágnes, Szalma József, Rautava Jaana, Snäll Johanna
University of Eastern Piedmont, Novara, Italy.
University of Eastern Piedmont, Novara, Italy.
J Stomatol Oral Maxillofac Surg. 2025 Jun;126(3S):102218. doi: 10.1016/j.jormas.2025.102218. Epub 2025 Jan 6.
Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous condition that includes a spectrum of oral clinical manifestations ranging from mild painless white lesions to painful erosions and ulcers. The purpose of this European multicenter study is to describe the general characteristics of OLP lesions, the clinical and histopathological diagnosis, and the management of OLP at different European Oral Medicine and Maxillofacial Surgery centers, in order to minimize selections biases and provide information about the current trends in the treatment of OLP across Europe.
Data and histopathological records of patients with OLP were retrospectively revised and only those patients that fulfilled the diagnostic criteria from the 2016 position paper by American Academy of Oral and Maxillofacial Pathology were included. The following data were recorded for each patient: gender, age, voluptuary habits, risk factors for OLP (psychological stress, medications, systemic diseases), location of OLP lesions, clinical presentation, patterns of clinical expression, symptoms, treatment, possible clinical improvement, and malignant transformation.
A total of 565 OLP patients (422 females, 143 males) fulfilled the inclusion criteria. The mean age of the study population at diagnosis was 60.11 years. In 262 patients (46.4 %), just a site of OLP was identified: in 186 of these "one-site" patients, OLP was diagnosed just in buccal mucosa. The most frequently observed clinical pattern was reticular. When evaluating the treatment received, 294 patients were kept in follow up with a Wait-and-see approach. The most frequent treatment regimen was the use of topical corticosteroids (123 patients). A significant statistical association was found between the prescription of topical corticosteroids (P < .0005) or retinoids (P < .000005) and symptoms improvement. Squamous cell carcinoma associated with OLP lesions was observed during the follow-up in 9 OLP patients out of 565 (1.6 %).
Reticular and mixed clinical patterns are the most frequent subtypes of OLP. The use of topical corticosteroids and retinoids for the management of OLP seems to allow good improvement results of symptoms and signs. A clinical long-term follow-up is fundamental due to the chronic nature of OLP and possible malignant transformation.
口腔扁平苔藓（OLP）是一种慢性炎症性黏膜皮肤疾病，其口腔临床表现范围广泛，从轻度无痛性白色病变到疼痛性糜烂和溃疡。这项欧洲多中心研究的目的是描述OLP病变的一般特征、临床和组织病理学诊断，以及不同欧洲口腔医学和颌面外科中心对OLP的管理，以尽量减少选择偏倚，并提供有关欧洲OLP治疗当前趋势的信息。
对OLP患者的数据和组织病理学记录进行回顾性修订，仅纳入符合美国口腔颌面病理学会2016年立场文件诊断标准的患者。记录每位患者的以下数据：性别、年龄、生活习惯、OLP的危险因素（心理压力、药物、全身性疾病）、OLP病变的位置、临床表现、临床表达模式、症状、治疗、可能的临床改善情况以及恶变情况。
共有565例OLP患者（422例女性，143例男性）符合纳入标准。研究人群诊断时的平均年龄为60.11岁。262例患者（46.4%）仅发现一个OLP部位：在这些“单部位”患者中，186例患者的OLP仅诊断于颊黏膜。最常观察到的临床模式是网状。在评估所接受的治疗时，294例患者采用观察等待的方法进行随访。最常用治疗方案是使用局部皮质类固醇（123例患者）。发现局部皮质类固醇（P <.0005）或维甲酸（P <.000005）的处方与症状改善之间存在显著统计学关联。在565例OLP患者的随访期间，观察到9例（1.6%）与OLP病变相关的鳞状细胞癌。
网状和混合型临床模式是OLP最常见的亚型。使用局部皮质类固醇和维甲酸治疗OLP似乎能使症状和体征得到较好改善。由于OLP的慢性性质和可能的恶变，长期临床随访至关重要。
