Clinical and demographic profile of oral lichen planus in Sri Lanka: a retrospective study

Purpose Several relatively large series from developed countries have extensively described the demographic and clinical characteristics of oral lichen planus (OLP). However, such descriptions from developing countries are rare. This study aimed to investigate the differences in these aspects within a cohort of Sri Lankan patients affected by OLP. Materials and Methods Cases diagnosed with OLP between 1999 and 2019 were retrieved. Demographic data, clinical presentation, main complaints, age, sex, lesion sites, and histological information, were collected from the database. Cases with lichenoid reactions and incomplete data were excluded. Instances with multiple biopsies were treated as single cases. Frequencies were compared using chi-square statistics. Results The database identified a total of 3734 cases. The male-to-female ratio was 1:1.6, indicating an overall female predominance. The youngest patient reported was 1 year and 2 months old, presenting with brownish pigmentations on the right side of the buccal mucosa. The highest number of cases were observed in the 41-50- year age group, followed by the 51-60-year age group. The most common clinical type was the reticular type, followed by atrophic and erosive types. 200 patients presented with blackish pigmentations in the oral mucosa, experiencing a burning sensation without evidence of the typical reticular background. The plaque type was more common on the dorsal surface of the tongue, showing a statistically significant association (p<0.05). Ninety cases exhibited dysplastic changes ranging from mild to moderate degrees, accounting for 2.4% of the total sample. Conclusion While the malignancy rate is not significantly high enough to reduce morbidity and mortality from cancer arising on OLP lesions, regular follow-up and examinations are recommended for early diagnosis of malignant transformation.