Does the Location of Oral Lesions in Oral Lichen Planus Allow Predicting the Outcome of Its Histopathological Examination?

TL;DR

This study explores whether the location of oral lesions in oral lichen planus can help predict the results of histopathological exams.

Contribution

The study identifies specific lesion locations strongly associated with positive histopathological outcomes in oral lichen planus.

Findings

White patches on the buccal mucosa were the strongest predictor of OLP with 91.3% sensitivity.

Lesions on mandibular and maxillary gingiva showed significant associations with positive histopathological results.

Location of lesions can aid diagnostic management but cannot confirm a definitive diagnosis alone.

Abstract

Objective: Numerous reports describe the typical localization of lesions in the oral cavity in various conditions, manifesting as oral lesions. We aimed to evaluate the correlation between these lesions and the results of histopathological examinations (HP). Methods: We examined 66 consecutive patients with oral lesions consistent with the clinical presentation of oral lichen planus (OLP). Standard HP evaluation was performed using light microscopy and, subsequently, the association between the precise location of the lesion and the histopathological diagnosis was assessed. Results: Erosions on the mandibular gingiva (p = 0.0086), white patches on the right buccal mucosa (p = 0.03197), white patches on the ventral surface of the tongue (p = 0.0397), white patches on the maxillary gingiva (p = 0.0228), white patches on the mandibular gingiva (p = 0.0062), white patches on the upper lip (p = 0.0226), and bilateral white patches on the buccal mucosa (p = 0.0104) were significantly more prevalent in patients with positive histopathological findings. White patches on the buccal mucosa emerged as the strongest predictor of histopathological diagnosis of OLP, with a sensitivity of 91.3% and a negative predictive value of 85.7%. Conclusions: The location of oral lesions may indicate OLP with high sensitivity and a negative predictive value, which may facilitate further diagnostic management; however, it is not sufficient to establish a definitive diagnosis.