# Demographic and Clinical Characteristics of Patients With Oral Lichen Planus in a Cohort From Casablanca, Morocco

## TL;DR

This study examines the characteristics of oral lichen planus patients in Morocco, finding it more common in middle-aged women and linked to diabetes.

## Contribution

The study provides demographic and clinical insights into oral lichen planus in a Moroccan cohort, highlighting diabetes as a common comorbidity.

## Key findings

- OLP predominantly affects women aged 50 to 60 years.
- The reticular form of OLP was most common, with buccal mucosa as the primary site.
- Diabetes was the most frequently associated comorbidity in OLP patients.

## Abstract

Background

Oral lichen planus (OLP) is a chronic inflammatory disorder that affects the oral mucosa and is more frequently observed in women. OLP presents in various forms, including reticular, papular, plaque-like, erosive, atrophic, and bullous. The etiology remains unclear, though immune dysregulation is thought to be a key factor. OLP has the potential to transform into oral squamous cell carcinoma (OSCC).

Materials and methods

We conducted a cross-sectional study at the Department of Oral Surgery and Pathology, University Hospital Ibn Rochd, Casablanca. Over a period of 46 months, patients diagnosed with OLP were followed. Data were collected using a standardized form that covered demographic, clinical, biological, and histological criteria, as well as follow-up information. Blood tests included complete blood count, glucose levels, and liver function tests. Biopsies were performed for diagnostic confirmation and follow-up, with direct immunofluorescence (DIF) used in complex cases. Patients with suspected cutaneous lichen planus (CLP) were referred to the dermatology department for evaluation. Treatment involved the removal of irritants, with corticosteroid therapy tailored to the severity of the lesion. Systemic corticosteroids were used for severe or treatment-resistant cases. Diabetic patients requiring systemic therapy were managed in collaboration with endocrinologists.

Results

Out of 9,841 consultations, 44 cases of OLP were identified, resulting in a prevalence rate of 4.5‰. The mean age of patients was 54.5 ± 13.5 years, with a predominance of women. Comorbidities included diabetes and hypertension in some cases. The reticular form was most common, followed by the bullous form. The buccal mucosa was the primary site of involvement. CLP co-occurred in 22.7% of cases. Malignant transformation was observed in one patient.

Discussion

The study, conducted at a single center with a focus on oral pathology, aligns with international findings, demonstrating a higher prevalence in women aged 50 to 60 years and a predominance of reticular forms with involvement of the buccal mucosa. A higher incidence of bullous lesions was observed compared to previous reports. Anti-HCV (hepatitis C virus) testing was systematically performed due to Morocco's moderate HCV prevalence. The association between OLP and diabetes may be influenced by the high diabetes prevalence in Morocco. Although treatment provided symptom relief, therapeutic options remain limited. The rate of malignant transformation was consistent with that reported in prior studies.

Conclusion

This study confirms a higher prevalence of OLP in women aged 50 to 60 years, with reticular forms and involvement of the buccal mucosa. Diabetes was the most commonly associated condition, and chronic HCV infection, while infrequent, may pose an increased risk. Regular monitoring is crucial due to the potential for malignant transformation, particularly in women and those with erosive or atrophic subtypes.