Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obervation Letter
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF
Letter To Editor
2008:74:5;509-511
doi: 10.4103/0378-6323.44323
PMID: 19052424

Oral-esophageal lichen planus associated with oral squamous cell carcinoma

GP Bombeccari1 , F Pallotti2 , G Guzzi3 , F Spadari1
1 Institute of Dentistry, Department of Oral Pathology and Medicine, University of Milan, Milan, Italy
2 Unit of Anatomical Pathology, IRCCS Maggiore Hospital, Mangiagalli and R. Elena Foundation, Milan, Italy
3 Italian Association for Metals and Biocompatibility Research - A.I.R.M.E.B.; Milan, Italy

Correspondence Address:
G P Bombeccari
Institute of Dentistry, Department of Oral Pathology and Medicine, University of Milan, Milan, Italy, Via Cervino, 30, 24068 Seriate, Bergamo
Italy
How to cite this article:
Bombeccari G P, Pallotti F, Guzzi G, Spadari F. Oral-esophageal lichen planus associated with oral squamous cell carcinoma. Indian J Dermatol Venereol Leprol 2008;74:509-511
Copyright: (C)2008 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous condition which affects approximately 0.2% to 3.8% of the general population, being more frequent in females. [1] Among OLP cases, only 1% may involve the esophagus. [2] The rate of malignant transformation in OLP is about 0.4% to 1.74%. [3]

In May 2004, a 64-year-old Italian woman was referred to our hospital with a history of oral white lesions. Clinical examination showed OLP in her oral cavity with reticular and plaque variants. Bilateral buccal mucosae were affected, particularly on the right side, with evidence of atrophic erosive foci. There were no cutaneous or genital lesions. She had had a sub-total thyroidectomy and suffered from mild hypertension; however, she was not under any medication.

The patient was negative for antibodies to HbsAg and hepatitis C virus. Because of oral lesion extensions accompanied by dysphagia, we performed an endoscopy of the pharynx-esophageal tract. The finding of ulcerative esophagitis necessitated an endoscopic ultrasonography, but there was no evidence of malignancy [Figure - 1]. The results of the oral biopsy confirmed the diagnosis of OLP associated with low-degree dysplasia. Therefore, the OLP lesion was subsequently partially removed.

We initiated treatment with a topical corticosteroid and the lesions were examined periodically every 3 months, monitoring the upper digestive tract. During a routine follow-up in February 2006, we performed an oral biopsy and took multiple samples using the toluidine vital staining method. The histopathological report showed a focal severe-degree dysplasia in the right retromolar trigonal region, which was promptly removed.

In May 2006 a new biopsy revealed an oral squamous cell carcinoma (OSCC) on the sublingual area [Figure - 2]. The radical removal was carried out after a grade 1 neoplasia staging (according to TNM classification) [Figure - 3].

We strongly support the multidisciplinary approach when OLP is associated with esophageal involvement. An esophageal stricture is found in half of these patients, and exceptionally, a squamous cell carcinoma can develop within esophageal lichen planus. [4] It is important to note that within 2 years of follow-up on diagnosis of OSCC, about 10% of the patients develop a new neoplasia in the gastric-respiratory tract. [5]

Our case emphasizes that where OLP affects wide areas, multiple biopsy samples and the toluidine vital staining method should be routinely used to assist in the choice of biopsy sites.

Such procedures allow us to select the lesion areas more likely to develop a malignant process. With an early diagnosis during the process of carcinogenesis, we can improve survival rates for patients with oral cancer.

References
1.
Vincent SD, Fotos PG, Baker KA, Williams TP. Oral lichen planus: The clinical, histological and therapeutic features of 100 cases. Oral Surg Oral Med Oral Pathol 1990;70:165-71.
[Google Scholar]
2.
Eisen D. The evaluation of cutaneous, genital, scalp, nail, esophageal, and ocular involvement in patients with oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;91:431-6.
[Google Scholar]
3.
Van der Meij EH, Schepman PK, Van der Waal I. The possible character of oral lichen planus and oral lichenoid lesions: A prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:164-71.
[Google Scholar]
4.
Bachmeyer C, Benchaa B, Roauth B, Petitjean S, Danne O, Blum L. Lichen planus: An unusual case of oesophageal stricture. J Eur Acad Dermatol Venereol 2007; [in press].
[Google Scholar]
5.
Regezi JA, Sciubba JJ, Jordan RC. White lesions. In: Oral pathology. 4 th ed. St. Louis, USA: edited by Saunders; 2003. p. 75-109.
[Google Scholar]

Fulltext Views
105

PDF downloads
68
Show Sections