Concordance between clinical and histopathological diagnoses of oral lichen planus

ObjectiveIn this study, we investigated the degree of concordance in the histopathological diagnosis among lesions clinically diagnosed with oral lichen planus (OLP) to understand the importance of the histopathological examination.MethodsIn total, 169 patients clinically diagnosed with OLP on their initial visit to our hospital between 2001 and 2012 were experienced. Of them, histopathological examinations were carried out for 77 patients (83 lesions), and they were selected as the subjects of this study. The age, gender, location of the lesion, clinical type of OLP determined via visual inspection, and histopathological findings were investigated.ResultsOf the 77 patients, 12 were male and 65 were female, with a mean age of 63.9 years. Histopathological examinations were performed in 83 lesions, of which 54 were diagnosed as OLP. Among the diagnostically discordant 29 lesions, most were histopathologically diagnosed as leukoplakia (15 lesions, 51.7%), whereas one was diagnosed as squamous cell carcinoma (3.4%). The most frequent location of discordant lesions was the tongue (discordant rate: 77.8%), and the most clinical type was plaque (discordant rate: 90.0%); all of which were atypical types of OLP.ConclusionsThe rate of discordance between the clinical and histopathological diagnoses was 34.9%. These results indicate that histopathological examinations are essential for obtaining the differential diagnosis to distinguish the lesion from other diseases with a clinical presentation similar to that of OLP.