BACKGROUND: Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are common chronic inflammatory diseases associated with malignant transformation. Risk factors associated with malignant transformation of OLP and OLL are not well defined. METHODS: A retrospective chart review assessed risk factors for progression of OLP and OLL to oral epithelial dysplasia (OED) or oral squamous cell carcinoma (OSCC) at a tertiary care centre in Toronto, Canada. RESULTS: Five-hundred-fifty-five patients identified with biopsy proven OLP or OLL met the inclusion criteria. In total, 3.2% (n = 18) progressed to OED (1.8%, n = 10) or OSCC (1.4%, n = 8). Risk factors associated with transformation included the plaque-like subtype (OR = 40.33, p < 0.001) and lesions located on the tongue (OR = 6.81, p = 0.008). CONCLUSIONS: Clinical examination to identify lesion subtype and location provides useful indicators for risk of progression in patients with OLL and OLP.
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