Estudo clínico-patológico de líquen plano oral: análise de 30 casos em uma população do nordeste brasileiro

Abstract

Introduction: Oral lichen planus (OLP) is an immune-mediated condition that affects the oral mucosa, with varied clinical manifestations, the reticular and erosive forms being the most common. Its etiopathogenesis is still uncertain, but it involves the destruction of basal keratinocytes by cytotoxic T lymphocytes. The WHO classifies OLP as a potentially malignant oral disorder due to occasional associations between epithelial dysplasia and typical morphological changes of OLP. This association contributes to diagnostic complexity, as the epithelium may present changes resulting from the autoimmune response. Objectives: To assess the clinical profile and morphological changes of 30 cases of OLP. Methodology: This research conducted a retrospective and observational analysis of the clinicopathological findings of cases diagnosed at the Pathological Anatomy and Cytopathology Service of the Department of Dentistry/UFRN. The sample cases were evaluated and categorized according to their clinical-demographic and histopathological aspects. Subsequently, descriptive statistical analysis was performed. Results: The most commonly affected sex was female (n = 22; 73.3%) and aged 40 years or older (n = 22; 73.3%). OLP appeared mostly in plaque form (n = 22; 73.3%) in the buccal mucosa region (n = 20; 66.7%) and tongue (n = 19; 63.3%). Morphological analysis revealed the presence of subepithelial inflammatory infiltrate (n = 26; 86.6%) and degeneration of the basal layer (n = 25; 83.3%). Epithelial dysplasia was observed in only 3 cases (10%). Conclusion: Based on the results, OLP showed a higher prevalence in women over 40 years of age, with plaque-like lesions on the buccal mucosa and tongue. Histologically, keratosis, acanthosis, subepithelial inflammatory infiltrate, and basal layer degeneration were common, confirming its immune-mediated origin. Although not the focus of the study, the presence of epithelial dysplasia in part of the sample reinforces the malignant potential of OLP, highlighting the importance of clinical follow-up.