Proliferative verrucous leukoplakia mimicking oral lichen planus: case report and literature review
PDF (Spanish)
PDF en inglés

Keywords

Oral leukoplakia
Oral lichen planus
Syndecan-1
B- Lymphocytes
CD20

How to Cite

Proliferative verrucous leukoplakia mimicking oral lichen planus: case report and literature review. (2024). Odontoestomatología, 25(42), 10. https://doi.org/10.22592/ode2023n42e419

Abstract

This report presents the clinical, microscopic and immunohistochemical aspects of a case of proliferative verrucous leukoplakia (PVL) mimicking oral lichen planus (OLP) in a 66-year-old woman. We also review the literature reporting cases of PVL mimicking OLP, where we found a higher prevalence in women who  do  not consume tobacco or alcohol. The initial manifestation of lichenoid areas was around the age of 59, with the diagnosis of PVL being established on average 6 years later, while malignan transformation occurred in 8 of the 22 cases at an average of 3.7 years after the final diagnosis of PVL. We emphasize the need for a close follow-up of any patient presenting white lesions of the oral mucosa. Lesions that are clinically and microscopically compatible with lichenoid reactions or OLP must be investigated and differentiated from PVL, which has a worse prognosis.

PDF (Spanish)
PDF en inglés

References

Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, et al. Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 2021 Nov;27(8):1862-1880.

Hansen LS, Olson JA, Silverman S Jr. Proliferative verrucous leukoplakia. A long-term study of thirty patients. Oral Surg Oral Med Oral Pathol. 1985;60:285-98.

Warnakulasuriya S. Clinical features and presentation of oral potentially malignant disorders. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:582–90.

Pentenero M, Meleti M, Vescovi P, Gandolfo S. Oral proliferative verrucous leucoplakia: are there particular features for such an ambiguous entity? A systematic review. Br J Dermatol. 2014;170:1039–47.

Villa A, Menon RS, Kerr AR, De Abreu Alves F, Guollo A, Ojeda D, et al. Proliferative leukoplakia:

Proposed new clinical diagnostic criteria. Oral Dis. 2018;24:749–60.

Iocca O, Sollecito TP, Alawi F, Weinstein GS, Newman JG, De Virgilio A, et al. Potentially malignant

disorders of the oral cavity and oral dysplasia: A systematic review and meta-analysis of malignant

transformation rate by subtype. Head Neck. 2020;42:539-555.

Alkan U, Bachar G, Nachalon Y, Zlotogorsky A, Levin EG, Kaplan I. Proliferative verrucous leukoplakia: a clinicopathological comparative study. Int J Oral Maxillofac Surg. 2022;51:1027-1033.

Aguirre-Urizar JM. Proliferative multifocal leukoplakia better name that proliferative verrucous leukoplakia. World J Surg Oncol. 2011;9:122.

González-Moles MÁ, Ramos-García P, Warnakulasuriya S. An appraisal of highest quality studies reporting malignant transformation of oral lichen planus based on a systematic review. Oral Dis. 2021;27:1908-1918.

van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003;32:507-12.

McCarthy C, Kazmi A, Austin T, Ho MW, Chengot P, Rajlawt BP, et al. The development of Proliferative Verrucous Leukoplakia on a background of oral lichen planus: A case series. Adv in Oral and Maxil Surg. 2022;6:100263.

Gillenwater AM, Vigneswaran N, Fatani H, Saintigny P, El-Naggar AK. Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity! Adv Anat Pathol. 2013;20:416-23.

Lopes MA, Feio P, Santos-Silva AR, Vargas PA. Proliferative verrucous leukoplakia may initially mimic lichenoid reactions. World J Clin Cases. 2015;3:861-863.

Gilligan G, Garola F, Piemonte E, Leonardi N, Panico R, Warnakulasuriya S. Lichenoid proliferative leukoplakia, lichenoid lesions with evolution to proliferative leukoplakia or a continuum of the same precancerous condition? A revised hypothesis. J Oral Pathol Med. 2021;50:129-135.

Carrozzo M, Porter S, Mercadante V, Fedele S. Oral lichen planus: A disease or a spectrum of tissue reactions? Types, causes, diagnostic algorhythms, prognosis, management strategies. Periodontol. 2019;80:105-125.

González-Moles MÁ, Warnakulasuriya S, González-Ruiz I, González-Ruiz L, Ayén Á, Lenouvel D, et al. Worldwide prevalence of oral lichen planus: A systematic review and meta-analysis. Oral Dis. 2021;27:813-828.

Cerero-Lapiedra R, Baladé-Martínez D, Moreno-López LA, Esparza-Gómez G, Bagán JV. Proliferative verrucous leukoplakia: a proposal for diagnostic criteria. Med Oral Patol Oral Cir Bucal. 2010;15:e839-45.

Ranganathan K, Kavitha L. Oral epithelial dysplasia: Classifications and clinical relevance in risk assessment of oral potentially malignant disorders. J Oral Maxillofac Pathol. 2019;23:19-27.

Morton TH, Cabay RJ, Epstein JB. Proliferative verrucous leukoplakia and its progression to oral carcinoma: report of three cases. J Oral Pathol Med. 2007;36:315-8.

Goodson ML, Sloan P, Robinson CM, Cocks K, Thomson PJ. Oral precursor lesions and malignant transformation--who, where, what, and when? Br J Oral Maxillofac Surg. 2015;53:831-5.

van der Waal I. Oral lichen planus and oral lichenoid lesions; a critical appraisal with emphasis on the diagnostic aspects. Med Oral Patol Oral Cir Bucal. 2009 Jul 1;14:E310-4.

Serrano-Sánchez P, Bagán JV, Jiménez-Soriano, Sarrión G. Drug-induced oral lichenoid reactions. A literature review. J Clin Exp Dent. 2010;2:e71-5.

Barba-Montero C, Lorenzo-Pouso AI, Gándara-Vila P, Blanco-Carrión A, Marichalar-Mendía X, García-García A, et al. Lichenoid areas may arise in early stages of proliferative verrucous leukoplakia: A long-term study of 34 patients. J Oral Pathol Med. 2022;51:573-581.

Müller S. Oral manifestations of dermatologic disease: a focus on lichenoid lesions. Head Neck Pathol. 2011;5:36-40.

Abadie WM, Partington EJ, Fowler CB, Schmalbach CE. Optimal Management of Proliferative Verrucous Leukoplakia: A Systematic Review of the Literature. Otolaryngol Head Neck Surg. 2015;153:504-11.

Garcia-Pola MJ, Llorente-Pendás S, González-Garcia M, García-Martín JM. The development of proliferative verrucous leukoplakia in oral lichen planus. A preliminary study. Med Oral Patol Oral Cir Bucal. 2016;21:e328-34.

Müller S. Oral epithelial dysplasia, atypical verrucous lesions and oral potentially malignant disorders: focus on histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:591-602.

Davidova LA, Fitzpatrick SG, Bhattacharyya I, Cohen DM, Islam MN. Lichenoid Characteristics in Premalignant Verrucous Lesions and Verrucous Carcinoma of the Oral Cavity. Head Neck Pathol. 2019;13:573–9.

Kamat SS, Kumar GS, Koshy AV. Immunohistochemical analysis of syndecan-1 in leukoplakia and oral submucous fibrosis. Dent Res J. 2013;10:321-7.

Wang H, Leavitt L, Ramaswamy R, Rapraeger AC. Interaction of syndecan and alpha6beta4 integrin cytoplasmic domains: regulation of ErbB2-mediated integrin activation. J Biol Chem. 2010;285:13569-79.

Anttonen A, Kajanti M, Heikkilä P, Jalkanen M, Joensuu H. Syndecan-1 expression has prognostic significance in head and neck carcinoma. Br J Cancer. 1999;79:558-64.

Gharbaran R. Advances in the molecular functions of syndecan-1 (SDC1/CD138) in the pathogenesis of malignancies. Crit Rev Oncol Hematol. 2015;94:1-17.

Gupta S, Jawanda MK. Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management. Indian J Dermatol. 2015;60:222-9.

Mahdavi N, Aminishakib P, Soltani N. Presence of B Cells and Plasma Cells in Oral Lichen Planus. J Dent. 2020;21:209-214.

McParland H, Warnakulasuriya S. Lichenoid morphology could be an early feature of oral proliferative verrucous leukoplakia. J Oral Pathol Med. 2021;50:229-235.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.