Discrepancy in the Histological Diagnoses of Oral Lichen Planus Based on WHO Criteria Versus the Newly Proposed Diagnostic Set of the American Academy of Oral and Maxillofacial Pathology

<b>Background/Objectives</b>: The diagnosis of oral lichen planus (OLP) is challenging because many other oral diseases demonstrate similar clinical and microscopic features. Clinicopathological discrepancy and inter- and intraobserver variability in the histological assessment of OLP ha...

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Main Authors: Maria Zaharieva Mutafchieva, Desislava Atanasova Tashkova
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/5/558
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author Maria Zaharieva Mutafchieva
Desislava Atanasova Tashkova
author_facet Maria Zaharieva Mutafchieva
Desislava Atanasova Tashkova
author_sort Maria Zaharieva Mutafchieva
collection DOAJ
description <b>Background/Objectives</b>: The diagnosis of oral lichen planus (OLP) is challenging because many other oral diseases demonstrate similar clinical and microscopic features. Clinicopathological discrepancy and inter- and intraobserver variability in the histological assessment of OLP have been shown in the literature, as there are no unified diagnostic criteria for the disease. In 2016, the American Academy of Oral and Maxillofacial Pathology (AAOMP) proposed a new diagnostic set for OLP. The aim of the study was to assess the reliability of the AAOMP histological criteria in diagnosing OLP. <b>Methods</b>: In this retrospective study, 34 histological sections, once diagnosed as OLP, were revised by a second pathologist using the WHO criteria. Then, all specimens were analyzed for the presence (P) or absence (A) of the criteria listed in the AAOMP diagnostic set. The reproducibility of the histological diagnosis of OLP when applying the different sets of diagnostic criteria was assessed. <b>Results</b>: From the AAOMP diagnostic criteria, hydropic degeneration was found in 35.2%, lymphocytic exocytosis in 32.3%, mild epithelial dysplasia in 2.9%, verrucous epithelial architectural change in 0% and band-like lymphocytic infiltrate, confined to the epithelium-lamina propria interface in 55.8% of the samples. Reproducibility of the histological diagnosis of OLP was achieved in only 19.3% of the cases when applying the 1978 WHO criteria versus the newly proposed AAOMP criteria. <b>Conclusions</b>: A large number of OLP cases failed to meet the AAOMP histological criteria in the present study. Further studies are needed to assess the validity of the proposed diagnostic set.
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spelling doaj-art-441db4d32d8b449abcc4f9d4e9812ed92025-08-20T02:05:24ZengMDPI AGDiagnostics2075-44182025-02-0115555810.3390/diagnostics15050558Discrepancy in the Histological Diagnoses of Oral Lichen Planus Based on WHO Criteria Versus the Newly Proposed Diagnostic Set of the American Academy of Oral and Maxillofacial PathologyMaria Zaharieva Mutafchieva0Desislava Atanasova Tashkova1Department of Periodontology and Oral Mucosa Diseases, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, BulgariaDepartment of General and Clinical Pathology, Faculty of Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria<b>Background/Objectives</b>: The diagnosis of oral lichen planus (OLP) is challenging because many other oral diseases demonstrate similar clinical and microscopic features. Clinicopathological discrepancy and inter- and intraobserver variability in the histological assessment of OLP have been shown in the literature, as there are no unified diagnostic criteria for the disease. In 2016, the American Academy of Oral and Maxillofacial Pathology (AAOMP) proposed a new diagnostic set for OLP. The aim of the study was to assess the reliability of the AAOMP histological criteria in diagnosing OLP. <b>Methods</b>: In this retrospective study, 34 histological sections, once diagnosed as OLP, were revised by a second pathologist using the WHO criteria. Then, all specimens were analyzed for the presence (P) or absence (A) of the criteria listed in the AAOMP diagnostic set. The reproducibility of the histological diagnosis of OLP when applying the different sets of diagnostic criteria was assessed. <b>Results</b>: From the AAOMP diagnostic criteria, hydropic degeneration was found in 35.2%, lymphocytic exocytosis in 32.3%, mild epithelial dysplasia in 2.9%, verrucous epithelial architectural change in 0% and band-like lymphocytic infiltrate, confined to the epithelium-lamina propria interface in 55.8% of the samples. Reproducibility of the histological diagnosis of OLP was achieved in only 19.3% of the cases when applying the 1978 WHO criteria versus the newly proposed AAOMP criteria. <b>Conclusions</b>: A large number of OLP cases failed to meet the AAOMP histological criteria in the present study. Further studies are needed to assess the validity of the proposed diagnostic set.https://www.mdpi.com/2075-4418/15/5/558oral lichen planusOLPAmerican Academy of Oral and Maxillofacial Pathology (AAOMP) diagnostic sethistological assessment
spellingShingle Maria Zaharieva Mutafchieva
Desislava Atanasova Tashkova
Discrepancy in the Histological Diagnoses of Oral Lichen Planus Based on WHO Criteria Versus the Newly Proposed Diagnostic Set of the American Academy of Oral and Maxillofacial Pathology
Diagnostics
oral lichen planus
OLP
American Academy of Oral and Maxillofacial Pathology (AAOMP) diagnostic set
histological assessment
title Discrepancy in the Histological Diagnoses of Oral Lichen Planus Based on WHO Criteria Versus the Newly Proposed Diagnostic Set of the American Academy of Oral and Maxillofacial Pathology
title_full Discrepancy in the Histological Diagnoses of Oral Lichen Planus Based on WHO Criteria Versus the Newly Proposed Diagnostic Set of the American Academy of Oral and Maxillofacial Pathology
title_fullStr Discrepancy in the Histological Diagnoses of Oral Lichen Planus Based on WHO Criteria Versus the Newly Proposed Diagnostic Set of the American Academy of Oral and Maxillofacial Pathology
title_full_unstemmed Discrepancy in the Histological Diagnoses of Oral Lichen Planus Based on WHO Criteria Versus the Newly Proposed Diagnostic Set of the American Academy of Oral and Maxillofacial Pathology
title_short Discrepancy in the Histological Diagnoses of Oral Lichen Planus Based on WHO Criteria Versus the Newly Proposed Diagnostic Set of the American Academy of Oral and Maxillofacial Pathology
title_sort discrepancy in the histological diagnoses of oral lichen planus based on who criteria versus the newly proposed diagnostic set of the american academy of oral and maxillofacial pathology
topic oral lichen planus
OLP
American Academy of Oral and Maxillofacial Pathology (AAOMP) diagnostic set
histological assessment
url https://www.mdpi.com/2075-4418/15/5/558
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