A descriptive analysis of oral lichen planus from tertiary diagnostic centres in the Western Cape
Lichen planus is a systemic disease that follows a chronic course. The exact aetiology remains unknown but an immune mediated pathogenesis has been implicated. Oral lichen planus is a common form of this disease and can occur in isolation or it may include the skin, genitalia and lesions involving the scalp and hair follicles. Epidemiological studies on oral lichen planus are few. Those that have been conducted have been in developed nations such as North America and Europe as well as Asia and the Middle East. Few African studies report on the demographics of the affected patients. Factors such as patient demographics and trends of diseases are essential to investigate. Findings of such studies may be useful in determining additional patient based criteria that can assist in obtaining a definitive diagnosis and subsequently aid in the management protocols of the specific disease in question. This process is as essential for oral lichen planus as for other diseases. Oral lichen planus can have clinical similarities with other diseases of the oral mucosa. Similarities can also be seen histologically that may further complicate the process of defining the diagnosis. Oral lichen planus may not be commonly associated with frank morbidity, but severe discomfort can be experienced in some clinical variants. This disease has been described as “difficult to manage” Camacho-Alonso et al, 2007). Furthermore, there is an ongoing debate about its malignant potential (Sugerman & Savage; 2002; Scully and Carrozzo; 2008). These factors support the relevance of further investigation of oral lichen planus. This study will report the demographics of patients who have been diagnosed with oral lichen planus in a subset of the South African population, within the Western Cape. The description of the ethnic groups in South Africa was as described by Statistics South Africa, namely; “African” was used to describe Black individuals, “Coloured” was used to describe individuals of mixed ethnic origin, “Indian” was used to describe patients whose ethnic origin was of the Indian/Asian continent, the latter however excluded persons of Chinese decent and “White” described those persons of European origin. The ethnic distribution reported from within the literature will report on the terminology used by the respective authors and hence not follow the guidelines outlined above.