Neoplasia/dysplasia Surveillance of Oral Lichen Planus in Malaysia: a Preliminary Study using Topography Maps

Background: Conventional methods for writing case notes detailing the progress of oral lichen planus (OLP),a precancerous condition that requires long-term surveillance, is both time-consuming and tedious for the busyclinician.
Objectives: To design and perform a simple surveillance on OLP patients based on colour-codedtopography mouth maps (TMM). Materials and methods: Three colour-coded TMM were employed: red forOLP in high risk oral mucosal sites, yellow for cases showing improvement and green for asymptomatic lesionsat each recall visit. In this preliminary study, these were applied on 30 histologically confirmed OLP individualsattending the Oral Medicine Clinic at the Department of Oral Pathology, Oral Medicine & Periodontology,Faculty of Dentistry, University of Malaya. The sites and extent of OLP lesions were charted on either red,yellow or green TMM based on defined criteria. This surveillance evaluated OLP in relation to patient’s age,race, gender, underlying systemic conditions, oral habits, initial onset of OLP, oral manifestations and presence/absence of clinically suspicious areas.
Results: Study sample comprised 4 (13.3%) Malays, 9 (30.0%) Chineseand 17 (56.7%) Indians. Most OLP patients belong to the green TMM (n=14, 46.6%) group followed by red(n=11, 36.7%) and yellow (n=5, 16.7%) groups. Of the 11 cases with red TMM, rebiopsy was performed on 4cases but no dysplasia was detected. Any local confounding factors namely periodontal disease or faulty dentalrestorations were managed accordingly.
Conclusions: TMM is simple to use and aided the clinicians in terms oftime saving and patient management. Hence, follow-up of OLP patients can be carried out more efficiently andappropriately. TMM can be used for surveillance of other oral precancerous lesions and conditions.