Malignant potential of oral and labial chronic discoid lupus erythematosus: a clinicopathological study of 87 cases.

Aims:  To investigate clinicopathological features and identify clinicopathological risk factors for the malignant transformation of oral and labial chronic discoid lupus erythematosus (DLE) in a relatively large number of patients from China.

Methods And Results: A total of 87 patients with clinical and histopathological diagnosis of DLE between 1993 and 2009 were reviewed retrospectively in our hospital. The average age at diagnosis was 51.7 years, with a male:female ratio of 1:1.8. The lower lip was the most common site (71.3%). We documented six DLE patients with malignant transformation. On univariate analysis, patients with high-risk dysplasia (P = 0.002) or aged >60 (P = 0.045) were associated with DLE malignant transformation, but gender, lesion site, smoking and alcohol intake were not risk factors. On multivariate analysis, high-risk dysplasia was a significant indicator for DLE malignant transformation. High-risk dysplasia was associated with a 14.24-fold [95% confidence interval (95% CI), 1.97-102.88; P = 0.008] increased risk of malignant transformation, compared with non/low-risk dysplasia.

Conclusions: The utilization of high-risk dysplasia as a significant indicator for evaluating malignant transformation risk in patients with DLE is suggested, which may be helpful to guide treatment selection.