Oral Lichen Planus and Thyroid Disease: A Case-Control Study

Mirlinda Sopi Krasniqi, Zana Sllamniku Dalipi, Valbona Zhjeqi

International Journal of Biomedicine. 2023;13(4):312-316.
DOI: 10.21103/Article13(4)_OA13
Originally published December 5, 2023


Background: Oral lichen planus (OLP) is a chronic inflammatory condition that primarily affects the oral mucosa. While the exact cause of OLP remains unclear, recently, there has been particular interest in researching the potential link between OLP and thyroid gland disorders.
Methods and Results: A total of 100 subjects participated in our research. Among them, 50 were patients (80% women and 20% men) diagnosed with OLP (the main group [MG]), and 50 subjects (60% women and 40% men) with various other oral mucosa concerns (aphthous stomatitis, burning mouth syndrome, herpetic stomatitis, and geographic tongue) comprised the comparison group [CG]. All participants underwent a comprehensive assessment of thyroid function, which included the measurement of free thyroxine (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), thyroid peroxidase antibodies (TPO-Ab), and an ultrasound examination of the thyroid gland performed by an endocrinologist.
Our results reveal a noteworthy gender-based difference in the occurrence of mucosal disorders, indicating a predominance of females. MG had a significantly higher prevalence of hypothyroidism, with 46% of patients affected. In contrast, in CG, the prevalence of hypothyroidism was lower, at 16%, and this difference was statistically significant (P=0.0012). In MG, 50% of cases were found to be in a euthyroid state. In contrast, in CG, a larger proportion (80%) of patients were in a euthyroid state, and this difference was statistically significant (P=0.0017).
Conclusion: Our study has identified a significant and positive association between hypothyroidism and OLP. We recommend that individuals diagnosed with OLP, especially women, consider undergoing routine screening for thyroid disease as part of their healthcare regimen.

oral lichen planus • mucosa • hypothyroidism
  1. Van der Waal I. Oral lichen planus: diagnosis and management. J Dent Indones. 2015;22(3):89-92.
  2. Srinivas K, Aravinda K, Ratnakar P, Nigam N, Gupta S. Oral lichen planus - Review on etiopathogenesis. Natl J Maxillofac Surg. 2011 Jan;2(1):15-6. doi: 10.4103/0975-5950.85847. 
  3. Wu P, Luo S, Zhou T, Wang R, Qiu X, Yuan P, Yang Y, Han Q, Jiang L. Possible Mechanisms Involved in the Cooccurrence of Oral Lichen Planus and Hashimoto's Thyroiditis. Mediators Inflamm. 2020 Feb 4;2020:6309238. doi: 10.1155/2020/6309238.
  4. Cerqueira JDM, Moura JR, Arsati F, Lima-Arsati YBO, Bittencourt RA, Freitas VS. Psychological disorders and oral lichen planus: A systematic review. J Investig Clin Dent. 2018 Nov;9(4):e12363. doi: 10.1111/jicd.12363.
  5. Bermejo-Fenoll A, López-Jornet P. Familial oral lichen planus: presentation of six families. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Aug;102(2):e12-5. doi: 10.1016/j.tripleo.2006.03.016.
  6. Guarneri F, Giuffrida R, Di Bari F, Cannavò SP, Benvenga S. Thyroid Autoimmunity and Lichen. Front Endocrinol (Lausanne). 2017 Jun 27;8:146. doi: 10.3389/fendo.2017.00146.
  7. Atanaskova Mesinkovska N, Brankov N, Piliang M, Kyei A, Bergfeld WF. Association of lichen planopilaris with thyroid disease: a retrospective case-control study. J Am Acad Dermatol. 2014 May;70(5):889-92. doi: 10.1016/j.jaad.2013.12.014. 
  8. Lo Muzio L, Santarelli A, Campisi G, Lacaita M, Favia G. Possible link between Hashimoto's thyroiditis and oral lichen planus: a novel association found. Clin Oral Investig. 2013 Jan;17(1):333-6. doi: 10.1007/s00784-012-0767-4. 
  9. Ajjan RA, Weetman AP. The Pathogenesis of Hashimoto's Thyroiditis: Further Developments in our Understanding. Horm Metab Res. 2015 Sep;47(10):702-10. doi: 10.1055/s-0035-1548832.
  10. Fabue LC, Soriano YJ, Pérez MG. Dental management of patients with endocrine disorders J ClinExp Dent. 2010;2:e196:203.
  11. Cianfarani F, Baldini E, Cavalli A, Marchioni E, Lembo L, Teson M, Persechino S, Zambruno G, Ulisse S, Odorisio T, D'Armiento M. TSH receptor and thyroid-specific gene expression in human skin. J Invest Dermatol. 2010 Jan;130(1):93-101. doi: 10.1038/jid.2009.180.
  12. Baliram R, Latif R, Zaidi M, Davies TF. Expanding the Role of Thyroid-Stimulating Hormone in Skeletal Physiology. Front Endocrinol (Lausanne). 2017 Oct 3;8:252. doi: 10.3389/fendo.2017.00252. 
  13. Boron WF, Boulpaep EL. Medical physiology. 2. ed. Philadelphia (PA): Saunders/Elsevier 2009. Chapter 49, The Thyroid Gland; p.1044-1056.
  14. Gupta S, Jawanda MK. Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management. Indian J Dermatol. 2015 May-Jun;60(3):222-9. doi: 10.4103/0019-5154.156315.
  15. Munde AD, Karle RR, Wankhede PK, Shaikh SS, Kulkurni M. Demographic and clinical profile of oral lichen planus: A retrospective study. Contemp Clin Dent. 2013 Apr;4(2):181-5. doi: 10.4103/0976-237X.114873. 
  16. Tang Y, Shi L, Jiang B, Zhou Z, Shen X. A Cross-Sectional Study of Oral Lichen Planus Associated With Thyroid Diseases in East China. Front Endocrinol (Lausanne). 2020 Jan 24;10:928. doi: 10.3389/fendo.2019.00928. 
  17. Xue JL, Fan MW, Wang SZ, Chen XM, Li Y, Wang L. A clinical study of 674 patients with oral lichen planus in China. J Oral Pathol Med. 2005 Sep;34(8):467-72. doi: 10.1111/j.1600-0714.2005.00341.x. 
  18. Maryam Baharvand, Farzaneh Hamrahi, Shahzad Gholami, Parisa Hajighasem. Frequency of oral Lichen Planus among hypothyroid patients. Braz Dent Sci. 2022 Jan/Mar;25(1): e2884.
  19. Maddheshiya N, Shivakumar GC, Misra N, Rastogi V, Kumar S. Prevalence of oral lichen planus in patients with hypothyroidism versus non-hypothyroidism - A case control study of 1000 cases. J Oral Maxillofac Pathol. 2022 Oct-Dec;26(4):509-517. doi: 10.4103/jomfp.jomfp_517_20.
  20. Zhou T, Li D, Chen Q, Hua H, Li C. Correlation Between Oral Lichen Planus and Thyroid Disease in China: A Case-Control Study. Front Endocrinol (Lausanne). 2018 Jun 18;9:330. doi: 10.3389/fendo.2018.00330.
  21. Robledo-Sierra J, Mattsson U, Jontell M. Use of systemic medication in patients with oral lichen planus - a possible association with hypothyroidism. Oral Dis. 2013 Apr;19(3):313-9. doi: 10.1111/odi.12009.
  22. Garcia-Pola MJ, Llorente-Pendás S, Seoane-Romero JM, Berasaluce MJ, García-Martín JM. Thyroid Disease and Oral Lichen Planus as Comorbidity: A Prospective Case-Control Study. Dermatology. 2016;232(2):214-9. doi: 10.1159/000442438.
  23. Alikhani M, Ghalaiani P, Askariyan E, Khunsaraki ZA, Tavangar A, Naderi A. Association between the clinical severity of oral lichen planus and anti-TPO level in thyroid patients. Braz Oral Res. 2017 Jan 5;31:e10. doi: 10.1590/1807-3107BOR-2017.vol31.0010. 

Download Article
Received September 29, 2023.
Accepted November 11, 2023.
©2023 International Medical Research and Development Corporation.