Inter-Observer and Intra-Observer Variations in the Assessment of Epithelial Dysplasia in Oral Lichenoid Diseases.

Marwa Zohdy,Simone Cazzaniga,Helmut Beltraminelli,Helga Nievergelt,Roland Blum,Valérie G A Suter,Laurence Feldmeyer

doi:10.3390/dermatopathology8020013

Abstract

Highlights

Oral lichen planus (OLP) and oral lichenoid lesions (OLL) can both present with histological dysplasia
Retrospective, interdisciplinary study, four board-certified dermatopathologists who routinely sign out oral mucosal biopsies for the evaluation of dysplasia evaluated the grade of epithelial dysplasia in 112 biopsies with an oral lichenoid inflammation
We found a great variability of the interpretation of dysplasia, with a low inter-observer reliability among the four examiners

Summary

Introduction

Oral lichen planus (OLP) and oral lichenoid lesions (OLL) can both present with histological dysplasia. Despite the presence of WHO-defined criteria for the evaluation of epithelial dysplasia, its assessment is frequently subjective (inter-observer variability). The lack of reproducibility in the evaluation of dysplasia is even more complex in the presence of a lichenoid inflammation. We evaluated dysplasia in 112 oral biopsies with lichenoid inflammation in order to study the interobserver and the intra-observer variability. Despite the presence of WHO-defined criteria to evaluate epithelial dysplasia—such as the presence of several architectural and cellular changes—their assessment is frequently subjective (inter-observer variability), and is inconsistent [5,6,7,8,9]. The lack of reproducibility in the evaluation of dysplasia is even more complex in the presence of a lichenoid inflammation, when the keratinocytes show reactive alterations which may appear as dysplastic changes. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations

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Conclusion