Response to a Comment on “Malignant transformation evidences of Oral Lichen Planus: When the time is of the essence”

Dear Editor, We want to thank Desai et al. [1] for the comment and discussion on our article “Malignant transformation evidences of Oral Lichen Planus: When the time is of the essence” [2]. Firstly, we are pleased to inform you that our extended work about Oral Lichen Planus (OLP) and malignant transformation was recently published, which allows us to better understand unclear issues [3]. However, regarding the letter by Desai RS et al., some clarifications deserve to be provided. We are in agreement with Guan et al. [4] who highlighted that OLP malignant transformation occurred also in not smokers patients. Our findings, indeed, showed a significant malignant transformation rate associated with localization of OLP lesions (especially on tongue margins, OR = 3.55 and P = 0.04) and with features of them (particularly erosive and ulcerative lesions, OR = 2.48 and P = 0.1). Regarding habits, smoking was found to be significantly associated with cancer transformation with an Odds Ratio (OR) of 3.29 (IC 0.58–18.37) and P = 0.18; on the other side, it was difficult to estimate the role of alcoholic consumption, due to uncertain answers of patients interviewed. Nevertheless, in our opinion, the important focus to evaluate is the observation period of patients when OLP is diagnosed and lesions. Our work showed the great importance of extending follow-up to early diagnose malignant transformation; indeed some of them occurred later than 4 years of observation, meaning that the cancer transformation rate of OLP lesions is a significant risk during the life as Guan et al. suggested in their research. Considering our results, we can conclude that clinical features of OLP lesions must be carefully evaluated for the correct timing of the follow-up, which must be as long as possible for them. We sincerely thank Desai RS et al. for the discussion about our work.