Lichen planus is probably a chronic inflammatory, immunologically induced mucocutaneous dermatosis. Lichen planus mucosae most commonly manifest itself in the oral cavity. Various trigger factors such as bacterial or viral infections, medication, or physical stimuli are discussed in the development of the disease. An association with infections caused by human papillomaviruses has also been described, but a causal relationship has not been sufficiently proven. A squamous cell carcinoma can develop on the basis of lichen planus mucosae as a facultative precancerous condition, but the malignant transformation rate is low. The risk of malignant transformation is significantly increased in patients with oral lichen planus who smoke, consume more alcohol, or have hepatitis C. We describe 2 patients who developed locally advanced squamous cell carcinoma on the basis of long-standing oral lichen planus. Both cases were successfully treated by radical tumor resection followed by reconstruction and adjuvant radiation/radiochemotherapy.

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