Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2021; 9(6): 1446-1454
Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1446
Treatment of oral lichen planus by surgical excision and acellular dermal matrix grafting: Eleven case reports and review of literature
Zhen-Zhen Fu, Li-Qiang Chen, Yao-Xiang Xu, Jin Yue, Qian Ding, Wen-Lin Xiao
Zhen-Zhen Fu, Li-Qiang Chen, Yao-Xiang Xu, Jin Yue, Qian Ding, Wen-Lin Xiao, Department of Stomatology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Zhen-Zhen Fu, Li-Qiang Chen, Yao-Xiang Xu, Jin Yue, Qian Ding, Wen-Lin Xiao, School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
Author contributions: Fu ZZ and Chen LQ were responsible for the data collection; Fu ZZ and Chen LQ drafted the manuscript; Ding Q carried out the analysis and interpreted the results; Xu YX and Yue J participated in the operation; Xiao WL designed the study and was the project supervisor; All authors reviewed and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and the accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wen-Lin Xiao, DDS, MD, Chief Doctor, Deputy Director, Department of Stomatology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China.
Received: October 17, 2020
Peer-review started: October 17, 2020
First decision: December 8, 2020
Revised: December 23, 2020
Accepted: January 6, 2021
Article in press: January 6, 2021
Published online: February 26, 2021

Oral lichen planus (OLP) is a chronic inflammatory disorder, and it can affect normal oral function. The conventional treatments for OLP are not always effective, and relapse easily occurs. Therefore, treatment of OLP is difficult and challenging. In this study, we evaluated over a long period the clinical efficacy of surgical excision and acellular dermal matrix (ADM) grafting in patients with refractory OLP.


Eleven patients with refractory OLP underwent a standardized protocol of surgical excision and ADM grafting. The condition of the area of the grafted wound, the intraoperative maximum mouth opening, pain, and clinical healing were assessed at postoperative follow-up visits. All patients had a flat surgical area with similar mucosal tissue coverage and local scar formation. Patients had no irritation and pain in their mucous membranes when eating acidic and spicy food. All patients’ mouth openings returned to normal within 2-6 mo after surgery. During follow-up, none of the patients had recurrence of OLP after surgery. The longest follow-up was 11 yr and the shortest was 6 mo, and none of the patients relapsed during follow-up.


Surgical excision and ADM grafting could be an effective method to treat refractory OLP.

Keywords: Lichen planus, Surgical excision, Acellular dermal matrix, Case report, Oral

Core Tip: We report 11 patients with oral lichen planus who were treated with medication but with poor efficacy, and relapse easily occurred. In order to relieve pain and avoid malignant transformation, we removed the lesions surgically and repaired the postoperative mucosal defect with acellular dermal matrix. The postoperative effect was good, the pain disappeared, and the degree of mouth opening returned to normal. No immunological rejection or recurrence of oral lichen planus was seen during follow-up of 6 mo to 11 yr.