Can deram be a cause of oral lichen planus?

OBJECTIVE To study the relationship between oral lichen planus LP and the habit of chewing deram. METHODS A clinically based controlled observational study including a total of 176 women who used to chew deram and 200 women who never used deram, who consulted the Dermatology Department of Basrah Teaching Hospital, and a private clinic, Barsah, Iraq during the period from February 2005 to July 2007. RESULTS The study showed that the incidence of oral LP is greater among 176 deram chewers (23.3%) in comparison with 200 women who never use deram (1.5%), particularly among those with frequent (51.2%) and prolonged (65.8%) chewing of deram. Oral lesions, were mostly asymptomatic (80.5%) and predominantly of reticulate pattern (87.9%). Avoidance of deram chewing induced marked or complete improvement of the oral lesions in 56.3% of cases even without treatment within a 3 month follow up period. Pathological examination showed features similar to classical LP. CONCLUSION Deram chewing should be considered as a possible cause of oral LP, particularly among frequent and prolonged chewers.