Relationship between anemia and oral lichen planus: New therapeutic perspectives based on anemia management: A systematic review and meta-analysis

Abstract

Anemia is a multifactorial condition influenced by nutritional deficiencies, chronic diseases, and inflammatory processes. These factors not only contribute to anemia but may also exacerbate oral conditions such as Oral Lichen Planus (OLP) by impairing epithelial integrity and immune function. By synthesizing published studies, this review seeks to clarify whether anemia is associated with OLP and to highlight biological mechanisms common to both conditions that could be relevant for future therapeutic development. Methods: A comprehensive literature search was conducted across the selected electronic databases: Medline/Pubmed, Scopus, and Cochrane. Methodological quality and potential bias of the included studies were evaluated using the Newcastle–Ottawa Scale (NOS), while the overall certainty of the evidence was appraised according to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) framework. Forest plots were generated using the Cochrane RevMan software to evaluate and visually summarize the results of the included studies. Results: Application of the search strategy resulted in the identification of 549 articles; after applying exclusion and inclusion criteria, 11 papers were selected. The prevalence of anemia, iron deficiency, and folic acid deficiency was significantly increased in the study population (p < 0.05); whereas hemoglobin deficiency was observed exclusively in women with statistical significance (p < 0.00001), driven by a single large study. Conclusions: Patients with OLP show a higher prevalence of anemia and deficiencies in key hematologic micronutrients such as vitamin B12, folic acid, and iron. Routine laboratory evaluation is recommended to detect and manage these systemic alterations. In addition to corticosteroid therapy, micronutrient supplementation may serve as a useful complementary treatment approach.