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Hepatitis C virus (HCV) infection induces variable dermatologic manifestations.To determine whether differences exist in the clinical features and behavior of oral lichen planus (OLP) between HCV-positive (HCV+ve) and HCV-negative (HCV−ve) patients.Two hundred and sixty three patients (156 women and 107 men), with a mean age of 55.5 years, with OLP (76 HCV+ve and 187 HCV−ve) were clinically evaluated. Previously, all local factors that could modify the clinical characteristics were removed and were monitored carefully following morphology.In both groups, the prevalent clinical form of OLP was the mixed form (33.1% in HCV−ve and 35.5% in HCV+ve patients), in which reticular-plaque lesions coexist with atrophic-erosive ones. The reticular form was more frequent in HCV+ve (25%) than in HCV−ve (18.7%) patients, whereas plaque lesions were more prevalent in HCV−ve (15.5%) than in HCV+ve (5.2%) patients (P < 0.01, chi-squared test). There were no significant differences in the frequency of erosive (27.2% in HCV−ve and 27.6% in HCV+ve) and atrophic (5.3% in HCV−ve and 5.2% in HCV+ve) forms between the two groups.Our findings show that there were statistically significant differences between OLP-HCV−ve and OLP-HCV+ve groups for reticular and plaque clinical forms. These findings underline the importance of liver examination in all OLP patients, including cases with mild, asymptomatic keratotic forms of the disease.