Oral Lichen Planus

Abstract

Lichen planus (LP) is a chronic, inflammatory, mucocutaneous, immune-mediated condition with variable clinical presentations. Oral lichen planus (OLP) is the oral variant and affects about 1–2% of the general adult population with characteristic relapses and remissions. OLP is about twice as common in females as in males. The most commonly involved oral sites are the buccal mucosa, lateral surfaces of the tongue, and gingivae, respectively. Six clinical patterns of OLP are described in literature: reticular, plaque-like, erythematous, erosive/ ulcerative, papular, and bullous. Helper and cytotoxic T lymphocytes, in addition to antigen-presenting cells, represent the key cells in the inflammatory infiltrate in OLP and play an essential role in its pathogenesis. The diagnosis of OLP is usually made by clinical and histological examinations. Lesions similar to OLP may develop as a reaction to dental restorative materials or systemic medications or conditions and are called oral lichenoid reactions (OLR). OLP and OLR may collectively be referred to as oral lichenoid lesions (OLLs). Management of symptomatic OLLs varies considerably and ranges from elimination of precipitating factors – local or systemic to long-term pharmacological interventions, mainly with topical immunosuppressants, corticosteroids in particular. In the light of the ongoing debate regarding the malignant transformation potential of OLLs, a long-term follow-up protocol is essential.