oral lichen planus

Definition

Lichen planus is a disorder affecting the skin or in the mouth.70% of patients with skin lesions have oral involvement, but only 10% of patients presenting with oral lesions have involvement .It is more common in women over 30-50 years of age.

Types

• Plaque-like
• Reticular
• Papular
• Erosive
• Atropic
• Bullous

Causes

The exact cause of oral lichen planus is unknown. However, it is likely to be related to an allergic or immune reaction. Predisposing factors include:

• Exposure to medications, HIV infection, liver disorders, reaction to amalgam or gold

lichen planus tongue

Signs and symptoms of oral lichen planus

• White irregular striae lesions
• Tend to be both sides (bilateral)
• Maybe asymptomatic or sore, especially with hot and spicy foods
• The atropic and erosive varieties though, are often painful
• Lacy, firm adherent, white plaques usually on inside of the cheek
• May also affect sides of tongue, gum and lips
• Painful (mild cases may have no discomfort)
• Lesions occasionally form painful ulcers

Investigations & diagnosis

Biopsy required to confirm diagnosis in cases of doubt and to differentiate from lichenoid reaction, keratosis, systemic lupus erythematosis or other white lesions

Treatment

Asymptomatic: no treatment

Symptomatic: Topical corticosteroid and rarely, intralesionally or systemically

Other drugs such as retinoids, griseofulvin or cyclosporine may have adverse effects.

Prognosis

Oral lichen planus is generally not harmful and can be cure. However it can recur if the predisposing factor is not removed or healed. It may have a small cancer potential

When to contact a doctor

Visit the doctor if:

• Your symptoms continue and get worse
• The skin or oral lesions change in appearance
• The condition recur even after treatment