Oral Lichen Planus
Oral lichen planus is a chronic inflammatory mucocutaneous disease of unknown etiology but with an immunological basis.
It is the most common infectious disease of the oral cavity, with a prevalence ranging from 0.2% to 1.9% of the population, and is more common in women than in men.
Causes of Oral Lichen Planus
There are a number of causes or aggravating factors, including the following:
- Genetic factors.
- Hormonal factors.
- Viruses. It is associated with the human papillomavirus and the human herpes virus.
- Medications. The main medications that affect the lesions and worsen them are chloroquine, captopril, enalapril, propranolol, ibuprofen, and furosemide.
- Local factors: dentures, metals, alcohol, tobacco, and bacterial plaque.
- Stress.
Types of Oral Lichen Planus
There are different types of lichen planus; they often appear in combination, but one type typically predominates:
- Predominantly white forms of oral lichen planus. These are whitish papular and reticular lesions (Wickham’s striae), which may be accompanied by reddish erosive areas.
- Predominantly red forms of oral lichen planus. These are atrophic, erosive, and desquamative erythematous lesions that are often accompanied by white streaks or papules.
Among the most common sites are various areas of the oral cavity, such as the buccal mucosa, the tongue (“butterfly-wing” lesion), and the gums (erythematous-desquamative gingivitis), but it can also appear on the skin, the genitals, and the esophagus.
Major Complications of Oral Lichen Planus
The main complications include the following:
- Mechanical, physical, or chemical erosion.
- Secondary infection with Candida or HPV.
- Drug-induced erosive flare-ups.
- Mucoceles.
- Scarring.
- Leukoplakia.
There is no cure for oral lichen planus; however, regular follow-up is recommended for asymptomatic cases. In cases where symptoms are present, local or systemic corticosteroids will be prescribed, and immunosuppressants may be added if there is no response to corticosteroids.
