Number V Oral lichen planus: clinical features and management

JBR Journal of Interdisciplinary Medicine and Dental Science, 2014

It is a well known fact that oral lichen planus (OLP) is a non infectious disease affecting the oral mucous membrane. It is considered to be an autoimmune disorder mediated mainly by the T-lymphocytes. It affects 1-2% of the general population with maximum prevelance seen among women above the age of 40. WHO considers it to be a potentially malignant disorder and the rate of malignant transformation has been put between 0.5-2%. This article mainly reviews the various pathogenetic mechanisms by which this unique disorder occurs along with the clinical, histopathological and treatment aspects.

Journal of Advanced Clinical and Research Insights, 2019

Oral reticular lichen planus (OLP) is a common mucocutaneous disease of uncertain cause. The disease seems to be autoimmune disease in which the apoptosis is triggered by CD8+T cells and non-specific mechanisms such as activation of matrix metalloproteinase and degranulation of mast cell. It is most often reported in patients with 30-60 years of age, group with a gender predilection, and female-to-male ratio of 1.4:1. This article is a case series of different forms and appearances of OLP with etiopathogenesis, clinical presentation, oral findings, diagnosis, malignant transformation potential, and treatment of OLP.

Journal of Pakistan Association of Dermatologists, 2022

Lichen planus (LP) is a chronic inflammatory condition affecting the skin and the mucous membrane. LP is a multifactorial condition and the pathogenesis depends mainly on the evoked cellular immunity. Most cases develop on the oral mucosa. Oral lichen planus (OLP) has several clinical patterns and the symptoms range from no symptoms to aches and burning sensations. The histopathological picture is considered a characteristic feature of OLO. OLP is incurable and the treatment aims to reduce the patient's complaints and enhance the quality of the patient's life. Although there is no uniform protocol for treatment, corticosteroids and adjuvant treatment are commonly used for OLP management. Malignant transformation is suspected in each OLP, despite the type and location of the OLP inside the mouth. Periodic follow up is required. Updating the data about the OLP is always needed to improve the outcomes of management.

Journal Oral Of Research, 2013

Oral lichen planus (OLP) is a mucocutaneous disease which can alter the skin, oral mucosa and other mucous membranes. It affects approximately one to two percent of the population, mainly women, and it occurs most frequently during the fifth and sixth decades of life. Usually, oral lesions appear before skin lesions and, sometimes, they expose themselves only in the oral mucosa. In the mouth, the most affected area is the buccal mucosa, although it can present itself on the tongue, gums and/or palate as well. 1-7 The course is chronic with frequent recurrences. Diagnosis is based on clinic and histology, but techniques such as direct immunofluorescence (DIF) can provide a valuable additional criterion. There is no fully effective treatment. 1, 8 Etiology and pathogenesis. Today, it is considered a disease of obscure etiology, although various triggers are proposed. Besides, there is a considerable controversy about OLP pathogenesis. 2, 9 Current evidence presents multifactorial pathogenesis of various immune mechanisms 2, 3, 10-13 : 1. Antigen-specific immune response: CD8+ cytotoxic cells are activated in OLP by major histocompatibility complex class I and II molecules when antigens are presented. 2. The proposed mechanisms involved in nonspecific immune response are mast cell degranulation and marked matrix metalloproteinases activation. 3. Another hypothesis is the autoimmune response. It is supported by various OLP characteristics such as chronicity, adult onset, association with other autoimmune diseases, female predilection, lack of TGF-ß1expression, overexpression of heat shock proteins, keratinocytes apoptosis and Langerhans cell maturation. Among others, these factors have been proposed as causative agents: genetic component, trauma, drugs, both viral and bacterial infectious agents, food allergy, autoimmunity, stress, immunodeficiency, dental materials

Journal of dental research, dental clinics, dental prospects, 2010

Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many un-established etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.

Journal of Oral Science, 2016

Oral lichen planus (OLP) is a T cellmediated chronic inflammatory disease with a varied clinical presentation. The present clinical study was carried out to clarify the demographic and clinical profile of 108 patients with OLP. The patients were identified based on the diagnostic criteria proposed by van der Meij et al. (2003) modified from the WHO (1978) clinical and histopathologic definition of OLP. Information such as age, gender, clinical presentation and type of OLP, site of involvement, symptoms, extraoral involvement, history of systemic disease, familial occurrence and risk factors like chewing and smoking tobacco, chewing betel quid, alcohol consumption were obtained. Mean age of OLP patients was 45.4 years, and among the identified patients, 70.4% were females. The most frequent clinical type was the reticular form (80.6%). The OLP lesions were symptomatic in 77.8% of the patients. The buccal mucosa was the most affected site (87.9%) and multiple oral lesions were observed in 41.7% of the patients. Among the OLP patients, 36.1% and 4.7% reported chewing tobacco and smoking tobacco, respectively. Histopathologically, epithelial dysplasia was seen in two cases. The chronic nature of OLP warrants patient education, psychological support and long-term follow up.

International Journal of Dermatology, 2015

Oral lichen planus (OLP) is a common T cell-mediated mucocutaneous disease of unknown etiology. A great number of factors have been suggested as relevant to the etiology of this disease. In this article, the authors assemble recent knowledge about the pathogenesis of OLP, discuss some proposed hypotheses, and compare OLP with oral lichenoid lesions.

Folia Medica

Lichen planus is a chronic mucocutaneous inflammatory disease aff ecting 1-2% of the general population with maximum prevalence of the disease in women above the age of 40. Its aetiology remains unclear and the pathogenesis is still the object of much speculation. It is considered to be an autoimmune disorder mediated mainly by the T-lymphocytes. The present paper presents the most well-known external agents (viruses in particular), internal agents like stress, and the heat shock protein thought to be trigger factors and describes the action of diff erent cells and proteins associated with the development of that disease. Diagnosis is based on clinical and histopathologic evidence; direct and indirect immunofluorescence techniques can also be of use. Despite the wide variety of therapeutic modalities, treatment outcomes are often insufficient. Currently, topical corticosteroids are widely accepted as a standard therapy, but also retinoids, calcineurin inhibitors and other immunosupp...

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology. In this paper we review the clinical and histological features of OLP, process of OLP diagnosis, causes of OLP, management of OLP patients and medical treatment of OLP lesions. Approximately 0.2 per cent OLP patients develop intra-oral carcinoma each year compared with approximately 0.005 per cent Australian adults. Possible mechanisms of increased oral cancer risk in OLP patients are presented. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. Patient education may improve the outcomes of OLP therapy and further reduce the risk of oral cancer in OLP patients. Although OLP may be diagnosed clinically, appropriate specialist referral is required for: (i) histological diagnosis; (ii) assessment of causative/exacerbating factors, associated diseases and oral cancer risk; (iii) patient education and management; (iv) medical treatment; and (v) long-term review and re-biopsy as required.

Journal of Contemporary Dentistry

Lichen planus is an autoimmune-mediated chronic inflammatory disease of unknown etiology, but studies have reported the role of cytotoxic T cells responsible for the disruption of basal keratinocytes and also causing the clinical symptoms. It is commonly seen in adults, with rare occurrence in children. It clinically manifests on the skin and oral mucosa, with skin lesions healing faster than the oral lesions. To obtain a diagnosis, a complete history and characteristic clinical features are usually sufficient for diagnosis, but there are certain other lesions like lichenoid reaction, contact sensitivity, white sponge nevus, pemphigoid and lupus erythematosus that show similar clinical characteristics, hence the need for histopathological evaluation using standard criteria given by Krutchkoff or World Health Organization (WHO). The treatment administered is always for eliminating symptoms and discomfort of the patients. A variety of pharmacological and natural alternatives have been used, along with frequent follow up visits in case of a tropic and erosive lichen planus. The purpose of this paper is to review the current trends in the management of oral lichen planus.