Rotaru D, Chisnoiu R, Picos AM, Chisnoiu A Treatment trends in oral lichen planus and oral lichenoid lesions (review). Exp Ther Med. 2020; 20 https://doi.org/10.3892/etm.2020.9328
Warnakulasuriya S, Kujan O, Aguirre-Urizar JM Oral potentially malignant disorders: a consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 2021; 27:1862-1880 https://doi.org/10.1111/odi.13704
Ramalingam S, Malathi N, Thamizhchelvan H, Sangeetha N, Rajan ST Role of mast cells in oral lichen planus and oral lichenoid reactions. Autoimmune Dis. 2018; 2018 https://doi.org/10.1155/2018/7936564
Thornhill M, Sankar V, Xu X The role of histopathological characteristics in distinguishing amalgam-associated oral lichenoid reactions and oral lichen planus. J Oral Pathol Med. 2006; 35:233-240 https://doi.org/10.1111/j.1600-0714.2006.00406.x
Shavit E, Hagen K, Shear N Oral lichen planus: a novel staging and algorithmic approach and all that is essential to know. F1000Res. 2020; 9 https://doi.org/10.12688/f1000research.18713.1
González-Moles M, Warnakulasuriya S, González-Ruiz I Worldwide prevalence of oral lichen planus: a systematic review and meta-analysis. Oral Dis. 2021; 27:813-828 https://doi.org/10.1111/odi.13323
Schmidt-Westhausen AM Oral lichen planus and lichenoid lesions: what's new?. Quintessence Int. 2020; 51:156-161 https://doi.org/10.3290/j.qi.a43868
Thom JJ, Holmstrup P, Rindum J, Pindborg JJ Course of various clinical forms of oral lichen planus. A prospective follow-up study of 611 patients. J Oral Pathol. 1998; 17:213-218 https://doi.org/10.1111/j.1600-0714.1988.tb01527.x
Field A, Longman L, Tyldesley WR Tyldesley's Oral Medicine, 5th edn. Oxford: Oxford University Press; 2003
Gheorghe C, Mihai L, Parlatescu I, Tovaru S Association of oral lichen planus with chronic C hepatitis. Review of the data in literature. Maedica (Bucur). 2014; 9:98-103
Alaizari NA, Al-Maweri SA, Al-Shamiri HM, Tarakji B, Shugaa-Addin B Hepatitis C virus infections in oral lichen planus: a systematic review and meta-analysis. Aust Dent J. 2016; 61:282-287 https://doi.org/10.1111/adj.12382
Elenbaas A, Enciso R, Al-Eryani K Oral lichen planus: a review of clinical features, etiologies, and treatments. Dent Rev. 2022; 2:(1) https://doi.org/10.1016/j.dentre.2021.100007
Arduino P, Karimi D, Tirone F Evidence of earlier thyroid dysfunction in newly diagnosed oral lichen planus patients: a hint for endocrinologists. Endocr Connect. 2017; 6:726-730 https://doi.org/10.1530/EC-17-0262
Siponen M, Huuskonen L, Läärä E, Salo T Association of oral lichen planus with thyroid disease in a Finnish population: a retrospective case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110:319-324 https://doi.org/10.1016/j.tripleo.2010.04.001
Khudhur AS, Di Zenzo G, Carrozzo M Oral lichenoid tissue reactions: diagnosis and classification. Expert Rev Mol Diagn. 2014; 14:169-184 https://doi.org/10.1586/14737159.2014.888953
Al-Hashimi I, Schifter M, Lockhart P Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103 Suppl:S25.e1-12 https://doi.org/10.1016/j.tripleo.2006.11.001
Lucchese A, Dolci A, Minervini G Vulvovaginal gingival lichen planus: report of two cases and review of literature. Oral Implantol (Rome). 2016; 9:54-60 https://doi.org/10.11138/orl/2016.9.2.054
Olszewska M, Banka-Wrona A, Skrok A Vulvovaginal-gingival lichen planus: association with lichen planopilaris and stratified epithelium-specific antinuclear antibodies. Acta Derm Venereol. 2016; 96:92-96 https://doi.org/10.2340/00015555-2141
Sharma N, Malhotra SK, Kuthial M, Chahal KS Vulvo-vaginal ano-gingival syndrome: Another variant of mucosal lichen planus. Indian J Sex Transm Dis AIDS. 2017; 38:86-88 https://doi.org/10.4103/0253-7184.203432
González-Moles MÁ, Ruiz-Ávila I, González-Ruiz L, Ayén Á, Gil-Montoya JA, Ramos-García P Malignant transformation risk of oral lichen planus: a systematic review and comprehensive metaanalysis. Oral Oncol. 2019; 96:121-130 https://doi.org/10.1016/j.oraloncology.2019.07.012
Garcia-Pola MJ, Llorente-Pendás S, González-Garcia M, García-Martín JM The development of proliferative verrucous leukoplakia in oral lichen planus. A preliminary study. Med Oral Patol Oral Cir Bucal. 2016; 21:e328-e334 https://doi.org/10.4317/medoral.20832
Locca O, Sollecito T, Alawi F Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype. Head Neck. 2020; 42:539-555 https://doi.org/10.1002/hed.26006
Suter VGA, Warnakulasuriya S The role of patch testing in the management of oral lichenoid reactions. J Oral Pathol Med. 2016; 45:48-57 https://doi.org/10.1111/jop.12328
Montebugnoli L, Venturi M, Gissi DB, Cervellati F Clinical and histologic healing of lichenoid oral lesions following amalgam removal: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 113:766-772 https://doi.org/10.1016/j.oooo.2011.12.007
Van der Meij EH, Van der Waal I Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003; 32:507-512 https://doi.org/10.1034/j.1600-0714.2003.00125.x
Eccles K, Carey B, Cook R Oral potentially malignant disorders: advice on management in primary care. J Oral Med Oral Surg. 2022; 28 https://doi.org/10.1051/mbcb/2022017
Rudralingam M, Randall C, Mighell AJ The use of topical steroid preparations in oral medicine in the UK. Br Dent J. 2017; 223:633-638 https://doi.org/10.1038/sj.bdj.2017.880
Finn D, Randall C, Field EA UK Dental Medicines Advisory Service: questions asked by dentists – part 5: prescribing for oromucosal diseases and dry mouth. Br Dent J. 2021; 231:689-695 https://doi.org/10.1038/s41415-021-3681-9
Scottish Dental Clinical Effectiveness Programme. Drug prescribing for dentistry. 2025. www.sdcepdentalprescribing.nhs.scot/ (accessed March 2025)
Ioannides D, Vakirlis E, Kemeny L European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol. 2020; 34:1403-1414 https://doi.org/10.1111/jdv.16464
Lajevardi V, Ghodsi SZ, Hallaji Z, Shafiei Z, Aghazadeh N, Akbari Z Treatment of erosive oral lichen planus with methotrexate. J Dtsch Dermatol Ges. 2016; 14:286-293 https://doi.org/10.1111/ddg.12636
Chauhan P, De D, Handa S, Narang T, Saikia UN A prospective observational study to compare efficacy of topical triamcinolone acetonide 0.1% oral paste, oral methotrexate, and a combination of topical triamcinolone acetonide 0.1% and oral methotrexate in moderate to severe oral lichen planus. Dermatol Ther. 2018; 31:(1) https://doi.org/10.1111/dth.12563
Yeshurun A, Bergman R, Bathish N, Khamaysi Z Hydroxychloroquine sulphate therapy of erosive oral lichen planus. Australas J Dermatol. 2019; 60:e109-e112 https://doi.org/10.1111/ajd.12948
Cheng S, Kirtschig G, Cooper S, Thornhill M, Leonardi-Bee J, Murphy R Interventions for erosive lichen planus affecting mucosal sites. Cochrane Database Syst Rev. 2012; 2012 https://doi.org/10.1002/14651858.CD008092.pub2
Wee JS, Shirlaw JS, Challacombe SJ, Setterfield JF Efficacy of mycophenolate mofetil in severe mucocutaneous lichen planus: a retrospective review of 10 patients. Br J Dermatol. 2012; 167:36-43 https://doi.org/10.1111/j.1365-2133.2012.10882.x
Didona D, Caposiena Caro RD, Sequeira Santos AM Therapeutic strategies for oral lichen planus: state of the art and new insights. Front Med. 2022; 9 https://doi.org/10.3389/fmed.2022.997190
Lodi G, Manfredi M, Mercadante V, Murphy R, Carrozzo M Interventions for treating oral lichen planus: corticosteroid therapies. Cochrane Database Syst Rev. 2020; 2 https://doi.org/10.1002/14651858.CD001168.pub3
Oral lichen planus (OLP) has an estimated global prevalence of 1% and is considered to be a disorder that requires lifelong surveillance. Clinical subtypes of OLP include reticular, atrophic, papular, plaque-like, ulcerative and bullous variants. OLP can present with desquamative gingivitis, and women may have associated vulval and/or vaginal involvement. Diagnosis of OLP is based on clinical and histopathological findings. Reticular and plaque-like OLP tends to be asymptomatic and seldom requires treatment. Ulcerative and atrophic OLP can generally be managed with topical corticosteroids. Severe and widespread ulcerative lesions may require systemic drugs.
CPD/Clinical Relevance: General dental practitioners need to be able to recognize the different clinical presentations of oral lichen planus and refer appropriately.
Article
Lichen planus is a chronic inflammatory mucocutaneous disease that affects the skin and the oral and genital mucosae.1 It can also involve the nails, scalp and, more rarely, the oesophageal mucosa and eyes.1
Oral lichen planus (OLP) tends to be persistent and spontaneous resolution is uncommon. Disease activity fluctuates with periods of remission and exacerbation.1
OLP has an elevated risk of malignant transformation and is classified as an oral potentially malignant disorder (OPMD) by the World Health Organization (WHO).2 OLP therefore requires lifelong surveillance.
The aetiology of OLP is not known; however, it is considered to be a chronic T-cell mediated disease of the oral mucosa.3
Basal keratinocytes in the oral mucosa are recognized as being antigenically foreign, and an immune response is initiated with CD4+ and CD8+ T lymphocytes producing cytokines including interleukin-2 and tumour necrosis factor within the oral epithelium.4,5 This induces chronic inflammation, resulting in cell-mediated damage and keratinocyte apoptosis.4,5
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