Different Treatment Modalities of Oral Lichen Planus—A Narrative Review

Abstract

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology which affects the oral mucosa. OLP varies in its clinical features from a reticular form that is, in most cases, asymptomatic, to atrophic–erosive, and is accompanied by symptoms of burning sensation and pain followed by difficulty in eating. Given the fact that OLP is a disease of unknown etiology, the treatment is symptomatic and involves suppressing the signs and symptoms of the disease using various topical and systemic drugs. The first line of therapy for treating symptomatic OLP is topical corticosteroids, whereas systemic corticosteroids are used for treating persistent lesions that do not respond to local treatment. However, the lack of convincing evidence on the efficacy of previous therapies, including topical corticosteroids, and numerous side effects that have appeared over recent years has resulted in the emergence and development of new therapeutic options. Some of the therapies mentioned are tacrolimus, efalizumab, dapson, interferon, retinoic acid, photochemotherapy with psoralen and ultraviolet A rays (PUVA), aloe vera, antimalarials, antibiotics and others. These therapies only partially meet the properties of efficacy and safety of use, thus justifying the continuous search and testing of new treatment methods.

Characteristics of Clinically Classified Oral Lichen Planus in Optical Coherence Tomography: A Descriptive Case-Series Study

“…These asymptomatic OLP forms do not require treatment with glucocorticoids or immunosuppressants, only medical monitoring at regular intervals depending on the variability of the pathology. In addition, supportive measures such as regular professional tooth cleaning, abstaining from nicotine and alcohol, switching to surfactant-free toothpaste and the removal of amalgam fillings are recommended to prevent the worsening of OLP [ 44 , 45 ]. The red forms include erosive (ulcerative), atrophic and bullous forms of OLP, which are commonly symptomatic.…”

“…The red forms include erosive (ulcerative), atrophic and bullous forms of OLP, which are commonly symptomatic. Consequently, local immunosuppressive therapy is usually performed, containing glucocorticoid irrigations and adhesive ointments with the aim of the epithelialization and closure of the collapsed epithelial layer [ 44 , 45 ].…”

The oral microbiome and oral and upper gastrointestinal diseases

“…Patients often experience pain, discomfort, burning sensation, and other symptoms. This may progress to dysphagia [ 116 ]. Eventually, severe physical or even neuropathic pain in OLP can manifest, which is often explained by the disruption of sensory nerves within the inflamed mucosal tissues [ 117 ].…”

Management of Oral Lichen Planus: Recent updates

“…It inhibits the formation and release of histamine, TNF-α and leukotrienes from mast cells, neutrophils and mononuclear cells. 5…”