Lichen planus and lichenoid reactions of the oral mucosa

Abstract

Oral lichenoid reactions represent a common end point in response to extrinsic agents (drugs, allergens), altered self-antigens, or superantigens. Oral lichen planus, a common and under-recognized inflammatory disorder, shares many clinical and histopathological features with oral lichenoid drug reaction and oral lichenoid contact reaction. Clinical presentation can vary from asymptomatic white reticular striae to painful erythema and erosions. Cutaneous and additional mucosal involvement is common. Delay in diagnosis of extraoral mucocutaneous lichen planus (LP) results in conjunctival scarring; vaginal stenosis; vulvar destruction; and stricture of the esophagus, urethra, and external auditory meatus. Although the etiology of LP is idiopathic, oral lichenoid reactions may be caused by medications or exogenous agents such as cinnamates and other flavorings. The clinical features, evaluation, and management of these oral lichenoid reactions are discussed.

Syndrome APECED et lichen plan atrophique : un cas

“…L'âge et le sexe du patient ne correspondent pas aux données épidémiologiques admises sur la prévalence du lichen plan oral (l'incidence est plus élevée chez les femmes et l'âge moyen d'apparition est de 50 ans) [21]. De plus la forme clinique observée (leucoplasiforme et atrophique) correspond à un lichen plan ancien.…”

Oral Manifestations of Dermatologic Disease: A Focus on Lichenoid Lesions

“…[6]. OLP is the only disease manifestation in up to 35% of patients and is nearly always bilateral or multifocal [1]. In the oral cavity there are three major clinical presentations: reticular, erythematous, and erosive ( Fig.…”

“…Many systemic medications can cause oral lichenoid reactions (OLR) although the exact incidence is unknown and the pathogenesis is unclear [1][2][3]. The onset of a drug related lichenoid reaction and initial medication use vary widely, from weeks to over a year [13].…”

“…A number of clinical as well as microscopic mimics of OLP exist making diagnosis challenging at times. Oral lichenoid lesions from systemic drug exposure or local allergic contact hypersensitivity are well documented [1]. Other immune-mediated diseases including mucous membrane pemphigoid, graft versus host disease, and lupus erythematosus can share common clinical and histological features with OLP [2].…”

Patient with Allergic Pathology: How to Handle It inDentistry.

“…Lichenoid reactions (RL) may involve the mucosa on the skin, or both [7].RLs are less common than lichen. These occur more in adult patients, and very rarely in children.…”