The Therapy of Oral Lichen Planus

Abstract

Oral lichen planus is a chronic mucocutaneous disease that is relatively common. Although many patients are asymptomatic and require no therapy, those who exhibit atrophic and erosive lesions are often a challenge to treat. All therapies are palliative, and none is effective universally. Currently employed treatment modalities include corticosteroids administered topically, intralesionally, or systemically. Alternative therapies include topical and systemic retinoids, griseofulvin, Cyclosporine, and surgery. Other medical treatments and experimental modalities, including mouth PUVA, have been reported to be effective. Controversy concerning the efficacy of all these treatments suggests that oral lichen planus is a heterogeneous disorder. Eliminating lichenoid drug eruptions, candidiasis, trauma, contact mucositis, and emotional stress may play a role in the management of these patients. This article is a review of the many treatments and measures that have been employed in the management of patients with oral lichen planus.

Oral lichenoid lesions related to dental restorative materials

“…Current treatment may reduce the pain and severity of lesions but is not curative. 38,39 The clinical manifestations and histopathological changes of lichenoid lesions and those for oral lichen planus are similar. Therefore it is important to distinguish between the two groups of lesions since their aetiology and hence their treatment is different.…”

High Frequency of Allelic Loss in Dysplastic Lichenoid Lesions

“…Unlike cutaneous lichen planus, OLP tends to be chronic. It has been suggested that complete remission of OLP is either nonexistent or infrequent (see review in Eisen 1993). Histologically, OLP is characterized by a dense bandlike lymphohistiocytic infiltrate in the immediate subepithelial region, with basal epithelial cell destruction.…”

The Effectiveness of Topical Pimecrolimus in the Treatment of Oral Lichen Planus

“…The buccal mucosa, tongue and gingival are the most common sites, whereas palatal lesions are uncommon (2,3). It is seen worldwide, mostly in the fifth to sixth decades of life, and is twice as common in women than in men (1,3,4). OLP is a T cell-mediated autoimmune disease however its cause is unknown in most cases (5).…”

“…OLP can present in a number of forms: reticular, plaquelike, papular, atrophic, erosive, and bullous (1,4,6). Reticular, papular, and plaque-like OLP are generally without symptoms.…”

“…Reticular, papular, and plaque-like OLP are generally without symptoms. Erosive, bullous, and atrophic lesions are generally a source of pain and discomfort (4,6).…”