Oral Lichen Planus and Lichenoid Mucositis - 21/03/14

Doi : 10.1016/j.cden.2014.01.001

Scott S. De Rossi, DMD ^a,^b,^c,^⁎ , Katharine Ciarrocca, DMD, MSEd ^d
^a Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
^b Department of Otolaryngology/Head & Neck Surgery, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
^c Department of Dermatology, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
^d Department of Oral Rehabilitation, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA

^∗Corresponding author. Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912.

Résumé

Oral lichen planus (OLP) is commonly found in middle-aged women. Although the cause is unknown, research points to several complex immunologic events and cells that are responsible for the inflammatory destruction and chronicity of these lesions. Biopsy for histologic diagnosis is recommended. The mainstay of treatment remains topical corticosteroids; however, newer therapies such as immunomodulating agents are available for recalcitrant lesions. In cases of lichenoid mucositis or reactions, treatment should be directed at identifying and removing the presumed cause. Given the apparent risk of squamous cell carcinoma in these patients, frequent follow-up and repeat biopsy are vital.

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Keywords : Lichen planus, Lichenoid mucositis, Lichenoid drug reaction, Oral lichen planus

Plan

Key points

Introduction

Nature of Problem and Definition

Prevalence/Incidence

Cause and Pathogenesis

Symptoms

Clinical findings

Physical Examination

Diagnostic Modalities

Pathology

Diagnostic dilemma: a premalignant lesion

Comorbidities

Lichenoid Drug Reactions

Hepatitis C and OLP

Management

Goals

Pharmacologic Strategies: Topical Medications

Pharmacologic Strategies: Systemic Therapies

Summary

A version of this article appeared as DeRossi SS, Ciarrocca KN. Lichen planus, lichenoid drug reactions, and lichenoid mucositis. Dent Clin North Am 2005;49:77–89.