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Review
. 2023 Dec 22;15(1):8-23.
doi: 10.4103/idoj.idoj_652_22. eCollection 2024 Jan-Feb.

Oral Lichen Planus: An Updated Review of Etiopathogenesis, Clinical Presentation, and Management

Yashpal Manchanda  1 , Sanjay K Rathi  2 , Arun Joshi  1 , Sudip Das  3
Affiliations
Review

Oral Lichen Planus: An Updated Review of Etiopathogenesis, Clinical Presentation, and Management

Yashpal Manchanda et al. Indian Dermatol Online J. .

Abstract

Lichen planus (LP) is a chronic idiopathic immune-mediated inflammatory condition. LP is a heterogeneous disease with varied clinical presentations having different natural history, prognosis, sequelae, and outcomes. It can affect skin, hair, nails, and mucosae. Mucosal LP (including oral LP) tends to be persistent and resistant to treatment, compared to cutaneous LP. Oral LP (OLP) is broadly divided into two main categories: hyperkeratotic (usually asymptomatic) and erosive (commonly symptomatic). It can present with symptoms including odynophagia, dysphagia, dysgeusia, and sensitivity to hot spicy foods. Apart from the superficial epidermal changes, which vary with the type of clinical presentation, histopathologically oral LP shows a unifying similar and consistent feature of a lichenoid interface dermatitis. Recently, researchers have highlighted the critical role played by IL-17 in the pathogenesis of OLP. World Health Organization has categorized oral LP as one of the oral potentially malignant disorders (OPMD), albeit with a low risk of malignant transformation. Also, in the last couple of years there have been various reports on the usage of newer drugs like anti-IL17, anti-IL12/23, anti-IL 23, PDE4 inhibitors, and JAK inhibitors in the management of refractory OLP. The principal aim of treatment still remains to resolve the symptoms, prolong the symptoms free period, and reduce the risk of potential malignant transformation. We have described many new revelations made in recent times regarding the etiopathogenesis, associated conditions as well as management of OLP. Thus, the objective of this review is to present a comprehensive up-to-date knowledge including the recent advances made regarding OLP.

Keywords: New pathogenesis; Oral lichen planus; patterns.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Classical white lacy reticular pattern of lesions on left buccal mucosa
Figure 2
Figure 2
Classical white lacy reticular pattern of lesions on lip and adjoining left buccal mucosa. (Dermoscope ILLUCO IDS-1100;Polarized 10X)
Figure 3
Figure 3
White lacy reticular pattern with pigmented area on periphery at lower end and central healing erosion on left buccal mucosa
Figure 4
Figure 4
OLP lesions characterized by hypertrophic plate on the central part of dorsal aspect of tongue
Figure 5
Figure 5
Large erosive plaques of OLP on posterior dorsal aspect of the tongue on both sides
Figure 6
Figure 6
Band like upper dermal lymphocytic infiltrate admixed with few plasma cells
See this image and copyright information in PMC

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