What can we learn from treatments of oral lichen planus?

Abstract

Oral lichen planus (OLP), a T-lymphocyte-mediated disease of the oral mucosa, has a complex pathogenesis that involves a number of factors. The disease is characterized by recurrent episodes and requires continuous follow up, and there is no curative treatment available. Erosive lichen planus, among others, has a risk of malignant transformation and requires standardized treatment to control its progression. Different clinical subtypes of oral lichen planus require appropriate treatment. Pharmacological treatments are the most widely available and have the greatest variety of options and a number of novel pharmacological treatments are presented as highlights, including JAK enzyme inhibitors. The second is photodynamic therapy, which is the leading physiological treatment. In addition, periodontal treatment and psychological treatment should not be neglected. In this review, we briefly discuss the most recent developments in therapies for oral lichen planus after summarizing the most widely used clinical treatments, aiming to provide different proposals for future clinical treatment.

Keywords: erosive type; microbes; nonpharmacological treatment; oral lichen planus; pharmacological treatment.

Figure 1

Clinical manifestations of different types of OLP (A) Right buccal mucosa: reticular pattern affecting the mucosa, a large erosive area and atrophy seen in the center. (B) The white patches and a reticular pattern called Wickham’s striae. (C) Right tongue margin: erosive type. (D) Left tongue margin: non-erosive type. OLP, oral lichen planus.

Figure 2

The JAKs/STAT signaling pathway is activated through cytokine (A) Inflammatory cytokines bind to the receptor, dimerizing it, activating JAKs, and phosphorylating the intracellular portion of the receptor. (B) STAT proteins bind at sites containing phosphorylated tyrosine. (C) STAT dimerizes and translocates into the nucleus to regulate gene expression. IL, interleukin; INF, interferon; JAKs and STAT, Janus kinases and Signal Transducers and Activators of Transcription (Created with BioRender.com).