Italian Consensus on the treatment of oral lichen planus

Abstract

Oral lichen planus (OLP) is a chronic inflammatory condition of uncertain etiology affecting oral mucosae by T-cell mediated chronic inflammation. It affects between 1% and 3% of the global population, predominantly middle-aged adults (50-60 years), with a higher incidence in women. The immune response is thought to target keratinocytes, leading to cell death, particularly through CD8+ T lymphocytes. OLP manifests in various clinical forms, such as reticular, papular, erosive, and atrophic, with the reticular subtype being the most common. Erosive OLP is the most severe, characterized by widespread oral erosions, while atrophic OLP often follows erosive stages, affecting the tongue with a depapillated surface. Currently, no curative treatment exists for OLP, and the management focuses on symptom relief, including reducing pain and discomfort. Thus, a multidisciplinary approach involving dermatologists, oral surgeons, and dentists is often required. For this reason, the scientific community represented in Italy by the Mucosal Diseases Study Group of SIDeMaST (Italian Society of Dermatology and Venereology) reports its experience in the management of OLP, providing clinical recommendations for dermatologists based on the latest scientific evidence to optimize the treatment and management of OLP.