Oral Lichen Planus: A Review Study

Authors

  • Muhanad L. Alshami Department of Dentistry, Dijlah University College, Iraq
  • Hiba H. Al-Rikaby Department of Periodontics, Al-Amiriya Specialist Dental Centre, Ministry of Health, Iraq.
  • Amir A. Majeed Department of Dentistry, Dijlah University College, Iraq

DOI:

https://doi.org/10.66344/jpad.v32i3.1936

Abstract

Lichen planus (LP) is a chronic inflammatory condition affecting the skin and the mucous membrane. LP is multifactorial and the pathogenesis depends mainly on the evoked cellular immunity. Most cases develop on the oral mucosa. Oral lichen planus (OLP) has several clinical patterns and the symptoms range from no symptoms to aches and burning sensations. The histopathological picture is considered a characteristic feature of OLP. OLP is incurable and the treatment aims to reduce the patient's complaints and enhance the quality of the patient's life. Although there is no uniform protocol for treatment, corticosteroids and adjuvant treatment are commonly used for OLP management. Malignant transformation can occur in OLP, despite the type and location of the OLP inside the mouth. Periodic follow up is required. Updating the data about OLP is always needed to improve the outcomes of management.

 

Author Biographies

  • Muhanad L. Alshami, Department of Dentistry, Dijlah University College, Iraq

    Department of Dentistry

  • Hiba H. Al-Rikaby, Department of Periodontics, Al-Amiriya Specialist Dental Centre, Ministry of Health, Iraq.

    Department of Periodontics,

  • Amir A. Majeed, Department of Dentistry, Dijlah University College, Iraq

    Department of Dentistry

References

1. Deganello A, Paderno A, Morello R, Fior M, Berretti G, Del Bon F, et al. Diagnostic Accuracy of Narrow Band Imaging in Patients with Oral Lichen Planus: A Prospective Study. The Laryngoscope. 2021;131(4):E1156-e61.

2. McCartan BE, Healy CM. The reported prevalence of oral lichen planus: a review and critique. J Oral Pathol Med. 2008;37(8):447-53.

3. Eisen D, Carrozzo M, Bagan Sebastian JV, Thongprasom K. Number V Oral lichen planus: clinical features and management. Oral Dis. 2005;11(6):338-49.

4. López‐Jornet P, Camacho‐Alonso F. Quality of life in patients with oral lichen planus. J Eval Clin Pract. 2010;16(1):111-3.

5. Ismail SB, Kumar SK, Zain RB. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci. 2007;49(2):89-106.

6. Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res. 2016;308(8):539-51.

7. Sharma S, Saimbi CS, Koirala B. Erosive oral lichen planus and its management: a case series. JNMA J Nepal Med Assoc. 2008;47(170):86-90.

8. Sugerman P, Savage N, Walsh L, Zhao Z, Zhou X, Khan A, et al. The pathogenesis of oral lichen planus. Crit Rev Oral Biol Med. 2002;13(4):350-65.

9. Laeijendecker R, Van Joost T, Tank B, Oranje AP, Neumann HA. Oral lichen planus in childhood. Pediatr Dermatol. 2005;22(4):299-304.

10. Bendick C. Diseases in Skin of Color. Braun-Falco´ s Dermatology. 2020:1-17.

11. Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res. 2016;308(8):539-51.

12. Bermejo-Fenoll A, López-Jornet P. Familial oral lichen planus: presentation of six families. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(2):e12-5.

13. Lowe NJ, Cudworth AG, Woodrow JC. HL-A antigens in lichen planus. Br J Dermatol. 1976;95(2):169-71.

14. Lodi G, Pellicano R, Carrozzo M. Hepatitis C virus infection and lichen planus: a systematic review with meta-analysis. Oral Dis. 2010;16(7):601-12.

15. Nagao Y, Sata M. Hepatitis C virus and lichen planus. J Gastroenterol Hepatol. 2004;19(10):1101-13.

16. Grossmann SdMC, Teixeira R, de Aguiar MCF, do Carmo MAV. Exacerbation of oral lichen planus lesions during treatment of chronic hepatitis C with pegylated interferon and ribavirin. Eur J Gastroenterol Hepatol. 2008;20(7):702-6.

17. Nadendla LK, Meduri V, Paramkusam G, Pachava KR. Association of salivary cortisol and anxiety levels in lichen planus patients. J Clin Diagnosict Res. 2014;8(12):ZC01.

18. Manczyk B, Gołda J, Biniak A, Reszelewska K, Mazur B, Zając K, et al. Evaluation of depression, anxiety and stress levels in patients with oral lichen planus. J Oral Sci. 2019;61(3):391-7.

19. Ivanovski K, Nakova M, Warburton G, Pesevska S, Filipovska A, Nares S, et al. Psychological profile in oral lichen planus. J Clinical Periodontol. 2005;32(10):1034-40.

20. Zhou T, Li D, Chen Q, Hua H, Li C. Correlation between oral lichen planus and thyroid disease in China: a case–control study. Front Endocrinol. 2018;9:330.

21. Lavaee F, Majd M. Evaluation of the association between oral lichen planus and hypothyroidism: a retrospective comparative study. J Dent. 2016;17(1):38.

22. Lo Muzio L, Santarelli A, Campisi G, Lacaita M, Favia G. Possible link between Hashimoto's thyroiditis and oral lichen planus: a novel association found. Clin Oral Invest.2013;17(1):333-6.

23. Shlomchik WD. Graft-versus-host disease. Nat Rev Immunol.2007;7(5):340-52.

24. Ferrara JL, Reddy P. Pathophysiology of graft-versus-host disease. In Seminars in hematology 2006 Jan 1 (Vol. 43, No. 1, pp. 3-10). WB Saunders.

25. aAl-Hashimi I, Schifter M, Lockhart PB, Wray D, Brennan M, Migliorati CA, et al. Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2007;103 Suppl:S25.e1-12.

26. Rai B, Kharb S, Jain R, Anand S. Salivary vitamin E and C in lichen planus. Gom J Med Sci. 2008;6(2).

27. Motahari P, Azar FP, Rasi A. Role of vitamin D and vitamin D receptor in oral lichen planus: A systematic review. Ethiop J Health Sci.2020;30(4):615–22.

28. Bahramian A, Bahramian M, Mehdipour M, Falsafi P, Khodadadi S, Dabaghi Tabriz F, et al. Comparing Vitamin D Serum Levels in Patients with Oral Lichen Planus and Healthy Subjects. J Dentistry (Shiraz, Iran). 2018;19(3):212-6.

29. Yiannias JA, el-Azhary RA, Hand JH, Pakzad SY, Rogers RS, 3rd. Relevant contact sensitivities in patients with the diagnosis of oral lichen planus. J Am Acad Dermatol. 2000;42(2 Pt 1):177-82.

30. Pande A, Rai P, Shetty D, Dharmadhikari S. Oral lichenoid reaction to dental amalgam and its association with desquamative gingivitis “a diagnostic conundrum”: A case report. Int J Oral Care Res. 2021;9(1):42.

31. Do Prado RF, Marocchio LS, Felipini RC. Oral lichen planus versus oral lichenoid reaction: difficulties in the diagnosis. Ind J Dent Res.2009;20(3):361.

32. McParland H. Oral Lichenoid and Lichen Planus-like Lesions. Prim Dent J. 2016;5(1):34-9.

33. El-Howati A, Thornhill MH, Colley HE, Murdoch C. Immune mechanisms in oral lichen planus. Oral Dis. 2022 Jan 28. doi: 10.1111/odi.14142. Epub ahead of print. PMID: 35092132.

34. DeAngelis LM, Cirillo N, McCullough MJ. The immunopathogenesis of oral lichen planus-Is there a role for mucosal associated invariant T cells? J Oral Pathol Med.2019;48(7):552-9.

35. Carrozzo M, Porter S, Mercadante V, Fedele S. Oral lichen planus: A disease or a spectrum of tissue reactions? Types, causes, diagnostic algorhythms, prognosis, management strategies. Periodontol 2000. 2019;80(1):105-25.

36. Brănişteanu DE, Pintilie A, Andreş LE, Dimitriu A, Oanţă A, Stoleriu G, et al. Ethiopatogenic Hypotheses in Lichen Planus. Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi. 2016;120(4):760-7.

37. Kulkarni G, Sakki EP, Kumar YV, Kolimi S, Perika R, Karthik KV, et al. Expression of CD1a by Langerhan's Cells in Oral Lichen Planus - A Retrospective Analysis. J Clin Diagnostic Res. 2016;10(6):Zc28-31.

38. Nogueira PA, Carneiro S, Ramos-e-Silva M. Oral lichen planus: an update on its pathogenesis. Int J Dermatol. 2015;54(9):1005-10.

39. Wu P, Luo S, Zhou T, Wang R, Qiu X, Yuan P, et al. Possible Mechanisms Involved in the Cooccurrence of Oral Lichen Planus and Hashimoto's Thyroiditis. Mediators Inflamm. 2020;2020:6309238.

40. 40Shimizu Y, Yoshikawa T, Kojima T, Shoda K, Nosaka K, Mizuno S, et al. Heat shock protein 105 peptide vaccine could induce antitumor immune reactions in a phase I clinical trial. Cancer Sci.2019; 110(10):3049-60.

41. Werneck JT, Dias EP, Gonçalves LS, Silva Junior A. CLA and CD62E expression in oral lichen planus lesions. J Oral Pathol Med. 2016;45(3):218-23.

42. Becker JC, Houben R, Vetter CS, Bröcker EB. The carcinogenic potential of tacrolimus ointment beyond immune suppression: a hypothesis creating case report. BMC Cancer. 2006;6(1):1-6.

43. McCullough MJ, Alrashdan MS, Cirillo N. Oral lichen planus. Contemporary Oral Medicine Springer International Publishing AG. 2017:1-40.

44. Vadivel JK, Govindarajan M, Somasundaram E, Muthukrishnan A. Mast cell expression in oral lichen planus: A systematic review. J Investig Clin Dent. 2019;10(4):e12457.

45. Sankari SL, Babu NA, Rajesh E, Kasthuri M. Apoptosis in immune-mediated diseases. J Pharma Bioallied Sci.2015;7(Suppl 1):S200-2.

46. Challacombe SJ, Shirlaw PJ, Thornhill MH. Immunology of diseases of the oral cavity. Mucosal immunology: Elsevier; 2015. p. 1943-83.

47. Peng Q, Zhang J, Ye X, Zhou G. Tumor-like microenvironment in oral lichen planus: evidence of malignant transformation? Expert Rev Clin Immunol.2017;13(6):635-43.

48. Sekiguchi R, Yamada KM. Basement membranes in development and disease. Curr Top Dev Biology.2018;130:143-91.

49. Mester A, Lucaciu O, Ciobanu L, Apostu D, Ilea A, Campian RS. Clinical features and management of oral lichen planus (OLP) with emphasis on the management of hepatitis C virus (HCV)-related OLP. Bosn J Bas Med Sci.2018;18(3):217.

50. Ramalingam S, Malathi N, Thamizhchelvan H, Sangeetha N, Rajan ST. Role of mast cells in oral lichen planus and oral lichenoid reactions. Autoimmune diseases. 2018;2018.

51. Wu KM, Wang YP, Lin HP, Chen HM, Chia JS, Sun A. Modulation of serum smooth muscle antibody levels by levamisole treatment in patients with oral lichen planus. J Formos Med Assoc.2013;112(6):352-7.

52. Karthikeson P, Kumar VJ. Oral Lichen Planus-A Review. J Pharm Sci. 2020;12(1):196-8.

53. Mårell L, Tillberg A, Widman L, Bergdahl J, Berglund A. Regression of oral lichenoid lesions after replacement of dental restorations. J Oral Rehabil.2014;41(5):381-91.

54. Eisen D, Carrozzo M, Bagan Sebastian JV, Thongprasom K. Number V Oral lichen planus: clinical features and management. Oral Dis.2005;11(6):338-49.

55. Carrozzo M, Porter S, Mercadante V, Fedele S. Oral lichen planus: A disease or a spectrum of tissue reactions? Types, causes, diagnostic algorhythms, prognosis, management strategies. J Periodontol. 2019;80(1):105-25.

56. Xue JL, Fan MW, Wang SZ, Chen XM, Li Y, Wang L. A clinical study of 674 patients with oral lichen planus in China. J Oral Pathol Med.2005;34(8):467-72.

57. Munde AD, Karle RR, Wankhede PK, Shaikh SS, Kulkurni M. Demographic and clinical profile of oral lichen planus: A retrospective study. Contem Clinical Dent.2013;4(2):181-5.

58. Maderal AD, Lee Salisbury P, 3rd, Jorizzo JL. Desquamative gingivitis: Clinical findings and diseases. J Am Acad Dermatol. 2018;78(5):839-48.

59. Yamanaka Y, Yamashita M, Innocentini LM, Macedo LD, Chahud F, Ribeiro-Silva A, et al. Direct immunofluorescence as a helpful tool for the differential diagnosis of oral lichen planus and oral lichenoid lesions. Am J Dermatopathol.2018;40(7):491-7.

60. Canto AM, Müller H, Freitas RR, Santos PS. Oral lichen planus (OLP): clinical and complementary diagnosis. An Bras Dermatol. 2010;85(5):669-75.

61. Warnakulasuriya S. Clinical features and presentation of oral potentially malignant disorders. Oral Surg. Oral Med. Oral Pathol. Oral Radiol.2018;125(6):582-90.

62. Varghese SS, George GB, Sarojini SB, Vinod S, Mathew P, Mathew DG, et al. Epidemiology of oral lichen planus in a cohort of south indian population: a retrospective study. J Cancer Prev. 2016;21(1):55.

63. aKaomongkolgit R, Daroonpan P, Tantanapornkul W, Palasuk J. Clinical profile of 102 patients with oral lichen planus in Thailand. Journal of clinical and experimental dentistry. 2019;11(7):e625-e9; bIon DI, Setterfield JF. Oral Lichen Planus. Prim Dent J. 2016;5(1):40-4.

64. Ioannides D, Vakirlis E, Kemeny L, Marinovic B, Massone C, Murphy R, et al. European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol. 2020;34(7):1403-14.

65. Parihar A, Sharma S, Bhattacharya SN, Singh UR. A clinicopathological study of cutaneous lichen planus. J Dermatologic Surg. 2015;19(1):21-6.

66. Lodolo M, Gobbo M, Bussani R, Torelli L, Rupel K, Ottaviani G, et al. Histopathology of oral lichen planus and oral lichenoid lesions: An exploratory cross-sectional study. Oral Dis. 2021 Dec 23. doi: 10.1111/odi.14112. Online ahead of print.

67. Raj AT, Behura SS, Sarode SC, Sarode GS, Awan KH, Patil S. The natural history of oral mucosal lesions with both lichenoid and epithelial dysplastic features: a systematic review. Transl Cancer Research. 2020;9(4):3076-83.

68. Gnepp DR, Bishop JA. Gnepp's Diagnostic Surgical Pathology of the Head and Neck E-Book: Elsevier Health Sciences; 2020.

69. Nico MMS, Fernandes JD, Lourenço SV. Educação Médica Continuada. An Bras Dermatol. 2011;86(4):633-43.

70. Tesic-Rajkovic S, Radovanovic-Dinic B. Lesions in the oral cavity and esophagus caused by prescribed drugs: A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022;166(1):21-7.

71. Mendiratta V, Sanke S, Chander R. Lichen Planus Pigmentosus: A Clinico-etiological Study. Ind Dermatol Online J. 2019;10(3):288-92.

72. Oberti L, Alberta L, Massimo P, Francesco C, Dorina L. Clinical Management of Oral Lichen Planus: A Systematic Review. Mini Rev Med Chem. 2019;19(13):1049-59.

73. Gupta S, Ghosh S, Gupta S. Interventions for the management of oral lichen planus: a review of the conventional and novel therapies. Oral Dis. 2017;23(8):1029-42.

74. Mauskar M. Erosive Lichen Planus. Obstet Gynecol Clin North Am. 2017;44(3):407-20.

75. Carbone M, Goss E, Carrozzo M, Castellano S, Conrotto D, Broccoletti R, et al. Systemic and topical corticosteroid treatment of oral lichen planus: a comparative study with long-term follow-up. J Oral Pathol Med. 2003;32(6):323-9.

76. Kamath VV, Setlur K, Yerlagudda K. Oral lichenoid lesions - a review and update. Ind J Dermatol. 2015;60(1):102.

77. Husein-ElAhmed H, Gieler U, Steinhoff M. Lichen planus: a comprehensive evidence-based analysis of medical treatment. J Eur Acad Dermatol Venereol. 2019;33(10):1847-62.

78. Ion DI, Setterfield JF. Oral lichen planus. Prim Dent J. 2016;5(1):40-4.

79. Chan ES, Thornhill M, Zakrzewska J. Interventions for treating oral lichen planus. Cochrane Database Syst Rev. 2000(2):Cd001168.

80. Suvarna C, Chaitanya NC, Ameer S, Mannava H, Bontala P, Alyami JS, et al. A Comparative Evaluation on the Effect of Oral Zinc 50 mg with or without 0.1% Triamcinolone Orabase on Oral Lichen Planus. Int J Appl Basic Med Res. 2020;10(1):54-8.

81. Marable DR, Bowers LM, Stout TL, Stewart CM, Berg KM, Sankar V, et al. Oral candidiasis following steroid therapy for oral lichen planus. Oral Dis. 2016;22(2):140-7.

82. Gonzalez‐Moles M, Bravo M, Gonzalez‐Ruiz L, Ramos P, Gil‐Montoya J. Outcomes of oral lichen planus and oral lichenoid lesions treated with topical corticosteroid. Oral Dis. 2018;24(4):573-9.

83. Al‐Maweri SA, Ashraf S, Kalakonda B, Halboub E, Petro W, AlAizari NA. Efficacy of photodynamic therapy in the treatment of symptomatic oral lichen planus: A systematic review. J Oral Pathol Med. 2018;47(4):326-32.

84. Sugerman PB, Savage NW. Oral lichen planus: causes, diagnosis and management. Aust Dent J. 2002;47(4):290-7.

85. Scully C, Eisen D, Carrozzo M. Management of oral lichen planus. Am J Clin Dermatol. 2000;1(5):287-306.

86. Eisen D. Evaluating and treating patients with oral lichen planus. Dermatol Ther. 2002;15(3):206-17.

87. Scardina GA, Messina P, Carini F, Maresi E. A randomized trial assessing the effectiveness of different concentrations of isotretinoin in the management of lichen planus. Int J Oral Maxillofac Surg. 2006;35(1):67-71.

88. Lauritano D, Arrica M, Lucchese A, Valente M, Pannone G, Lajolo C, et al. Oral lichen planus clinical characteristics in Italian patients: a retrospective analysis. Head Face Med. 2016;12:18.

89. a Lyakhovitsky A, Amichai B, Sizopoulou C, Barzilai A. A case series of 46 patients with lichen planopilaris: demographics, clinical evaluation, and treatment experience. J Dermatol Treat. 2015;26(3):275-9; b García-Pola MJ, González-Álvarez L, Garcia-Martin JM. Treatment of oral lichen planus. Systematic review and therapeutic guide. Med Clin (Barc). 2017;149(8):351-62.

90. Mollaoglu N. Oral lichen planus: a review. Br J Oral Maxillofac Surg. 2000;38(4):370-7.

91. van der Hem PS, Egges M, van der Wal JE, Roodenburg JL. CO2 laser evaporation of oral lichen planus. Int J Oral Maxillofac Surg. 2008;37(7):630-3.

92. Rajendran R. Oral lichen planus. J Oral Maxillofac Pathol. 2005;9(1):3.

93. González-Moles M, Ruiz-Ávila I, González-Ruiz L, Ayén Á, Gil-Montoya JA, Ramos-García P. Malignant transformation risk of oral lichen planus: A systematic review and comprehensive meta-analysis. Oral Oncol. 2019;96:121-30.

94. Burkhart NW, Burkes EJ, Burker EJ. Meeting the educational needs of patients with oral lichen planus. Gen Dent. 1997;45(2):126-32; quiz 43-4.

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27.08.2022

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Oral Lichen Planus: A Review Study. J Pak Assoc Dermatol [Internet]. 2022 Aug. 27 [cited 2026 Sep. 14];32(3):574-8. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/1936