Oral lichen planus olp is a disease of unknown etiology affecting. Etiology and pathogenesis lichen planus is believed to result from an abnormal tcellmediated immune response in which basal epithelial cells are recognized as foreign because of changes in the antigenicity of their cell surface. Oral lichen planus is a noninfectious, chronic inflammatory condition that involves the oral mucosal stratified squamous epithelium and the underlying lamina propria and may be accompanied by skin lesions. Despite being one of the most common oral mucosal diseases and recognized as early as 1866, oral lichen planus olp is still a disease without a clear etiology or pathogenesis, and with uncertain premalignant potential. Lichen planus lp is a chronic inflammatory and immune mediated disease that affects the skin, nails, hair, and mucous membranes. Oral lichen planus is a inflammatory condition that affects the inside of the mouth.
Oral lichen planus british association of dermatologists. Lichen planus is a chronic, inflammatory, autoimmune disease that affects the skin, oral mucosa, genital mucosa, scalp, and nails. Oral lichen planus with malignant transformation to. From a continuing study of 108 cases of oral mucosal lichen planus, including so called druginduced lichenoid reactions, the response of patients to topical. Many contributing factors are suggested in the etiopathogenesis of lichen planus. Although reticular lp is usually asymptomatic, pain typically accompanies the. Oral lichen planus diagnosis and treatment mayo clinic.
As there is a risk of malignant potential reported with this disease, early diagnosis and proper management of the patient is necessary. Oral and vaginal lichen planus occur on the moist surfaces of the mouth and vagina, where inflammation caused by the disease often leads to surface skin layers falling off, leaving raw open areas. This overview describes the current understanding of the immunopathologic mechanisms implicated in oral lichen planus. Patients may develop reticular oral lp white papules and plaques, erythematous atrophic oral lp mucosal atrophy and red patches, andor erosive oral lp erosions or ulcers picture 1ab.
Calcineurin inhibitors, similar to oral drugs used to prevent rejection of transplanted organs, may be effective for treating oral lichen planus. Current literature has predominantly sided with the notion that oral lichen planus olp carries the risk for malignant potential. Erosive lichen planus elp is an uncommon variant of oral lichen planus that is chronic and sometimes untreatable, according to the mayo clinic. Etiology and pathogenesis lichen planus is believed to result from an abnormal tcellmediated immune response in which basal epithelial. Lichen planus lichen planus lp is a disease of the skin andor mucous membranes that resembles lichens. The etiology behind olp developing into oral squamous cell carcinoma is poorly understood. Lichen planus is a skin rash caused by an immune response. The magic of herbal curcumin therapy in recurrent oral. An initial episode of oral lichen planus may last for weeks or months. Even though, lot of research is carried out on this disease, still the precise etiopathogenesis and treatment is controversial. Pdf both antigenspecific and nonspecific mechanisms may be involved in the pathogenesis of oral lichen planus olp. Oral lichen planus olp is a chronic inflammatory disease of unknown etiology.
Oral lichen planus is usually a chronic condition and can last for many years. It can affect mucosa in other parts of the body including the esophagus, genitals and the skin. Webmd explains other symptoms, causes, and treatment. Lichen planus was first described in the literature by eramus wilson in 18699. Figure caption and citation for the preceding image starts. Lichen planus lp is a skin condition which shows exacerbations and remissions over time. Erosive oral and genital ulceration mostly occurs in women. Lichen planus is an uncommon disorder of unknown cause that most commonly affects middleaged adults. Olp lesions contain few bcells or plasma cells and minimal deposits of immunoglobulin or complement. It is thought to be the result of an autoimmune process with an unknown initial trigger. Lichen planus lp is a chronic, but benign and selflimited disease of the skin andor oral mucosa with an unknown etiology. Mucosal lesions are classified into six clinical forms and there is. The exact etiology of oral lichen planus is not well understood.
Oral lichen planus olp is a mucosal subtype of lichen planus. Malignant transformation into oral squamous cell carcinoma oscc is considered as one of the most serious complications of the disease. However, lichenoid reactions are seen following contact with. Signs and symptoms include patches of fine white lines and dots most commonly in the inside of the cheeks, gums, andor tongue. We present a case of a 77yearold female who suffered from oral lichen planus olp involving her gingiva and bilateral buccal mucosa for over 6 months. T1 etiology and pathogenesis of oral lichen planus. Where the trigger is known, a lesion is known as a lichenoid. This article discusses different hypotheses that have been suggested. Oral lichen planus olp is a chronic inflammatory disease of unknown etiology with significant impact on patients quality of life. Lichen sclerosus ls is a chronic inflammatory dermatosis that results in white plaques with epidermal atrophy and scarring. Oral lichen planus olp occurs more frequently than the cutaneous form and tends to. Mal ig na nt pot en ti al is hi gh for atr op hi c an d er os iv e fo rm s of o lp 4, 6, r eq ui ri ng r eg ul ar f ol lo w up of p at ie nt s. The cause of oral lichen planus is not known in most instances, but it is likely to be related to the bodys immune system.
Mucosal involvement is observed in less than 20% of patients. It is characterized by polygonal, flattopped, violaceous papules and plaques with overlying, reticulated, fine white scale wickhams striae, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. In discussing the etiology of lichen planus most writers have been content to enumerate certain generalities as to age, sex and environment, and to epitomize our ignorance in some such phrase as the exact etiology is unknown or the causes are obscure. Oral lichen planus symptoms and causes mayo clinic. But these medications have a food and drug administration warning because of an unclear association with cancer.
Lichen planus lesions are described using the six ps. Oral lichen planus cant be passed from one person to another. Oral lichen planus fact sheet oral surgeon indianapolis. According to literature immunity, plays a key role in etiology of lichen planus. Oral lichen planus is a complex and poorly understood clinical condition. Oral lichen planus olp occurs more frequently than the cutaneous form and tends to be more persis. An overview oral lichen planus olp is a noninfectious chronic inflammatory condition that involves the oral mucosal stratified. Oral lichen planus olp is a common t cellmediated mucocutaneous disease of unknown etiology. However, oral lichen planus occurrence is related to a tcell mediated immune response. Although the etiology and pathogenesis of olp are not fully understood, oral lichen planus has been associated with multiple disease processes and agents, such as viral and bacterial infections, autoimmune diseases, medications, vaccinations and dental restorative materials. The chart showing pdf series, word series, html series, scan qr codes. Pdf the pathogenesis of oral lichen planus researchgate. Lichen planus is a tcell mediated chronic inflammatory mucocutaneous disease of unknown cause.
Vitamin d as a cofactor in the disease is scar cely discussed in the literature. Oral lichen planus is a chronic disease that causes painful patches inside the mouth. The lesions of cutaneous lichen planus typically resolve within 12 years, whereas the reticular forms of oral lichen planus have a mean duration of 5 years and erosive lesions of oral lichen planus are longlasting and persist for up to 1520 years or longer. N2 oral lichen planus is a noninfectious, chronic inflammatory condition that involves the oral mucosal stratified squamous epithelium and the underlying lamina propria and may be accompanied by skin lesions.
Oral lichen planus sometimes involves your throat or esophagus. In this article, the authors assemble recent knowledge about the pathogenesis of olp, discuss some proposed hypotheses, and compare olp with oral lichenoid. Markers of oral lichen planus malignant transformation. Symptoms can usually be managed, but people who have oral lichen planus need regular monitoring because they may be at risk of developing mouth cancer in the. Oral lichen planus oral lp is a mucosal subtype of lp that presents with a variety of clinical features. Oral lichen planus mayo clinic clinical photographs used with permission citation ends. Oral lichen planus olp is a chronic mucosal condition commonly encountered in. The condition is painful, most commonly affecting the oral mucosa. Oral lichen planus olp is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. Most people with lichen planus experience no to few symptoms, others may have painful sores or ulcers in the mouth. Oral lichen planus genetic and rare diseases information. Atrophicerosive lichen planus oral lichen planus is usually diagnosed by clinical and histological examinations, although the clinical appearance alone can suffice in classical lesions bilateral white striae in cheek mucosa. Request pdf etiology and pathogenesis of oral lichen planus. The disorder occurs when the immune system mounts an attack against cells of the oral mucous membranes for unknown reasons.
Examples include tacrolimus protopic and pimecrolimus. A great number of factors have been suggested as relevant. Lichen planus may affect the skin cutaneous lichen planus, oral cavity oral lichen planus, genitalia penile or vulvar lichen planus, scalp lichen planopilaris, nails, or esophagus. A great number of factors have been suggested as relevant to the etiology of this disease.
Various factors seem to be involved in the progression of malignant transformation. Lichen sclerosus has both genital and extragenital presentations and also goes by the names lichen sclerosus et atrophicus dermatological literature, balanitis xerotica obliterans glans penis presentation, and krau. While oral lichen planus usually begins during midlife, it can occur at any age. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Pdf lichen planus is a chronic inflammatory mucocutaneous disease. An update on etiology, pathogenesis, clinical presentation, diagnosis and management. The mechanism of olp is complex and not yet fully understood. Oral lichen planus olp is frequently encountered by the dermatologists and oral physician. We showed that oral hygiene measures and conventional periodontal treatment and strict maintenance were sufficient to control the gingival involvement of olp. In cases of oral lichen planus, the mucous membranes inside the mouth are the only area affected.
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