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Oral Lichen PlanusAka: Lichen Planus of Buccal Mucosa

Epidemiology
1. Prevalence: 1-2% in United States
2. Age usually >40 years
3. Gender predominance: Slightly more common in women
Pathophysiology
1. Autoimmune mediated apoptosis of epithelial cells
2. Involves CD8+ cytotoxic T-Cells
Signs
1. Reticular type
  1. Distributed on posterior Buccal mucosa
  2. Asymptomatic lesions
  3. Appearance
    1. White confluent Papules or
    2. Lacelike (lichenoid) network of striations
      1. Also known as Wickham's striae
2. Erosive type
  1. Painful erythema or ulcers
  2. Surrounded by white radiating striae
3. Desquamative Gingivitis type (Erosive type variation)
  1. Generalized erythema or Ulceration of the Gingiva
Associated conditions
1. Pruritic cutaneous Papules may occur on body
Evaluation
1. Biopsy lichenoid lesions if not classic appearance
Management
1. Asymptomatic lesions require no treatement
2. Topical Corticosteroids may be used if symptomatic
  1. Kenalog in Orobase
  2. Corticosteroid oral rinses
3. Routine surveillance
  1. May be associated with Oral Cancer risk
References
1. Sugerman (2000) Clin Dermatol 18:533

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 3/22/2010. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.