Number V Oral lichen planus: clinical features and management

Area of Science:

• Oral pathology
• Immunodermatology
• Epithelial biology

Background:

• Oral lichen planus (OLP) is a common, chronic inflammatory condition impacting stratified squamous epithelia.
• Unlike cutaneous lichen planus (LP), oral lesions are persistent, rarely remit spontaneously, and carry a potential risk of malignancy.
• OLP is understood as a T cell-mediated autoimmune disorder where CD8+ T cells induce apoptosis in oral epithelial cells.

Purpose of the Study:

• To summarize the key aspects of oral lichen planus, including its pathophysiology, diagnosis, and management.
• To highlight the chronic and potentially premalignant nature of OLP compared to cutaneous LP.
• To discuss diagnostic criteria and therapeutic options for OLP.

Main Methods:

• Review of current literature on oral lichen planus.
• Analysis of diagnostic approaches, including clinical presentation and histopathology.
• Evaluation of established and emerging treatment modalities for OLP.

Main Results:

• Clinical diagnosis of OLP can be supported by characteristic oral lesions, especially when accompanied by classic skin lesions.
• Histopathologic examination via oral biopsy is crucial for confirming OLP and ruling out dysplasia or malignancy.
• Topical corticosteroids remain the primary treatment, with newer agents also available.

Conclusions:

• Oral lichen planus is a distinct entity from cutaneous lichen planus, characterized by chronicity and potential for malignant transformation.
• Accurate diagnosis relies on a combination of clinical assessment and histopathological analysis.
• Management strategies focus on symptom control and monitoring for dysplasia, with topical corticosteroids being a mainstay therapy.