Oral lichen planus: a review

Oral lichen planus (OLP) is a common chronic inflammatory disorder thought to have a low risk of associated malignancy. A genetic predisposition linked to Th1 cytokine polymorphisms may promote the T cell-mediated immunological response to an induced antigenic change that is supposed to lead to OLP lesions. Some putative etiologic factors, mainly amalgam restorations and hepatitis C virus, have been studied in detail. The diagnosis of OLP can be made from the clinical features if they are sufficiently characteristic, but biopsy is recommended to confirm the diagnosis, exclude dysplasia and malignancy and if active treatment is required. The management of OLP is mainly aimed at controlling the symptoms and topical immunomodulators such as powerful corticosteroids and calcineurin inhibitors have been used. However, their long-term effects need to be better explored and understood. Current therapeutic data is probably still insufficient to make detailed recommendations with regard to the specific dosage, formulation, mode of delivery or length of therapy.