Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations

Ibtisam Al-Hashimi, Mark Schifter, Peter B. Lockhart, David Wray, Michael Brennan, Cesar A. Migliorati, Tony Axéll, Alison J. Bruce, William Carpenter, Ellen Eisenberg, Joel B. Epstein, Palle Holmstrup, Mats Jontell, Francina Lozada-Nur, Raj Nair, Bud Silverman, Kobkan Thongprasom, Martin Thornhill, Saman Warnakulasuriya, Isaäc van der Waal

Research output: Contribution to journalArticlepeer-review

291 Scopus citations

Abstract

Several therapeutic agents have been investigated for the treatment of oral lichen planus (OLP). Among these are corticosteroids, retinoids, cyclosporine, and phototherapy, in addition to other treatment modalities. A systematic review of clinical trials showed that particularly topical corticosteroids are often effective in the management of symptomatic OLP lichen planus. Systemic corticosteroids should be only considered for severe widespread OLP and for lichen planus involving other mucocutaneous sites. Because of the ongoing controversy in the literature about the possible premalignant character of OLP, periodic follow-up is recommended. There is a spectrum of oral lichen planus-like ("lichenoid") lesions that may confuse the differential diagnosis. These include lichenoid contact lesions, lichenoid drug reactions and lichenoid lesions of graft-versus-host disease. In regard to the approach to oral lichenoid contact lesions the value of patch testing remains controversial. Confirmation of the diagnosis of an oral lichenoid drug reaction may be difficult, since empiric withdrawal of the suspected drug and/or its substitution by an alternative agent may be complicated. Oral lichenoid lesions of graft-versus-host disease (OLL-GVHD) are recognized to have an association with malignancy. Local therapy for these lesions rests in topical agents, predominantly corticosteroids.

Original languageEnglish (US)
Pages (from-to)S25.e1-S25.e12
JournalOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology
Volume103
Issue numberSUPPL.
DOIs
StatePublished - Mar 2007

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology
  • Dentistry(all)

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