Oral lichen planus: patient profile, disease progression and treatment responses

Article Abstract:

Oral lichen planus may be difficult to treat and may lead to squamous cell cancer in a minority of patients. This immunological disease commonly affects the mouth, and is usually treated with topical or oral corticosteroids.

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Diagnosing and managing oral lichen planus

Article Abstract:

A review is presented of the symptoms and treatment of oral lichen planus, a condition in which hard white patches and ulcers appear in the mouth. Typically, patients notice discomfort in their mouths when eating hot or spicy foods before the lesions have developed; some say that outbreaks are more common during stressful periods. Lichen planus is associated with, among others, diseases such as diabetes mellitus, ulcerative colitis (a chronic inflammatory bowel disorder), and viral and bacterial infections. Although the status of lichen planus as a premalignant disease is not confirmed, patients should be closely observed. The pathophysiology of lichen planus, which is reviewed, includes infiltration by T cells (white blood cells of the immune system) directed against antigens (proteins that elicit an immune response); as a result of their activity, cells normally present in the mucous tissue react, causing white patches, redness in other areas, and, in more extreme cases, ulcers or blisters. Thus, these changes probably represent different stages of the disease, rather than different kinds of lichen planus. Treatment efforts attempt to control the ulcerations and other symptoms; the white areas rarely vanish. The most effective therapy at the present time for oral lichen planus is steroid medication, either administered systemically or applied topically. Diagnostic and treatment guidelines are presented for dentists who treat patients with chronic inflammation of their mucous membranes. A biopsy may be performed to determine whether candidiasis (a fungal infection) is present, or for lesions whose response to treatment is atypical. Since this is a chronic disorder, an important component of treatment is patient education regarding possible outcomes. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Assessing the characteristics of patients with oral lichen planus

Article Abstract:

The development of lichen planus appears to be associated with life stress levels in the patient. Lichen planus is an inflammation of the skin or inside of the mouth resembling resembling lichen growing on a rock. It varies in extent and discomfort and may produce small ulcers. Its cause is unknown but stress has been implicated. A group of 146 lichen planus patients completed a questionnaire. Nearly all were white, most were married and had at least some college education, and the average age was 58. More than one-third of respondents thought stress had triggered the disease, far more than any other cause to attributed it . Half the group had experienced increased life stress in the form of deaths or illnesses or relationship problems with families or co-workers at the time of onset. Considerable numbers reported other medical conditions such as high blood pressure, stomach problems, or headaches that also have a relationship to stress.

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