Lichen Planus

Etiology: Idiosyncratic allergies to drugs and dental amalgam; systemic disease such as hepatitis, diabetes [Older adults are 6 to 8 times more likely to have diabetes mellitus than young adults. However a diagnosis of diabetes should not limit oral health care. Dental implications include increased risk of oral ulcerations, periodontal disease and Candida albicans proliferation. Timing of care during the day and maintenance of appropriate levels of sugar intake are additional points to be considered. ], biliary cirrhosis and sclerosing cholangitis; and history of allogenic transplants have all been implicated in cases of lichen planus.
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Striae of Wickham
 

Confined lesions that are symmetrically distributed and display purplish red appearance.
Oral eruptions often have a reticular pattern and occur on the buccal (cheek), tongue, and lower lip.
Lesions are white fine dots, slightly raised and present as lines (Striae of Wickham).
Erosive patterns may be painful.

 
Treatment Planning: Biopsy may be required to establish diagnosis. Patients with Lichen planus should be followed on a regular basis and suspicious areas should be biopsied to rule out possibility of malignancy. This disorder may be self-limiting and often clears without treatment.
 

 

ORAL00000016.gif Erosive Lichen Planus

A more severe form of lichen planus that may affect older individuals is erosive lichen planus.  Patients often refuse to eat compromising their nutritional and medical status.  Lesions may be seen on the gingival, tongue, lips, and buccal mucosa. Lesions are often bilateral.  This lesion should be differentiated from pemphigoid lesions.

 

ORAL00000016.gif Lichen Planus Eruptions

Medications Associated with Lichen Plannus Eruptions:

ORAL00000016.gif Erythemia Multiforme, a differential diagnosis

ORAL00000016.gif Oral Manifestations of Drug Therapy

ORAL00000016.gif Common Oral Lesions