Oral Lichen Planus – Known and Unknown: a Review

Abstract

Lichen planus is a chronic mucocutaneous inflammatory disease aff ecting 1-2% of the general population with maximum prevalence of the disease in women above the age of 40. Its aetiology remains unclear and the pathogenesis is still the object of much speculation. It is considered to be an autoimmune disorder mediated mainly by the T-lymphocytes. The present paper presents the most well-known external agents (viruses in particular), internal agents like stress, and the heat shock protein thought to be trigger factors and describes the action of diff erent cells and proteins associated with the development of that disease. Diagnosis is based on clinical and histopathologic evidence; direct and indirect immunofluorescence techniques can also be of use. Despite the wide variety of therapeutic modalities, treatment outcomes are often insufficient. Currently, topical corticosteroids are widely accepted as a standard therapy, but also retinoids, calcineurin inhibitors and other immunosuppressants can be administered. Because of the aspect relevant to these drugs, priority is given to alternative harmless methods such as LLLT and PDLT. There is an ongoing controversy in the literature about the possible premalignant character of oral lichen planus, however, periodic followup is recommended.

Comparison of oral Nano-Curcumin with oral prednisolone on oral lichen planus: a randomized double-blinded clinical trial

“…Different amounts of free radicals and reactive oxygen species (ROS) are induced during this process. These reactions can damage lipids, proteins, and nucleic acids in cells [ 12 , 22 ]. OLP (as a potentially malignant disorder) symptoms, along with its classification, mandates effective management and regular monitoring [ 22 ].…”

Analysis of the Efficacy of Two Treatment Protocols for Patients with Symptomatic Oral Lichen Planus: A Randomized Clinical Trial

“…One of the most important problems in the management of OLP is its chronic-recurrent nature, which requires long-term therapy. It is currently impossible to achieve complete eradication of the disease with the available methods [ 9 ], as there is little data on the long-term therapeutic results of OLP patients and there is no definitive treatment that would result in long-term remission [ 10 ]. The treatment must be aimed at achieving specific objectives, such as the elimination/reduction of atrophic and ulcerative lesions, the alleviation of symptoms and the potential reduction of the risk of malignant transformation.…”

Perfil clínico-epidemiológico do Líquen Plano Oral em uma população do Nordeste do Brasil

“…Apesar dos diversos estudos a respeito do LPB, sua etiologia segue desconhecida e patogénese incerta. 9,31 Desta forma, o manejo do LPB é considerado um desafio, 9 e objetiva, sobretudo, a redução da inflamação e consequente alívio dos sintomas. 32 Dentre as terapias tópicas já propostas estão os corticosteróides, inibidores da calcineurina, ciclosporina, retinóides e rapamicina; e as sistémicas envolvem o uso de corticosteróides, imunomoduladores, antimicrobianos, retinóides, mesalamina, curcuminóides e agentes biológicos.…”