Treatment trends in oral lichen planus and oral lichenoid lesions (Review)

Abstract

Oral lichen planus (OLP) is a chronic inflammatory disease, associated with altered cell-mediated immunological function. It has long-term evolution, repeated exacerbations, sometimes painful and resistant to treatment, even all of these, OLP significantly affects patient's life quality. Not least, OLP is accompanied by an increased risk of malignant transformation. A wide spectrum of therapeutic options is available, but none are curative. In this review, 58 structured studies on the clinical symptomatology and treatment strategy of OLP were analyzed. The literature research was performed according to the criteria of the PRISMA system. This study summarizes current knowledge regarding management of OLP and oral lichenoid lesions, discusses the challenges of choosing an adequate treatment and, in attempt to improve the quality of patient life, trying to describe a therapeutic algorithm that takes into consideration the clinical features of the disease. Current OLP therapy aims at eliminating all mucosal-related lesions, reduce symptomatology and decrease the risk of oral cancer and include corticosteroids, immunomodulatory agents, retinoids, ultraviolet irradiation and/or laser therapy.

Impact of Oral Lichen Planus on Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis

“…Over the decades, clinicians have been treating OLP using various modalities, mostly using drugs [4]. Unfortunately, there is no definitive curative treatment for OLP at present, and the available treatment modalities are not effective in achieving complete resolution of OLP.…”

“…These clinical symptoms may make patients prone to the development of stress, anxiety, and depression [3]. OLP is treated with a variety of medicines and agents to achieve systematic relief or complete resolution [4]. Unfortunately, these interventions mostly provide the objective evidence of benefits in the majority of clinical studies and can give a misleading sense of improvement in OLP and QoL.…”

Familial oral lichen planus in a 3-year-old boy: a case report with eight years of follow-up

“…According to an updated review about OLP treatment, the aims of therapeutic management are eliminating painful symptoms, promoting healing of erosive lesions, reducing the risk of malignant transformation, and prolongating symptom free periods [15]. For erosive OLP, corticosteroids were recommended as first-line treatment in consensus guidelines [15,16]. However, systemic or topical application of corticosteroids present various adverse effects, containing oral candidiasis, a smarting sensation in the mouth, gingival tenderness, insomnia, mood swings, fatigue, and water retention [16][17][18].…”

“…According to an updated review about OLP treatment, the aims of therapeutic management are eliminating painful symptoms, promoting healing of erosive lesions, reducing the risk of malignant transformation, and prolongating symptom free periods [ 15 ]. For erosive OLP, corticosteroids were recommended as first-line treatment in consensus guidelines [ 15 , 16 ].…”

Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

“…Lichen planus (LP) is a common muco-cutaneous disease that can be remain confined exclusively to the oral mucosa or present in a more widespread format [ 86 , 87 , 88 ]. It is an autoimmune/inflammatory condition affecting the skin, oral mucosa and tongue; within the oral cavity it may manifest in several different forms or subtypes generally described as reticular or ‘lace like’ (Wickham’s striae), bullous and erosive [ 86 , 89 ].…”