COMMON LESIONS OF THE ORAL CAVITY

oralcavitykapak

LICHEN PLANUS

Ayşegül Öndeş1
Anzel Toprak Bişkin2
Esin Akol Görgün3

1Adıyaman University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology,Adıyaman, Türkiye
2Adıyaman University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Adıyaman,Türkiye
3Adıyaman University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Adıyaman, Türkiye

Öndeş A, Bişkin AT, Akol Görgün E. Lichen Planus. In: Çakır B editor. Common Lesions of the Oral Cavity. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.59-65.

ABSTRACT

Lichen planus is a skin disease primarily affecting the skin surface and mucous membranes with- out showing organ involvement. Peripheral involvement in the body can be seen on the wrists, back, and legs. It is also one of the common lesions seen in the oral mucosa. It is characterized by itchy, purple-pink colored, flat-surfaced, shiny, 3-5 mm in size, numerous small raised formations. The sur- face shows fine hyperkeratotic striations. It is not an infectious disease and does not have contagious properties. It is a chronic inflammatory disease. It is a white lesion that cannot be removed from the surface, mostly affecting women. The age range is usually above 40 years. It affects 2% of the general population. Although it can appear in various areas of the mouth, it most commonly appears bilaterally and symmetrically on the buccal mucosa. The dorsal surface of the tongue and gingiva often follow. The floor of the mouth, palate, and lips are less commonly affected. The etiology is not clearly known. There are various factors, and the treatment focuses on eliminating the factors that may cause it and reducing acute symptoms. Topical corticosteroids are the first choice for the treatment of mild and moderate lichen planus. Systemic corticosteroids are used for severe forms. Clinically, it is classified into six types. One or more subtypes can be seen together in patients. Over time, transitions between clinical types may occur. The most common form is the reticular form. Erosive and atrophic subtypes show symptoms such as pain and tenderness, while reticular plaques and bullous subtypes may not show any symptoms and can be discovered incidentally during examination. Spicy and hot foods in- crease the symptoms of erosive and atrophic subtypes. The reticular type shows a lace-like character- istic striation, known as Wickham striae. Wickham striae are seen at the periphery of all types except the reticular type. The presence of Wickham striae is a pathognomonic feature in defining a lesion as lichen planus. Erosive and atrophic subtypes carry the suspicion of malignancy, which is why lichen planus is considered a premalignant lesion. It is important for clinicians to be aware of these forms and not overlook them during the examination. The disease has periods of symptomatic flare-ups and remissions. Maladjusted dentures, cheek and lip chewing habits, and dental interventions are among the factors that increase the lesion.

Keywords: Mouth mucosa; Lichen planus; OralLichen planus; Mouth; Precancerous conditions; Methotrexate

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