Oral lichen planus: Pathogenesis, clinical features, and diagnosis
- Ginat W Mirowski, DMD, MD
Ginat W Mirowski, DMD, MD
- Associate Professor
- Department of Oral Pathology, Medicine, and Radiology - Indiana University, School of Dentistry
- Bethanee J Schlosser, MD, PhD
Bethanee J Schlosser, MD, PhD
- Assistant Professor - Departments of Dermatology and Obstetrics/Gynecology
- Northwestern University, Feinberg School of Medicine
Lichen planus (LP) is a chronic inflammatory disorder that affects the skin and mucous membranes. Oral LP is a mucosal subtype of LP that most commonly occurs in middle-aged adults. Oral LP may occur alone or in conjunction with other forms of LP (picture 1A-C). (See "Lichen planus", section on 'Clinical features'.)
The clinical findings of oral LP range from reticular white plaques to mucosal erythema, erosions, ulceration, and hyperkeratotic plaques (picture 2A-C). Although reticular lesions are often asymptomatic, pain frequently accompanies the other manifestations of oral LP.
The pathogenesis, clinical manifestations, and diagnosis of oral LP will be reviewed here. Discussion of the management of oral LP and reviews of other forms of LP are provided separately. (See "Oral lichen planus: Management and prognosis" and "Lichen planus" and "Lichen planopilaris" and "Vulvar lichen planus" and "Overview of nail disorders", section on 'Lichen planus' and "Lichenoid drug eruption (drug-induced lichen planus)".)
Epidemiologic data on oral lichen planus (LP) vary. Population-based studies performed in Asia, Europe, North America, and the Middle East have found disease prevalence rates between less than 1 percent and 3 percent .
Oral LP most commonly occurs in middle-aged adults. Large retrospective studies from Europe and the United States indicate that the average age of patients presenting with oral LP is around 50 to 60 years [2-4]. Oral LP is rare in children [5-9].
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