Oral Lichen Planus

Overview

Oral lichen planus is a chronic condition affecting the inside of the mouth. It typically occurs as white, lacy patches, swollen red tissues, or open sores on the inner cheeks, gums, and tongue. This may lead to sensations of burning, pain, or other forms of discomfort.

Lichen planus can manifest on various mucosal surfaces throughout the body. However, when it occurs in the mouth, it is specifically termed oral lichen planus. It often arises when the immune system unexpectedly attack against cells in the oral mucous membranes.

Although this condition cannot be transmitted from one person to another or considered dangerous, it can cause discomfort. Individuals with symptoms may require medication to alleviate them. In some cases, regular monitoring may be required due to the potential risk of developing mouth cancer in the affected areas.

Symptoms

Oral lichen planus typically forms in two distinct ways: bright red gum tissue or white, web-like lesions. The common locations for these lesions include the inside of the cheeks, gums, tongue, inner tissues of the lips, and the palate.

The symptoms may be divided into two categories:

• Reticular oral lichen planus: Most cases of these are not painful. On the inside of the cheeks, this type typically manifests as white patches or lesions that resemble threads. These regions are usually elevated slightly.
• Erosive oral lichen planus: Those who have this condition occasionally have gum tissue that is a vivid red color. In severe cases, one may get ulcers on the tongue, gums, or mouth floor. For those who have erosive oral lichen planus, eating and drinking hot, spicy, or acidic foods or beverages might be uncomfortable. They may experience a burning sensation or pain, bleeding and irritation during tooth brushing, gingivitis, painful and thickened patches on the tongue, as well as discomfort when speaking, chewing, or swallowing.

In addition to oral lichen planus, lichen planus lesions can affect various parts of the body, leading to different symptoms:

• Genital: Genital lesions, especially in females, may lead to pain, burning, and discomfort during intercourse, often presenting as red or eroded patches, occasionally exhibiting whitish areas. Similar lesions can also manifest on male genitalia.
• Skin: It can appear as itchy, purplish, flat-topped bumps.
• Scalp. On the scalp, the presence of skin lesions can result in either temporary or permanent hair loss.
• Nails: Toenails or fingernails may show ridges, thinning, or splitting, leading to temporary or permanent nail loss.
• Ears: This may be affected, potentially causing hearing loss.
• Eyes: Lichen planus can cause scarring and blindness.
• Esophagus: Lichen planus may result in narrowing or the formation of tight, ringlike bands, making swallowing difficult when it occurs.

If there is a white, thread-like lesions or red patches in the mouth, or if any of the signs and symptoms occur, consult a healthcare provider for proper diagnosis and treatment.

Causes

The cause of oral lichen planus is not fully understood, but it is believed to be influenced by genetic factors and the immune system. It indicates that T lymphocytes, a type of white blood cell associated with inflammation, may be activated in this condition.

Certain medications, including beta-blockers and nonsteroidal anti-inflammatory drugs (NSAIDs), can trigger its development. Additionally, specific diseases like hepatitis B and primary biliary cirrhosis may be associated with oral lichen planus. Other triggering factors also include allergy-causing agents such as dental materials, mouth injuries, and infections.

Risk factors

Oral lichen planus can affect anyone, but women are twice as prone to developing the condition compared to men. The majority of cases of oral lichen planus are observed in adults aged 50 and older.

Although more studies are required to establish the contributing factors to its occurrence, it is believed that having an immune-lowering disorder or using specific medications may elevate the risk of developing this condition.