Lichen planus is a chronic, inflammatory, autoimmune disease that affects the skin, oral mucosa, genital mucosa, scalp, and nails. Lichen planus lesions are described using the six P's planar [flat-topped], purple, polygonal, pruritic, papules, plaques. Onset is usually acute, affecting the flexor surfaces of the wrists, forearms, and legs. The lesions are often covered by lacy, reticular, white lines known as Wickham striae. Classic cases of lichen planus may be diagnosed clinically, but a 4-mm punch biopsy is often helpful and is required for more atypical cases. High-potency topical corticosteroids are first-line therapy for all forms of lichen planus, including cutaneous, genital, and mucosal erosive lesions. In addition to clobetasol, topical tacrolimus appears to be an effective treatment for vulvovaginal lichen planus. Topical corticosteroids are also first-line therapy for mucosal erosive lichen planus.
Lichen planus is an itchy skin rash that is caused by an immune response. It can occur anywhere on your skin. In cases of oral lichen planus, the mucous membranes inside your mouth are the only area affected.
Oral lichen planus is a chronic condition. There is no cure, so the treatment focuses on helping severe lesions heal and reducing pain or other discomfort. Your doctor will monitor your condition to determine the appropriate treatment or stop treatment as necessary. If you have no pain or discomfort and if only white, lacy lesions are present, you may not need any treatment. For more-severe symptoms, you may need one or more of the options below. Treatments such as topical numbing agents can be used to provide temporary relief for areas that are particularly painful. Corticosteroids may reduce inflammation related to oral lichen planus. One of these forms may be recommended:. Side effects vary, depending on the method of use.
Background Oral lichen planus OLP is a chronic inflammatory disorder that can cause local irritation and discomfort with attendant poor dentition and nutrition. Although a range of therapeutic options is available, data on the long-term efficacy of treatments for this chronic disease are limited. To identify agents that might be effective in OLP treatment over a longer term, and to explore their sequential use in treatment-refractory patients, we studied patients who received multiple OLP therapies and who were followed up for an average of more than 2 years. Observations We performed a retrospective medical record review of 50 patients with histologically confirmed OLP. Patients were treated according to a therapeutic ladder of sequential treatments, beginning with topical corticosteroids and progressing through topical immunomodulators, systemic retinoids, methotrexate, and thalidomide.