Abstract
Background
Oral Lichen Planus (OLP) is a chronic autoimmune mucocutaneous condition, the exact etiology of which is still unknown. It is known to occur chiefly in adults and has a reported prevalence of 0.5–2% in general population and < 2–3% of total in pediatric population. OLP is considered as Oral Potentially Malignant Disorder with a malignant transformation rate of 1–2% in adults. Its occurrence in children is a rare finding with few cases reported in the literature. As a result, it gets misdiagnosed by the general practitioner and hence, there is a need to consider OLP in differential diagnosis of white lesions of oral cavity even in children. Therefore, in this paper, we present six cases of childhood OLP along with their management and follow-up.
Case series
We present here six patients aged between 11 and 13 years who presented either as incidental finding or as symptomatic lesions and were diagnosed with OLP. Symptomatic patients were treated with topical steroid ointment and both the symptomatic and asymptomatic patients were followed-up. We have also presented literature review of childhood OLP reported in PubMed, Medline and google scholar from 1980 till December 2020.
Conclusion
OLP is unusual in children and is often left untreated due to low awareness among the patients. Can be often misdiagnosed and should be considered in differential diagnosis of any white lesion of oral cavity. Any such lesions must be correctly diagnosed in time to institute appropriate management and follow-up.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aghbari SMH, Abhushouk AI, Attia A, Elmaraezy A, Menshawy A, Ahmed MS, Elsaadany BA, Ahmed EM. Malignant transformation of oral lichen planus and lichenoid lesions: a meta-analysis of 20095 patient data. Oral Oncol. 2017;68:92–102. https://doi.org/10.1016/j.oraloncology.2017.03.012.
Agrawal S, Garg VK, Joshi A, Aggarwal A, Sah SP. Lichen planus after vaccination in a child: a case report from Nepal. J Dermatol. 2000;27(9):618–20. https://doi.org/10.1111/j.1346-8138.2000.tb02240.x.
Aguirre JM, Bagan JV, Rodriguez C, et al. Efficacy of mometasone furoate microemulsion in the treatment of erosive-ulcerative oral lichen planus: pilot study. J Oral Pathol Med. 2004;33:381–5. https://doi.org/10.1111/j.1600-0714.2004.00213.x.
Alam F, Hamburger J. Oral mucosal lichen planus in children. Int J Paediatr Dent. 2001;11(3):209–14. https://doi.org/10.1046/j.1365-263x.2001.00266.x.
Anuradha Ch, Reddy GS, Nandan SRK, Kumar RS, Reddy BV. Oral mucosal lichen planus in nine year old child. N Y State Dent J. 2011;77(6):28–30.
Borrego Hernando L, Vanaclocha Sebastian F, Hergueta Sanchez J, et al. Lichen planus pemphigoides in a 10-year-old girl. J Am Acad Dermatol. 1992;26:124–5. https://doi.org/10.1016/s0190-9622(08)80527-0.
Cascone M, Celentano A, Adamo D, Leuci S, Ruoppo E, Mignona MD. Oral lichen planus in childhood: a case series. Int J Dermatol. 2017. https://doi.org/10.1111/ijd.13571.
Chaitra TR, Telgi RL, Kishor A, Kulkarni AU. Juvenile oral lichen planus: a clinical rarity. BMJ Case Rep. 2012. https://doi.org/10.1136/bcr-2012-006192.
Chandna P, Adlakha VK, Singal G, Sharma R. Pediatric oral lichen planus: review and case report. Curr Pediatr Rev. 2014;10(4):292–6. https://doi.org/10.2174/1573396311666150113212652.
Chatterjee K, Bhattacharya S, Mukherjee CG, Majumdar A. A retrospective study of oral lichen planus in pediatric population. J Oral Maxillofac Pathol. 2012;16(3):363–7. https://doi.org/10.4103/0973-029X.102486.
Cheng YSL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper from the American academy of oral and maxillofacial pathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(3):332–54. https://doi.org/10.1016/j.oooo.2016.05.004.
Chiang CP, Chang JY, Wang YP, Wu YH, Lu SY, Sun A. Oral lichen planus-differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. J Formosan Med Assoc. 2018;117(9):756–65. https://doi.org/10.1016/j.jfma.2018.01.021.
Chinnasamy NK, Venugopal DC, Sankarapandian S, Narasimhan M. Oral lichen planus in a 7-year-old child: a rare case report. Int J Clin Pediatr Dent. 2020;13(1):91–3. https://doi.org/10.5005/jp-journals-10005-1713.
Chitturi RT, Sindhuja P, Parameswar RA, Nirmal RM, Reddy VR, Dineshshankar J, Yoithapprabhunath TR. A clinical study on oral lichen planus with special emphasis on hyperpigmentation. J Pharm Bioallied Sci. 2015;7(Suppl 2):S495–8. https://doi.org/10.4103/0975-7406.163513.
Condoo A, Chattopadhyay C. Use and abuse of topical corticosteroids in children. Ind J Paed Dermatol. 2014;15(1):1–4.
Cottoni F, Ena P, Tedde G, Montesu MA. Lichen planus in children: a case report. Paediatr Dermatol. 1993;10(2):132–5. https://doi.org/10.1111/j.1525-1470.1993.tb00038.x.
Das UM, Beena JP. Oral lichen planus in children. Int J Clin Pediatr Dent. 2009;2(1):49–51. https://doi.org/10.5005/jp-journals-10005-1043.
De Moraes PC, Teixeira RG, Tacchelli DP, Bönecker M, Junqueira JL, Oliveira LB. Atypical case of oral lichen planus in a pediatric patient: clinical presentation and management. Pediatr Dent. 2011;33(5):445–7.
Edwards PC, Kelsch R. Oral lichen planus: Clinical presentation and management. J Can Dent Assoc. 2002;68:494–9.
Eisen D. The clinical features, malignant potential and systemic associations of oral lichen planus: a study of 723 patients. J Am Acad Dermatol. 2002;46(2):207–14. https://doi.org/10.1067/mjd.2002.120452.
Eisen D, Carrozzo M, Bagan Sebastian JV, Thongprasom K. Number V oral lichen planus: clinical features and management. Oral Dis. 2005;11(6):338–49. https://doi.org/10.1111/j.1601-0825.2005.01142.x.
George S, John SA, Anandaraj S, Isaac JS, Harris A, Reshmi J. Childhood oral lichen planus: report of two cases. J Dent (tehran). 2015;12(5):374–8.
Gonzalez-Moles MA, Morales P, Rodriguez-Archilla A, Isabel IR, Gonzalez-Moles S. Treatment of severe chronic oral erosive lesions with clobetasol propionate in aqueous solution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:264–70. https://doi.org/10.1067/moe.2002.120522.
GunaShekhar M, Sudhakar R, Shahul M, Tenny J, Ravikanth M, Manikyakumar N. Oral lichen planus in childhood: a rare case report. Dermatol Online J. 2010;16:9.
Handa S, Sahoo B. Childhood lichen planus: a study of 87 cases. Int J Dermatol. 2002;41(7):423–7. https://doi.org/10.1046/j.1365-4362.2002.01522.x.
Hassan S, Mansoori S, Ansari I, Siddiqui S. Oral lichen planus in an 8 year old child: a case report with a brief literature review. J Oral Maxillofac Pathol. 2020;24:S128–34. https://doi.org/10.4103/jomfp.JOMFP_343_19.
Hugar SM, Reddy R, Gokhale N, Hugar SS. Oral lichen planus in child: a rare case report. J Adv Clin Res Insights. 2015;2:226–8.
Khandelwal V, Nayak PA, Nayak UA, Gupta A. Oral lichen planus in a young Indian child. BMJ Case Rep. 2013. https://doi.org/10.1136/bcr-2013-010516.
Khudhur AS, Di Zenzo G, Carrozzo M. Oral lichenoid tissue reactions: diagnosis and classification. Expert Rev Mol Diagn. 2014;14:169–84. https://doi.org/10.1586/14737159.2014.888953.
Laeijendecker R, Van JT, Tank B, Oranje AP, Neumann HA. Oral lichen planus in childhood. Pediatr Dermatol. 2005;22(4):299–304. https://doi.org/10.1111/j.1525-1470.2005.22403.x.
Limas C, Limas CJ. Lichen planus in children: a possible complication of Hepatitis B vaccines. Paediatr Dermatol. 2002;19(3):204–9. https://doi.org/10.1046/j.1525-1470.2002.00079.x.
Lodi G, Scully C, Carrozzo M, Sugerman P, Thongprasom K. Current controversies in oral lichen planus: Report of an international consensus meeting. Part 2. Clinical management and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:164–78. https://doi.org/10.1016/j.tripleo.2004.06.076.
Lozada-Nur F, Miranda C, Maliksi R. Double-blind clinical trial of 0.05% clobetasol propionate (corrected from proprionate) ointment in orabase and 0.05% fluocinonide ointment in orabase in the treatment of patients with oral vesiculoerosive diseases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1994;77:598–604. https://doi.org/10.1016/0030-4220(94)90318-2.
Lu SL, Qi XM, Dong G, Chen SL, Guo DW, Wang YL, Yang PS. Clinical characteristics and analysis of familial oral lichen planus in eight Chinese families. Exp Ther Med. 2016;12:2281–4. https://doi.org/10.3892/etm.2016.3597.
Mignogna MD, Lo Muzio L, Lo Russo L, Fedele S, Ruoppo E, Bucci E. Clinical guidelines in early detection of oral squamous cell carcinoma arising in oral lichen planus: a 5-year experience. Oral Oncol. 2001;37:262–7. https://doi.org/10.1016/s1368-8375(00)00096-8.
Mignogna MD, Lo Russo L, Fedele S, Ruoppo E, Califano L, Lo ML. Clinical behaviour of malignant transforming oral lichen planus. Eur J Surg Oncol. 2002a;28:838–43. https://doi.org/10.1053/ejso.2002.1302.
Mignogna MD, Fedele S, Lo Russo L, et al. Polyglandular autoimmune syndrome type II associated with oral lichen planus. Int J Dermatol. 2002b;41:244–6. https://doi.org/10.1046/j.1365-4362.2002.14505.x.
Milligan A, Graham-Brown RAC. Lichen planus in children: a review of 6 cases. Clin Exp Dermatol. 1990;15(5):340–2. https://doi.org/10.1111/j.1365-2230.1990.tb02108.x.
Moger G, Thippanna CK, Kenchappa M, Puttalingaiah VD. Erosive oral lichen planus with cutaneous involvement in a 7 year old girl: a rare case report. J Indian Soc Pedod Prev Dent. 2013;31(3):197–200. https://doi.org/10.4103/0970-4388.117972.
Morankar R, Singh V. Unusual presentation of oral lichen planus without any cutaneous manifestation in a 5 years old child—a case report. J Sci Dent. 2016;6(2):36–9.
Muller S. Oral lichenoid lesions: distinguishing the benign from the deadly. Mod Pathol. 2017;30:S54-67. https://doi.org/10.1038/modpathol.2016.121.
Nanda A, Al-Ajmi HS, Al-Sabah H, Al-Hasawi F, Alsaleh QA. Childhood lichen planus: a report of 23 cases. Paediatr Dermatol. 2001;18(1):1–4. https://doi.org/10.1046/j.1525-1470.2001.018001001.x.
Padmini C, Bai KY, Chaitanya V, Reddy MS. Ulcerative lichen planus in childhood. Case Rep Dent. 2013;2013: 874895. https://doi.org/10.1155/2013/874895.
Patel S, Yeoman CM, Murphy R. Oral lichen planus in childhood: a report of three cases. Int J Paediatr Dent. 2005;15:118–22. https://doi.org/10.1111/j.1365-263X.2005.00601.x.
Patsakas A, Demetriou N, Angelopoulos A. Melanin pigmentation and inflammation in human gingiva. J Periodontol. 1981;52:701–4. https://doi.org/10.1902/jop.1981.52.11.701.
Pedro LA, Ferrisse TM, Fernandes D, Silveira HA, Ortega RM, Leon JE, Bufalino A. Use of low-level laser therapy for oral lichen planus in children. J Oral Maxillofac Surg Med Pathol. 2018;30(6):559–61.
Rotaru D, Chisnoiu R, Picos AM, Picos A, Chisnoiu A. Treatment trends in oral lichen planus and oral lichenoid lesions (review). Exp Ther Med. 2020;20:198. https://doi.org/10.3892/etm.2020.9328.
Saawarn N, Shashikanth MC, Saawarn S, Jirge V, Chaitanya NC, Pinakapani R. Lycopene in the management of oral lichen planus: a placebo-controlled study. Ind J Dent Res. 2011;22:639–43. https://doi.org/10.4103/0970-9290.93448.
Sandhu K, Handa S, Kanwar AJ. Familial lichen planus. Pediatr Dermatol. 2003;20:186. https://doi.org/10.1046/j.1525-1470.2003.20221_5.x.
Sanjaya P, Hallikeri K, Angadi P. Disseminated form of childhood lichen planus. East J Med. 2013;16:72–5.
Scully C, Carrozzo M. Oral mucosal disease: lichen planus. Br J Oral Maxillofac Surg. 2008;46:15–21. https://doi.org/10.1016/j.bjoms.2007.07.199.
Scully C, de Almeida OP, Welbury R. Oral lichen planus in childhood. Br J Dermatol. 1994;130:131–3. https://doi.org/10.1111/j.1365-2133.1994.tb06905.x.
Sharma R, Maheshwari V. Childhood lichen planus: a report of fifty cases. Pediatr Dermatol. 1999;16(5):345–8. https://doi.org/10.1046/j.1525-1470.1999.00074.x.
Sharma G, Sardana D, Vohra P, Rehani S, Nagpal A. Oral lichen planus in a pediatric patient: a novel therapeutic approach. J Dent (tehran). 2017;14(2):109–14.
Shirasuna K. Oral lichen planus: malignant potential and diagnosis. Oral Sci International. 2017;11:1–7.
Singal A. Familial mucosal lichen planus in three successive generations. Int J Dermatol. 2005;44:81–2. https://doi.org/10.1111/j.1365-4632.2004.02146.x.
Tonkaboni A, Maraghehpour B. Oral lichen planus in a child in association with psychological stress: a case report. J Craniomaxillofac Res. 2018;5(3):136–8.
van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003;32:507–12. https://doi.org/10.1034/j.1600-0714.2003.00125.x.
Walton KE, Bowers EV, Drolet BA, et al. Childhood lichen planus: demographics of a US population. Pediatr Dermatol. 2010;27(1):34–8. https://doi.org/10.1111/j.1525-1470.2009.01072.x.
Wang F, Tan Y, Zhang J, Zhou G. Familial oral lichen planus in a 3-year-old boy: a case report with eight years of follow-up. BMC Oral Health. 2020;20:341. https://doi.org/10.1186/s12903-020-01333-x.
Warnakulasuriya S. Oral potentially malignant disorders: a comprehensive review on clinical aspects and management. Oral Oncol. 2020;102: 104550. https://doi.org/10.1016/j.oraloncology.2019.104550.
Woo VL, Manchanda-Gera A, Park DS, Yoon AJ, Zegarelli DJ. Juvenile oral lichen planus: report of two cases. Pediatr Dent. 2007;29(6):525–30.
Zychowska M, Batycka-Baran A, Bran W. Oral lichen planus with severe nail involvement in a 10 year old boy. Acta Derm Venereol. 2015;95(3):372–3. https://doi.org/10.2340/00015555-1957.
Funding
No funding was received for this manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Authors have no conflict of Interest to declare in regards to this article.
Informed consent for publication
Written informed consent was obtained from parents for publication.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Shikha, Gupta, S., Mahajan, A. et al. Childhood oral lichen planus: a case series with review of literature. Eur Arch Paediatr Dent 23, 341–353 (2022). https://doi.org/10.1007/s40368-021-00690-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40368-021-00690-7