Skip to main content
SpringerLink
Log in

Oral Lichen Planus: An Update on Diagnosis and Management

  • Review Article
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Oral lichen planus (OLP) is a chronic inflammatory disease whose pathogenesis involves a T-cell mediated, epithelium-directed inflammation in response to unknown antigen(s). The disease evolves by intermittent flares and displays polymorphous clinical features (reticular, erosive, atrophic, plaque, papular, bullous, etc.). When present, symptoms vary depending on the clinical form and range from discomfort to severe pain. Topical superpotent corticosteroids constitute the first-line treatment of symptomatic flares, whereas a wide range of second/third-line treatments are available among topical calcineurin inhibitors, systemic corticosteroids, systemic retinoids, topical/systemic immunomodulators, etc. Follow-up of patients is necessary to detect transformation into squamous cell carcinoma, occurring in approximately 1% of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Source: Dr Dujardin, Pathology Department, University Hospital of Tours, France

Fig. 12

Similar content being viewed by others

References

  1. González-Moles MÁ, Warnakulasuriya S, González-Ruiz I, González-Ruiz L, Ayén Á, Lenouvel D, et al. Worldwide prevalence of oral lichen planus: a systematic review and meta-analysis. Oral Dis. 2021;27(4):813–28.

    Article  PubMed  Google Scholar 

  2. Cassol-Spanemberg J, Rodríguez-de Rivera-Campillo ME, Otero-Rey EM, Estrugo-Devesa A, Jané-Salas E, López-López J. Oral lichen planus and its relationship with systemic diseases. A review of evidence. J Clin Exp Dent. 2018;10(9):e938–44.

    PubMed  PubMed Central  Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. Shikha, Gupta S, Mahajan A, Ambika, Garg R, Ghosh S. Childhood oral lichen planus: a case series with review of literature. Eur Arch Paediatr Dent. 2022;23(2):341–53.

  5. Kurago ZB. Etiology and pathogenesis of oral lichen planus: an overview. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(1):72–80.

    Article  PubMed  Google Scholar 

  6. El-Howati A, Thornhill MH, Colley HE, Murdoch C. Immune mechanisms in oral lichen planus. Oral Dis. 2023;29(4):1400–15.

    Article  PubMed  Google Scholar 

  7. Baek K, Lee J, Lee A, Lee J, Yoon HJ, Park HK, et al. Characterization of intratissue bacterial communities and isolation of Escherichia coli from oral lichen planus lesions. Sci Rep. 2020;10(1):3495.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Villa TG, Sánchez-Pérez Á, Sieiro C. Oral lichen planus: a microbiologist point of view. Int Microbiol Off J Span Soc Microbiol. 2021;24(3):275–89.

    Google Scholar 

  9. Wang H, Zhang D, Han Q, Zhao X, Zeng X, Xu Y, et al. Role of distinct CD4(+) T helper subset in pathogenesis of oral lichen planus. J Oral Pathol Med. 2016;45(6):385–93.

    Article  CAS  PubMed  Google Scholar 

  10. Shan J, Li S, Wang C, Liu L, Wang X, Zhu D, et al. Expression and biological functions of the CCL5-CCR5 axis in oral lichen planus. Exp Dermatol. 2019;28(7):816–21.

    Article  CAS  PubMed  Google Scholar 

  11. Piccinni MP, Lombardelli L, Logiodice F, Tesi D, Kullolli O, Biagiotti R, et al. Potential pathogenetic role of Th17, Th0, and Th2 cells in erosive and reticular oral lichen planus. Oral Dis. 2014;20(2):212–8.

    Article  PubMed  Google Scholar 

  12. Lodi G, Giuliani M, Majorana A, Sardella A, Bez C, Demarosi F, et al. Lichen planus and hepatitis C virus: a multicentre study of patients with oral lesions and a systematic review. Br J Dermatol. 2004;151(6):1172–81.

    Article  CAS  PubMed  Google Scholar 

  13. Lodi G, Pellicano R, Carrozzo M. Hepatitis C virus infection and lichen planus: a systematic review with meta-analysis. Oral Dis. 2010;16(7):601–12.

    Article  CAS  PubMed  Google Scholar 

  14. Petti S, Rabiei M, De Luca M, Scully C. The magnitude of the association between hepatitis C virus infection and oral lichen planus: meta-analysis and case control study. Odontology. 2011;99(2):168–78.

    Article  PubMed  Google Scholar 

  15. Alaizari NA, Al-Maweri SA, Al-Shamiri HM, Tarakji B, Shugaa-Addin B. Hepatitis C virus infections in oral lichen planus: a systematic review and meta-analysis. Aust Dent J. 2016;61(3):282–7.

    Article  CAS  PubMed  Google Scholar 

  16. Carrozzo M, Quadri R, Latorre P, Pentenero M, Paganin S, Bertolusso G, et al. Molecular evidence that the hepatitis C virus replicates in the oral mucosa. J Hepatol. 2002;37(3):364–9.

    Article  CAS  PubMed  Google Scholar 

  17. Pilli M, Penna A, Zerbini A, Vescovi P, Manfredi M, Negro F, et al. Hepatology. 2002;36(6):1446–52.

    Article  CAS  PubMed  Google Scholar 

  18. González-Moles MÁ, de Porras-Carrique T, Ramos-García P. Association of oral lichen planus with hepatic disorders and hepatocellular carcinoma: systematic review and meta-analysis. Med Oral Patol Oral Cirugia Bucal. 2023;18:25661.

    Google Scholar 

  19. Syrjänen S, Lodi G, von Bültzingslöwen I, Aliko A, Arduino P, Campisi G, et al. Human papillomaviruses in oral carcinoma and oral potentially malignant disorders: a systematic review. Oral Dis. 2011;17(Suppl 1):58–72.

    Article  PubMed  Google Scholar 

  20. Ma J, Zhang J, Zhang Y, Lv T, Liu J. The magnitude of the association between human papillomavirus and oral lichen planus: a meta-analysis. PLoS ONE. 2016;11(8): e0161339.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Viguier M, Bachelez H, Poirier B, Kagan J, Battistella M, Aubin F, et al. Peripheral and local human papillomavirus 16-specific CD8+ T-cell expansions characterize erosive oral lichen planus. J Invest Dermatol. 2015;135(2):418–24.

    Article  CAS  PubMed  Google Scholar 

  22. Kramer IR, Lucas RB, Pindborg JJ, Sobin LH. Definition of leukoplakia and related lesions: an aid to studies on oral precancer. Oral Surg Oral Med Oral Pathol. 1978;46(4):518–39.

    Article  CAS  PubMed  Google Scholar 

  23. van der Meij EH, Schepman KP, Plonait DR, Axéll T, van der Waal I. Interobserver and intraobserver variability in the clinical assessment of oral lichen planus. J Oral Pathol Med. 2002;31(2):95–8.

    Article  PubMed  Google Scholar 

  24. 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(9):507–12.

    Article  PubMed  Google Scholar 

  25. Cheng YSL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(3):332–54.

    Article  PubMed  Google Scholar 

  26. González-Moles MÁ, Ramos-García P. Oral lichen planus and related lesions. What should we accept based on the available evidence? Oral Dis. 2022.

  27. González-Moles MÁ, Ramos-García P, Warnakulasuriya S. An appraisal of highest quality studies reporting malignant transformation of oral lichen planus based on a systematic review. Oral Dis. 2021;27(8):1908–18.

    Article  PubMed  Google Scholar 

  28. González-Moles MÁ, Ruiz-Ávila I, González-Ruiz L, Ayén Á, Gil-Montoya JA, Ramos-García P. Malignant transformation risk of oral lichen planus: A systematic review and comprehensive meta-analysis. Oral Oncol. 2019;96:121–30.

    Article  PubMed  Google Scholar 

  29. Al-Hashimi I, Schifter M, Lockhart PB, Wray D, Brennan M, Migliorati CA, et al. Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(Suppl):S25.e1-12.

    PubMed  Google Scholar 

  30. Campana F, Lan R, Girard C, Rochefort J, Le Pelletier F, Leroux-Villet C, et al. French guidelines for the management of oral lichen planus (excluding pharmacological therapy). Ann Dermatol Venereol. 2022;149(1):14–27.

    Article  CAS  PubMed  Google Scholar 

  31. Fortuna G, Aria M, Schiavo JH. Drug-induced oral lichenoid reactions: a real clinical entity? A systematic review. Eur J Clin Pharmacol. 2017;73(12):1523–37.

    Article  PubMed  Google Scholar 

  32. Ramos-García P, González-Moles MÁ, Warnakulasuriya S. Oral cancer development in lichen planus and related conditions-3.0 evidence level: A systematic review of systematic reviews. Oral Dis. 2021 Nov;27(8):1919–35.

  33. Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res. 2016;308(8):539–51.

    Article  PubMed  Google Scholar 

  34. Dunsche A, Kästel I, Terheyden H, Springer ING, Christophers E, Brasch J. Oral lichenoid reactions associated with amalgam: improvement after amalgam removal. Br J Dermatol. 2003;148(1):70–6.

    Article  CAS  PubMed  Google Scholar 

  35. Thornhill MH, Pemberton MN, Simmons RK, Theaker ED. Amalgam-contact hypersensitivity lesions and oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(3):291–9.

    Article  PubMed  Google Scholar 

  36. López-Jornet P, Camacho-Alonso F. Do metal restorations in mouth alter clinical and histological appearance of oral lichen planus? N Y State Dent J. 2008;74(6):40–3.

    PubMed  Google Scholar 

  37. Cobos-Fuentes MJ, Martínez-Sahuquillo-Márquez A, Gallardo-Castillo I, Armas-Padrón JR, Moreno-Fernández A, Bullón-Fernández P. Oral lichenoid lesions related to contact with dental materials: a literature review. Med Oral Patol Oral Cirugia Bucal. 2009;14(10):e514-520.

    Article  Google Scholar 

  38. Issa Y, Brunton PA, Glenny AM, Duxbury AJ. Healing of oral lichenoid lesions after replacing amalgam restorations: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(5):553–65.

    Article  CAS  PubMed  Google Scholar 

  39. Ibrahim SS, Ragy NI, Nagy NA, El-kammar H, Elbakry AM, Ezzatt OM. Evaluation of muco-adhesive tacrolimus patch on caspase-3 induced apoptosis in oral lichen planus: a randomized clinical trial. BMC Oral Health. 2023;14(23):99.

    Article  Google Scholar 

  40. Weston G, Payette M. Update on lichen planus and its clinical variants. Int J Womens Dermatol. 2015;1(3):140–9.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Gorouhi F, Davari P, Fazel N. Cutaneous and mucosal lichen planus: a comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis. ScientificWorldJournal. 2014;2014: 742826.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Eisen D. The evaluation of cutaneous, genital, scalp, nail, esophageal, and ocular involvement in patients with oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(4):431–6.

    Article  CAS  PubMed  Google Scholar 

  43. Hewitt J, Pelisse M, Lessana-Leibowitch M, Sedel D, Fischesser D, Moyal-Barracco M, et al. Vulvovaginogingival syndrome. New characteristic grouping of plurimucous erosive lichen planus. Rev Stomatol Chir Maxillofac. 1985;86(2):57–65.

    CAS  PubMed  Google Scholar 

  44. Setterfield JF, Neill S, Shirlaw PJ, Theron J, Vaughan R, Escudier M, et al. The vulvovaginal gingival syndrome: a severe subgroup of lichen planus with characteristic clinical features and a novel association with the class II HLA DQB1*0201 allele. J Am Acad Dermatol. 2006;55(1):98–113.

    Article  PubMed  Google Scholar 

  45. Gupta MK, Lipner SR. Review of nail lichen planus: epidemiology, pathogenesis, diagnosis, and treatment. Dermatol Clin. 2021;39(2):221–30.

    Article  CAS  PubMed  Google Scholar 

  46. Schauer F, Monasterio C, Technau-Hafsi K, Kern JS, Lazaro A, Deibert P, et al. Esophageal lichen planus: towards diagnosis of an underdiagnosed disease. Scand J Gastroenterol. 2019;54(10):1189–98.

    Article  CAS  PubMed  Google Scholar 

  47. Decker A, Schauer F, Lazaro A, Monasterio C, Schmidt AR, Schmitt-Graeff A, et al. Esophageal lichen planus: current knowledge, challenges and future perspectives. World J Gastroenterol. 2022;28(41):5893–909.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Rennie CE, Dwivedi RC, Khan AS, Agrawal N, Ziyada W. Lichen planus of the larynx. J Laryngol Otol. 2011;125(4):432–5.

    Article  CAS  PubMed  Google Scholar 

  49. Shaikh ZI, Arfan-ul-Bari, Mashhood AA, Qayyum A, Latif-ur-Rahman. Mucosal lichen planus simultaneously involving oral mucosa, conjunctiva and larynx. J Coll Physicians Surg Pak JCPSP. 2010;20(7):478–9.

  50. Sharma N, Malhotra SK, Kuthial M, Chahal KS. Vulvo-vaginal ano-gingival syndrome: Another variant of mucosal lichen planus. Indian J Sex Transm Dis AIDS. 2017;38(1):86–8.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Thorne JE, Jabs DA, Nikolskaia OV, Mimouni D, Anhalt GJ, Nousari HC. Lichen planus and cicatrizing conjunctivitis: characterization of five cases. Am J Ophthalmol. 2003;136(2):239–43.

    Article  PubMed  Google Scholar 

  52. Mohebbi M, Mirghorbani M, Banafshe Afshan A, Towfighi M. Lichen planus in ocular surface: major presentations and treatments. Ocul Immunol Inflamm. 2019;27(6):987–94.

    Article  CAS  PubMed  Google Scholar 

  53. González-Moles MÁ, Warnakulasuriya S, González-Ruiz I, Ayén Á, González-Ruiz L, Ruiz-Ávila I, et al. Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper. Med Oral Patol Oral Cirugia Bucal. 2021;26(4):e541–8.

    Article  Google Scholar 

  54. Abe A, Ito Y, Hayashi H, Momokita M, Taniguchi S, Nakayama A. Evaluation of the classification and clinical characteristics of oral lichen planus and its treatment effect in different clinical types: a retrospective study. Adv Oral Maxillofac Surg. 2022;1(8): 100369.

    Article  Google Scholar 

  55. Hiremath S, Kale AD, Hallikerimath S. Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria. Turk Patoloji Derg. 2015;31(1):24–9.

    PubMed  Google Scholar 

  56. Mravak-Stipetić M, Lončar-Brzak B, Bakale-Hodak I, Sabol I, Seiwerth S, Majstorović M, et al. Clinicopathologic correlation of oral lichen planus and oral lichenoid lesions: a preliminary study. ScientificWorldJournal. 2014;2014: 746874.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Solomon LW, Helm TN, Stevens C, Neiders ME, Kumar V. Clinical and immunopathologic findings in oral lichen planus pemphigoides. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(6):808–13.

    Article  PubMed  Google Scholar 

  58. Hübner F, Langan EA, Recke A. Lichen planus pemphigoides: from lichenoid inflammation to autoantibody-mediated blistering. Front Immunol. 2019;10:1389.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Azzi L, Cerati M, Lombardo M, Pellilli M, Croveri F, Maurino V, et al. Chronic ulcerative stomatitis: a comprehensive review and proposal for diagnostic criteria. Oral Dis. 2019;25(6):1465–91.

    Article  PubMed  Google Scholar 

  60. Halonen M, Siponen M. Lichenoid lesions of the upper labial mucosa: a systematic review and a report of a new case with extensive follow-up. Acta Odontol Scand. 2023;81(1):29–39.

    Article  PubMed  Google Scholar 

  61. Ramos-e-Silva M, de-Moura-Castro Jacques C, Coelho da Silva Carneiro S. Premalignant nature of oral and vulval lichen planus: facts and controversies. Clin Dermatol. 2010;28(5):563–7.

  62. Lodi G, Manfredi M, Mercadante V, Murphy R, Carrozzo M. Interventions for treating oral lichen planus: corticosteroid therapies. Cochrane Database Syst Rev. 2020;2(2):CD001168.

  63. Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36(10):575–80.

    Article  CAS  PubMed  Google Scholar 

  64. Aghbari SMH, Abushouk AI, Attia A, Elmaraezy A, Menshawy A, Ahmed MS, et al. Malignant transformation of oral lichen planus and oral lichenoid lesions: a meta-analysis of 20095 patient data. Oral Oncol. 2017;68:92–102.

    Article  CAS  PubMed  Google Scholar 

  65. González-Moles MÁ, Warnakulasuriya S, González-Ruiz I, González-Ruiz L, Ayén Á, Lenouvel D, et al. Clinicopathological and prognostic characteristics of oral squamous cell carcinomas arising in patients with oral lichen planus: a systematic review and a comprehensive meta-analysis. Oral Oncol. 2020;106: 104688.

    Article  PubMed  Google Scholar 

  66. Bombeccari GP, Guzzi G, Tettamanti M, Giannì AB, Baj A, Pallotti F, et al. Oral lichen planus and malignant transformation: a longitudinal cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(3):328–34.

    Article  PubMed  Google Scholar 

  67. Gandolfo S, Richiardi L, Carrozzo M, Broccoletti R, Carbone M, Pagano M, et al. Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: a follow-up study in an Italian population. Oral Oncol. 2004;40(1):77–83.

    Article  CAS  PubMed  Google Scholar 

  68. Carbone M, Arduino PG, Carrozzo M, Gandolfo S, Argiolas MR, Bertolusso G, et al. Course of oral lichen planus: a retrospective study of 808 northern Italian patients. Oral Dis. 2009;15(3):235–43.

    Article  CAS  PubMed  Google Scholar 

  69. Ioannides D, Vakirlis E, Kemeny L, Marinovic B, Massone C, Murphy R, et al. European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol. 2020;34(7):1403–14.

    Article  CAS  PubMed  Google Scholar 

  70. Liu C, Xie B, Yang Y, Lin D, Wang C, Lin M, et al. Efficacy of intralesional betamethasone for erosive oral lichen planus and evaluation of recurrence: a randomized, controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(5):584–90.

    Article  PubMed  Google Scholar 

  71. Savage NW, McCullough MJ. Topical corticosteroids in dental practice. Aust Dent J. 2005;50(4 Suppl 2):S40-44.

    CAS  PubMed  Google Scholar 

  72. da Silva EL, de Lima TB, Rados PV, Visioli F. Efficacy of topical non-steroidal immunomodulators in the treatment of oral lichen planus: a systematic review and meta-analysis. Clin Oral Investig. 2021;25(9):5149–69.

    Article  PubMed  Google Scholar 

  73. Samycia M, Lin AN. Efficacy of topical calcineurin inhibitors in lichen planus. J Cutan Med Surg. 2012;16(4):221–9.

    Article  CAS  PubMed  Google Scholar 

  74. Paller AS, Fölster-Holst R, Chen SC, Diepgen TL, Elmets C, Margolis DJ, et al. No evidence of increased cancer incidence in children using topical tacrolimus for atopic dermatitis. J Am Acad Dermatol. 2020;83(2):375–81.

    Article  CAS  PubMed  Google Scholar 

  75. Ju HJ, Han JH, Kim MS, Lee SH, Shin JW, Choi M, et al. The long-term risk of lymphoma and skin cancer did not increase after topical calcineurin inhibitor use and phototherapy in a cohort of 25,694 patients with vitiligo. J Am Acad Dermatol. 2021;84(6):1619–27.

    Article  CAS  PubMed  Google Scholar 

  76. Weiner DM, Clark AK, Bhansali RS, Pappas-Taffer L, Barta SK, Villasenor-Park J, et al. Usage and safety of topical tacrolimus in patients with mycosis fungoides. Clin Exp Dermatol. 2022;47(6):1200–1.

    Article  PubMed  Google Scholar 

  77. Arana A, Pottegård A, Kuiper JG, Booth H, Reutfors J, Calingaert B, et al. Long-term risk of skin cancer and lymphoma in users of topical tacrolimus and pimecrolimus: final results from the extension of the cohort study protopic Joint European Longitudinal Lymphoma and Skin Cancer Evaluation (JOELLE). Clin Epidemiol. 2021;13:1141–53.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Thongprasom K, Chaimusig M, Korkij W, Sererat T, Luangjarmekorn L, Rojwattanasirivej S. A randomized-controlled trial to compare topical cyclosporin with triamcinolone acetonide for the treatment of oral lichen planus. J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol. 2007;36(3):142–6.

    CAS  Google Scholar 

  79. Scardina GA, Messina P, Carini F, Maresi E. A randomized trial assessing the effectiveness of different concentrations of isotretinoin in the management of lichen planus. Int J Oral Maxillofac Surg. 2006;35(1):67–71.

    Article  CAS  PubMed  Google Scholar 

  80. Singh AR, Rai A, Aftab M, Jain S, Singh M. Efficacy of steroidal vs non-steroidal agents in oral lichen planus: a randomised, open-label study. J Laryngol Otol. 2017;131(1):69–76.

    Article  CAS  PubMed  Google Scholar 

  81. Petruzzi M, Lucchese A, Lajolo C, Campus G, Lauritano D, Serpico R. Topical retinoids in oral lichen planus treatment: an overview. Dermatol Basel Switz. 2013;226(1):61–7.

    Article  CAS  Google Scholar 

  82. Samimi M, Le Gouge A, Boralevi F, Passeron T, Pascal F, Bernard P, et al. Topical rapamycin versus betamethasone dipropionate ointment for treating oral erosive lichen planus: a randomized, double-blind, controlled study. J Eur Acad Dermatol Venereol. 2020;34(10):2384–91.

    Article  CAS  PubMed  Google Scholar 

  83. Ali S, Wahbi W. The efficacy of aloe vera in management of oral lichen planus: a systematic review and meta-analysis. Oral Dis. 2017;23(7):913–8.

    Article  CAS  PubMed  Google Scholar 

  84. Carbone M, Goss E, Carrozzo M, Castellano S, Conrotto D, Broccoletti R, et al. Systemic and topical corticosteroid treatment of oral lichen planus: a comparative study with long-term follow-up. J Oral Pathol Med. 2003;32(6):323–9.

    Article  CAS  PubMed  Google Scholar 

  85. Gupta S, Ghosh S, Gupta S. Interventions for the management of oral lichen planus: a review of the conventional and novel therapies. Oral Dis. 2017;23(8):1029–42.

    Article  CAS  PubMed  Google Scholar 

  86. Torti DC, Jorizzo JL, McCarty MA. Oral lichen planus: a case series with emphasis on therapy. Arch Dermatol. 2007;143(4):511–5.

    Article  PubMed  Google Scholar 

  87. Handler HL. Isotretinoin for oral lichen planus. J Am Acad Dermatol. 1984;10(4):674.

    Article  CAS  PubMed  Google Scholar 

  88. Alsenaid A, Alamri A, Ruzicka T, Wolf R. Effective and safe use of alitretinoin after acitretin failure in oral lichen planus. Dermatol Ther. 2020;33(6): e14441.

    Article  CAS  PubMed  Google Scholar 

  89. Kunz M, Urosevic-Maiwald M, Goldinger SM, Frauchiger AL, Dreier J, Belloni B, et al. Efficacy and safety of oral alitretinoin in severe oral lichen planus—results of a prospective pilot study. J Eur Acad Dermatol Venereol. 2016;30(2):293–8.

    Article  CAS  PubMed  Google Scholar 

  90. Kolios AGA, Marques Maggio E, Gubler C, Cozzio A, Dummer R, French LE, et al. Oral, esophageal and cutaneous lichen ruber planus controlled with alitretinoin: case report and review of the literature. Dermatol Basel Switz. 2013;226(4):302–10.

    Article  Google Scholar 

  91. Rivas-Tolosa N, Requena C, Llombart B, Alcalá R, Serra-Guillén C, Calomarde L, et al. Antimalarial drugs for the treatment of oral erosive lichen planus. Dermatol Basel Switz. 2016;232(1):86–90.

    Article  CAS  Google Scholar 

  92. Eisen D. Hydroxychloroquine sulfate (plaquenil) improves oral lichen planus: an open trial. J Am Acad Dermatol. 1993;28(4):609–12.

    Article  CAS  PubMed  Google Scholar 

  93. Raj SC, Baral D, Garhnayak L, Mahapatra A, Patnaik K, Tabassum S, et al. Hydroxychloroquine—a new treatment option for erosive oral lichen planus. Indian J Dent Res Off Publ Indian Soc Dent Res. 2021;32(2):192–8.

    Article  Google Scholar 

  94. Yeshurun A, Bergman R, Bathish N, Khamaysi Z. Hydroxychloroquine sulphate therapy of erosive oral lichen planus. Australas J Dermatol. 2019;60(2):e109–12.

    Article  PubMed  Google Scholar 

  95. Turan H, Baskan EB, Tunali S, Yazici S, Saricaoglu H. Methotrexate for the treatment of generalized lichen planus. J Am Acad Dermatol. 2009;60(1):164–6.

    Article  PubMed  Google Scholar 

  96. Lajevardi V, Ghodsi SZ, Hallaji Z, Shafiei Z, Aghazadeh N, Akbari Z. Treatment of erosive oral lichen planus with methotrexate. J Dtsch Dermatol Ges. 2016;14(3):286–93.

    PubMed  Google Scholar 

  97. Verma KK, Mittal R, Manchanda Y. Azathioprine for the treatment of severe erosive oral and generalized lichen planus. Acta Derm Venereol. 2001;81(5):378–9.

    Article  CAS  PubMed  Google Scholar 

  98. Wee JS, Shirlaw PJ, Challacombe SJ, Setterfield JF. Efficacy of mycophenolate mofetil in severe mucocutaneous lichen planus: a retrospective review of 10 patients. Br J Dermatol. 2012;167(1):36–43.

    Article  CAS  PubMed  Google Scholar 

  99. Macario-Barrel A, Balguerie X, Joly P. Treatment of erosive oral lichen planus with thalidomide. Ann Dermatol Venereol. 2003;130(12 Pt 1):1109–12.

    CAS  PubMed  Google Scholar 

  100. Camisa C, Popovsky JL. Effective treatment of oral erosive lichen planus with thalidomide. Arch Dermatol. 2000;136(12):1442–3.

    Article  CAS  PubMed  Google Scholar 

  101. Chainani-Wu N, Collins K, Silverman S. Use of curcuminoids in a cohort of patients with oral lichen planus, an autoimmune disease. Phytomedicine. 2012;19(5):418–23.

    Article  CAS  PubMed  Google Scholar 

  102. Chainani-Wu N, Madden E, Lozada-Nur F, Silverman S. High-dose curcuminoids are efficacious in the reduction in symptoms and signs of oral lichen planus. J Am Acad Dermatol. 2012;66(5):752–60.

    Article  CAS  PubMed  Google Scholar 

  103. White CM, Chamberlin K, Eisenberg E. Curcumin, a turmeric extract, for oral lichen planus: A systematic review. Oral Dis. 2019;25(3):720–5.

    Article  PubMed  Google Scholar 

  104. Yarom N. Etanercept for the management of oral lichen planus. Am J Clin Dermatol. 2007;8(2):121–121.

    Article  PubMed  Google Scholar 

  105. Chao TJ. Adalimumab in the management of cutaneous and oral lichen planus. Cutis. 2009;84(6):325–8.

    PubMed  Google Scholar 

  106. Holló P, Szakonyi J, Kiss D, Jokai H, Horváth A, Kárpáti S. Successful treatment of lichen planus with adalimumab. Acta Derm Venereol. 2012;92(4):385–6.

    Article  PubMed  Google Scholar 

  107. Solimani F, Pollmann R, Schmidt T, Schmidt A, Zheng X, Savai R, et al. Therapeutic targeting of Th17/Tc17 cells leads to clinical improvement of lichen planus. Front Immunol. 2019;10:1808.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  108. AbuHilal M, Walsh S, Shear N. Treatment of recalcitrant erosive oral lichen planus and desquamative gingivitis with oral apremilast. J Dermatol Case Rep. 2016;10(3):56–7.

    PubMed  PubMed Central  Google Scholar 

  109. Bettencourt M. Oral lichen planus treated with apremilast. J Drugs Dermatol. 2016;15(8):1026–8.

    PubMed  Google Scholar 

  110. Paul J, Foss CE, Hirano SA, Cunningham TD, Pariser DM. An open-label pilot study of apremilast for the treatment of moderate to severe lichen planus: a case series. J Am Acad Dermatol. 2013;68(2):255–61.

    Article  CAS  PubMed  Google Scholar 

  111. Perschy L, Anzengruber F, Rappersberger K, Itzlinger-Monshi B, Aichelburg MC, Graf V, et al. Apremilast in oral lichen planus—a multicentric, retrospective study. J Dtsch Dermatol Ges. 2022;20(3):343–6.

    PubMed  Google Scholar 

  112. Shao S, Tsoi LC, Sarkar MK, Xing X, Xue K, Uppala R, et al. IFN-γ enhances cell-mediated cytotoxicity against keratinocytes via JAK2/STAT1 in lichen planus. Sci Transl Med. 2019;11(511):eaav7561.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  113. Abduelmula A, Bagit A, Mufti A, Yeung KCY, Yeung J. The use of janus kinase inhibitors for lichen planus: an evidence-based review. J Cutan Med Surg. 2023;23:12034754231156100.

    Google Scholar 

  114. Moussa A, Colla T, Morrison B, Sinclair R. Effective treatment of oral lichen planus with the JAK inhibitor baricitinib. Australas J Dermatol. 2022;63(2):276–7.

    Article  PubMed  Google Scholar 

  115. Kooybaran NR, Petzold G, Ströbel P, Schön MP, Mössner R. Alleviation of erosive oral and esophageal lichen planus by the JAK1 inhibitor upadacitinib. J Dtsch Dermatol Ges. 2021;19(12):1778–80.

    Article  PubMed  Google Scholar 

  116. Balestri R, Bortolotti R, Rech G, Girardelli CR, Zorzi MG, Magnano M. Treatment of oral erosive lichen planus with upadacitinib. JAMA Dermatol. 2022;158(4):457–8.

    Article  PubMed  Google Scholar 

  117. Hoseinpour Jajarm H, Asadi R, Bardideh E, Shafaee H, Khazaei Y, Emadzadeh M. The effects of photodynamic and low-level laser therapy for treatment of oral lichen planus—a systematic review and meta-analysis. Photodiagnosis Photodyn Ther. 2018;23:254–60.

    Article  PubMed  Google Scholar 

  118. He Y, Deng J, Zhao Y, Tao H, Dan H, Xu H, et al. Efficacy evaluation of photodynamic therapy for oral lichen planus: a systematic review and meta-analysis. BMC Oral Health. 2020;20(1):302.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  119. Hanna R, Dalvi S, Tomov G, Hopper C, Rebaudi F, Rebaudi AL, et al. Emerging potential of phototherapy in management of symptomatic oral lichen planus: a systematic review of randomised controlled clinical trials. J Biophotonics. 2023;5: e202300046.

    Article  Google Scholar 

  120. Gonzalez-Moles MA, Bravo M, Gonzalez-Ruiz L, Ramos P, Gil-Montoya JA. Outcomes of oral lichen planus and oral lichenoid lesions treated with topical corticosteroid. Oral Dis. 2018;24(4):573–9.

    Article  CAS  PubMed  Google Scholar 

  121. Mignogna MD, Lo Russo L, Fedele S. Gingival involvement of oral lichen planus in a series of 700 patients. J Clin Periodontol. 2005;32(10):1029–33.

    Article  PubMed  Google Scholar 

  122. Garcia-Pola MJ, Rodriguez-López S, Fernánz-Vigil A, Bagán L, Garcia-Martín JM. Oral hygiene instructions and professional control as part of the treatment of desquamative gingivitis. Systematic review. Med Oral Patol Oral Cirugia Bucal. 2019;24(2):e136–44.

    Google Scholar 

  123. Stone SJ, McCracken GI, Heasman PA, Staines KS, Pennington M. Cost-effectiveness of personalized plaque control for managing the gingival manifestations of oral lichen planus: a randomized controlled study. J Clin Periodontol. 2013;40(9):859–67.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Université François Rabelais, Tours, France

    Agathe Louisy, Eiryann Humbert & Mahtab Samimi

  2. Maxillofacial Surgery and Stomatology Department, CHU Tours, Tours, France

    Agathe Louisy

  3. Department of Dermatology, CHU Tours, Avenue de la République, 37170, Tours, France

    Eiryann Humbert & Mahtab Samimi

  4. INRA, UMR 1282, Tours, France

    Mahtab Samimi

Authors
  1. Agathe Louisy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eiryann Humbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mahtab Samimi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mahtab Samimi.

Ethics declarations

Funding

Not applicable.

Conflict of interest

M Samimi has received fees from Amgen and Novartis for speaking at educational meetings; has received fees from Merck-Pfizer for advisory board; has received reimbursement for travel and accommodation expenses from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Galderma International, Janssen Cilag, Lilly France, MSD France, Pierre Fabre Médicaments France, Sanofi Aventis. A Louisy and E Humbert have no conflicts of interest.

Availability of data and material

Not applicable.

Ethics approval

Not applicable.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Code availability

Not applicable.

Author contributions

AL, EH and MS contributed to the literature review and writing of the manuscript. All authors have read and approve the final version of the manuscript and agree to be accountable for the work.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Louisy, A., Humbert, E. & Samimi, M. Oral Lichen Planus: An Update on Diagnosis and Management. Am J Clin Dermatol 25, 35–53 (2024). https://doi.org/10.1007/s40257-023-00814-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40257-023-00814-3

Search

Navigation