Oral lichen planus

• chronic, immune-mediated mucosal condition that affects up to 2% of the population
• adults  50–60 years
• common in women than in men (1.4: 1) 
• aetiology is unknown. Is an immune response, may be precipitated by exogenous antigens:
• Drugs (gold therapy, antibiotics, nonsteroidal anti-inflammatory drugs)
• Dental restorative materials (mercury, nickel, gold, resins, acrylates) 
• Hepatitis C
• clinical subtype:
  • reticular (most common) – ‘net-like’ pattern
  • erosive
  • plaque-like forms

Multiple subtypes may be observed in a single patient.

• The majority patients with oral lichen planus are asymptomatic, and no treatment is required. 
• If the condition is symptomatic or erosive, referral to an oral medicine specialist for the commencement of topical or, in certain cases, systemic immunosuppressive agents is indicated
• The prognosis for oral lichen planus is uncertain.
  • It can clear up within a few months or persist (with or without treatment) for decades. There are often periods of remission and relapse.