title: Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations.
abstract: Several therapeutic agents have been investigated for the treatment of oral lichen planus (OLP). Among these are corticosteroids, retinoids, cyclosporine, and phototherapy, in addition to other treatment modalities. A systematic review of clinical trials showed that particularly topical corticosteroids are often effective in the management of symptomatic OLP lichen planus. Systemic corticosteroids should be only considered for severe widespread OLP and for lichen planus involving other mucocutaneous sites. Because of the ongoing controversy in the literature about the possible premalignant character of OLP, periodic follow-up is recommended. There is a spectrum of oral lichen planus-like ("lichenoid") lesions that may confuse the differential diagnosis. These include lichenoid contact lesions, lichenoid drug reactions and lichenoid lesions of graft-versus-host disease. In regard to the approach to oral lichenoid contact lesions the value of patch testing remains controversial. Confirmation of the diagnosis of an oral lichenoid drug reaction may be difficult, since empiric withdrawal of the suspected drug and/or its substitution by an alternative agent may be complicated. Oral lichenoid lesions of graft-versus-host disease (OLL-GVHD) are recognized to have an association with malignancy. Local therapy for these lesions rests in topical agents, predominantly corticosteroids.
authors.affiliation: Salivary Dysfunction Clinic, Baylor College of Dentistry, Houston, TX, USA.
authors.forename: Ibtisam
authors.initials: I
authors.lastname: Al-Hashimi
authors.forename: Mark
authors.initials: M
authors.lastname: Schifter
authors.forename: Peter B
authors.initials: PB
authors.lastname: Lockhart
authors.forename: David
authors.initials: D
authors.lastname: Wray
authors.forename: Michael
authors.initials: M
authors.lastname: Brennan
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Migliorati
authors.forename: Tony
authors.initials: T
authors.lastname: Axéll
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Bruce
authors.forename: William
authors.initials: W
authors.lastname: Carpenter
authors.forename: Ellen
authors.initials: E
authors.lastname: Eisenberg
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.forename: Palle
authors.initials: P
authors.lastname: Holmstrup
authors.forename: Mats
authors.initials: M
authors.lastname: Jontell
authors.forename: Francina
authors.initials: F
authors.lastname: Lozada-Nur
authors.forename: Raj
authors.initials: R
authors.lastname: Nair
authors.forename: Bud
authors.initials: B
authors.lastname: Silverman
authors.forename: Kobkan
authors.initials: K
authors.lastname: Thongprasom
authors.forename: Martin
authors.initials: M
authors.lastname: Thornhill
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
authors.forename: Isaäc
authors.initials: I
authors.lastname: van der Waal
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006086:Graft vs Host Disease / Q000150:complications / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017676:Lichen Planus, Oral / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D017512:Lichenoid Eruptions / Q000175:diagnosis / Q000628:therapy; D012176:Retinoids / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D012176:Retinoids