title: Oral lichen planus: a condition with more persistence and extra-oral involvement than suspected?
abstract: BACKGROUND
  Lichen planus is a relatively common and often studied chronic mucocutaneous condition. Reports detailing certain aspects relevant to patients affected have been lacking or inconsistent.
  
  
  METHODS
  A questionnaire-based survey was employed to assess the duration of oral lesions and the prevalence of self-reported potential extra-oral manifestations associated with oral lichen planus in 87 patients. All patients had recognized clinical features of oral lichen planus, and most had had histopathological confirmation following oral biopsy.
  
  
  RESULTS
  We report the findings of a preliminary survey which assessed the duration of oral lesions and the prevalence of extra-oral lesions consistent with lichen planus in patients presenting with oral lesions. The study confirmed the chronic nature of oral lichen planus and the rarity of spontaneous resolution. Most subjects had experienced symptoms for one to ten years (66 patients; 75.8%). Approximately 40% (36 patients) of the sample reported clinical features suggestive of extra-oral manifestations of lichen planus by the time that their oral lesions were apparent. The most commonly reported extra-oral manifestations involved the nails (27.6%, 24 patients). 25.3% (22 patients) reported a persistently sore throat suggestive of oesophageal or pharyngeal involvement. Skin (17.2%, 11 patients), and genital (10.3%, 9 patients) involvement was relatively infrequently reported. Most patients reported extra-oral lesions at only one site.
  
  
  CONCLUSIONS
  The survey results suggest that in patients with oral lichen planus oral lesions persist for a prolonged period, and that extra-oral lesions may be more common than suspected. However, further studies involving specialists to examine extra-oral sites are required.
authors.affiliation: Unit of Oral Medicine, Division of Maxillofacial Medical Diagnostic and Surgical Sciences, UCL Eastman Dental Institute and UCLH NHS Foundation Trust, London, UK.
authors.forename: Marta
authors.initials: M
authors.lastname: Bidarra
authors.forename: John A G
authors.initials: JA
authors.lastname: Buchanan
authors.forename: Crispian
authors.initials: C
authors.lastname: Scully
authors.forename: David R
authors.initials: DR
authors.lastname: Moles
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Porter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004935:Esophageal Diseases / Q000150:complications; D005260:Female; D006801:Humans; D017676:Lichen Planus, Oral / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000150:complications; D010612:Pharyngitis / Q000150:complications; D012871:Skin Diseases / Q000150:complications; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014623:Vaginal Diseases / Q000150:complications; D014845:Vulvar Diseases / Q000150:complications; D055815:Young Adult