Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Oral lichen planus (LIE-kun PLAY-nus) is an ongoing (chronic) inflammatory condition that affects mucous membranes inside your mouth. Oral lichen planus may appear as white, lacy patches; red, swollen tissues; or open sores. These lesions may cause burning, pain or other discomfort.

Oral lichen planus can't be passed from one person to another. The disorder occurs when the immune system mounts an attack against cells of the oral mucous membranes for unknown reasons (autoimmune disorder).

Symptoms can usually be managed, but people who have oral lichen planus need regular monitoring because they may be at risk of developing mouth cancer in the affected areas.

Source: http://www.mayoclinic.com

Signs and symptoms of oral lichen planus affect the mucous membranes of the mouth.

Appearance

The lesions may appear as:

• Lacy, white, raised patches of tissues
• Red, swollen, tender patches of tissues
• Open sores

Location

These lesions may appear on the:

• Inside of the cheeks, the most common location
• Gums
• Tongue
• Inner tissues of the lips
• Palate

Pain or discomfort

The red, inflamed lesions and open sores of oral lichen planus can cause a burning sensation or pain. The white, lacy patches may not cause discomfort when they appear on the inside of the cheeks but may be painful when they involve the tongue.

Other signs or symptoms

Other signs or symptoms may include:

• Change in taste or a blunted taste sensation if the tongue is affected
• Sensitivity to hot or spicy foods
• Bleeding and irritation with tooth brushing
• Inflammation of the gums (gingivitis)

Other types of lichen planus

If you have oral lichen planus, you may have lichen planus lesions affecting other parts of your body.

• Skin. Lesions usually appear as purplish, flat-topped bumps that are often itchy.
• Genitals. Lesions on the female genitalia often cause pain or burning and discomfort with intercourse. The lesions are usually red and eroded and occasionally appear as white areas. This can lead to scarring and loss of normal vaginal function and an inability to have intercourse.
• Ears. Lichen planus of the ears can lead to hearing loss.
• Scalp. When skin lesions appear on the scalp — a rare condition — they may cause temporary or permanent hair loss.
• Nails. Lichen planus of the toenails or fingernails, also rare, may result in ridges on the nails, thinning or splitting of nails, and temporary or permanent nail loss.
• Eyes. Rarely, lichen planus may involve the mucous membrane surfaces of the eyes, and can cause a loss of tear duct function and scarring of the eyelids.
• Esophagus. Lichen planus of the esophagus also is rare, but when it occurs, it may result in a narrowing of the esophagus or the formation of tightened, ring-like bands in the esophagus that can make swallowing difficult.

When to see a doctor

See your doctor or dentist if you:

• Notice sores inside your mouth that don't heal
• Have white or red patches in your mouth
• Have mouth pain
• Have repeated bleeding in your mouth when brushing or flossing
• Notice any change in the way your mouth looks and feels
• Have lesions or sores on your skin, genitals, scalp or nails
• Develop unexplained scarring of the transparent membrane (conjunctiva) that covers the white part of your eyeball
• Develop ear canal inflammation (otitis) that does not respond to treatment or does not have an apparent diagnosis or cause

Source: http://www.mayoclinic.com

The cause of oral lichen planus is unknown. T lymphocytes — certain white blood cells involved in inflammation — are normally active at the site of disease or injury and cause the lesions. Doctors and researchers don't know what prompts T lymphocytes to be activated in oral lichen planus. However, in some people, certain factors, such as those below, may trigger an inflammatory disorder.

• Hepatitis C infection and other types of liver disease
• Hepatitis B vaccine
• Allergy-causing agents (allergens), such as foods, dental materials or other substances
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others)
• Certain medications for heart disease, high blood pressure or arthritis

Source: http://www.mayoclinic.com

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Your doctor or dermatologist makes a diagnosis of oral lichen planus based on your symptoms, a careful examination of the abnormalities in your mouth and, if necessary, the results of lab tests. These tests may include:

• Biopsy. Your doctor may take a small tissue sample from one or more lesions in your mouth. The tissue is examined under a microscope to identify a typical pattern of T lymphocytes consistent with a diagnosis of oral lichen planus. Other more specialized microscopic tests may be needed to identify profiles of immune system proteins commonly associated with the disorder.
• Cultures. Using a cotton swab to take a sample of cells from your mouth and then examining the sample under a microscope can reveal whether you have a secondary fungal, bacterial or viral infection.
• Blood tests. These may be done to rule out conditions such as hepatitis C, which may rarely be associated with oral lichen planus, and lupus, which may look similar to oral lichen planus.
• Allergy tests. Your doctor may refer you to an allergy specialist (allergist) or dermatologist for skin patch testing to identify agents to which you may be allergic and that may act as triggers for your condition.

Source: http://www.mayoclinic.com

Factors that may complicate the condition or worsen symptoms include:

• Tobacco products
• Alcohol
• Rough dental work
• Poorly fitting dentures
• Poor oral habits, such as biting the lip or cheeks
• Buildup of dental plaque or tartar
• Stress

In addition, oral lichen planus may increase the risk of oral cancers, particularly a type known as squamous cell carcinoma. To help prevent cancer, take these actions:

• Get oral cancer screenings annually or as directed by your doctor.
• If you drink alcohol, do so in moderation. Talk to your doctor to see if you should avoid alcohol completely.
• If you use any tobacco products, quit. Talk to your doctor if you need help ending a tobacco habit.

Source: http://www.mayoclinic.com

In addition to regular medical and dental treatment, self-care measures may help improve your oral lichen planus symptoms or help prevent recurring episodes of severe symptoms. These include:

• Practicing good oral hygiene. Keep your mouth clean to reduce your symptoms and help prevent infection. Gently brush your teeth at least twice a day and floss daily. See your dentist twice a year for checkups and cleanings, or more often as directed by your dentist.
• Adjust your diet. Cut out spicy or acidic foods if they seem to trigger or worsen your symptoms. And reduce or eliminate the use of caffeine, alcohol or tobacco.

Source: http://www.mayoclinic.com

Some factors can increase the likelihood of developing oral lichen planus.

• Middle-aged women are most often affected, although anyone can develop oral lichen planus.
• Having a disorder that compromises your immune system may increase your risk of developing oral lichen planus.
• Genes may play a role in the development of oral lichen planus.

Source: http://www.mayoclinic.com