Lichen Planus– advice sheet

Lichen planus is an inflammatory disease that strikes primarily the skin and mucous membranes. In rare cases, it also affects the hair and nails. The causes of lichen planus are largely unknown. A few cases are linked to allergic reactions to specific drugs or dental materials. It affects men and women equally, and occurs most often in middle-aged adults.

 

Lichen planus is not an infectious disease. It is impossible to ‘catch’ from someone who has it or give it to someone else. The disease is not a form of cancer. It does not appear to be inherited and is not nutrition related.

 

Lichen planus of the mouth most commonly affects the inside of the cheeks, gums and tongue. Oral lichen planus lasts longer than skin lichen planus. Fortunately, most cases of lichen planus of the mouth cause minimal problems. A few people who have oral lichen planus also have skin lichen planus. Women may also have lichen planus of the vaginal area.

 

Oral lichen planus typically appears as patches of fine white lines and dots. These changes usually do not cause symptoms. They are often found by dentists during routine check– ups. More severe forms of oral lichen planus cause painful sores and ulcers in the mouth. Often a biopsy of affected tissue is needed to confirm a diagnosis of lichen planus. Your doctor may have to make sure that the sores are not caused by a yeast or herpes infection. Sometimes, a biopsy is needed along with blood tests.

 

There have been cases of lichen planus like allergic reactions to dental materials but they are very rare. Because of the time and expense involved, removing dental materials is recommended only as a treatment of last resort.

 

While there are many theories to explain lichen planus, many doctors believe it can be classified as an autoimmune disease. This means the inflammatory cells that normally fight germs attack normal parts of the skin and mucous membranes.

 

 

Treatment

 

There is no known cure for oral lichen planus. The good news is that the disease often causes no pain or burning and treatment may not be needed. More severe forms of lichen planus—those with pain, burning, redness, blisters, sores and ulcers can be treated with a variety of medications, both applied to the sores (topical) and taken by mouth (oral). It is very important to keep a watchful eye on oral lichen planus. As with any disease of the lining of the mouth, lichen planus can lead to poor dental hygiene and gum disease. We would recommend regular visits to the dentists for examination and cleaning at least twice a year.

 

Spicy foods, citrus juices, tomato products, caffeinated drinks like coffee and cola and crispy foods like toast and corn chips should be decreased or eliminated from the diet as they can aggravate lichen planus and interfere with its ability to heal

 

 

Are you at risk?

 

When lichen planus is very severe, especially if the underside of the tongue is involved, there is a slightly increased risk of developing oral cancer—about twice that of the general population. Because of this increased risk, we would recommend discontinuing the use of alcohol and tobacco products, which also increase the risk.

 

This leaflet has been designed for you to improve your understanding of your condition, and contains information on may frequently asked questions. If you have any questions or would like further explanation please discuss this with your doctor or attending nurse.