From the Guidelines
Oral lichen planus affecting the lips, tongue, or mucous membranes should be treated with high-potency topical steroids, such as clobetasol 0.05% or fluocinonide 0.05% gel, as recommended by the NCCN guidelines 1. When managing oral lichen planus, it is essential to consider the severity of the disease and the affected areas.
- For mucosal disease, gel formulations of topical steroids are preferred, while cream, lotion, or ointment can be used for other affected areas.
- Tacrolimus 0.1% ointment is also a recommended option for all grades of lichen planus and lichenoid diseases 1. Key aspects of treatment include:
- Applying topical corticosteroids directly to affected areas 2-3 times daily for 2-4 weeks
- Maintaining excellent oral hygiene to prevent irritation and infection
- Avoiding spicy, acidic, or hot foods that may exacerbate symptoms
- Stopping tobacco and alcohol use to reduce the risk of malignant transformation Regular dental check-ups are crucial, as oral lichen planus is considered potentially pre-malignant, with a small risk of developing into oral cancer. Symptoms of oral lichen planus typically include white lacy patterns on mucous membranes, painful red areas, and sometimes ulceration, which can be effectively managed with proper treatment, improving quality of life 1.
From the Research
Oral Lichen Planus on Lips and Tongue or Mucous Membrane
- Oral Lichen Planus (OLP) is a chronic inflammatory condition that affects oral mucosal surfaces, including the lips and tongue 2.
- The condition is characterized by T cell-mediated cytotoxicity and can cause significant pain, particularly in its erosive or ulcerative forms 3.
- OLP can affect the oral mucosa, including the lips, tongue, and other mucous membranes, and can be associated with other systemic diseases 4.
Treatment Options
- Topical corticosteroids are considered the first-line treatment for OLP, and are often used to reduce pain and discomfort 2, 3.
- Other treatment options include calcineurin inhibitors, such as tacrolimus, which may be more effective at resolving pain than corticosteroids 3.
- Other substances, such as retinoids, hyaluronic acid, and Aloe Vera, may also be used to treat OLP, particularly when the first-line approach is refractory 2.
- Phototherapy and low/high energy pulsing light may also be used to treat OLP, although the evidence for these treatments is limited 2.
Clinical Presentation and Diagnosis
- OLP can present with a range of clinical features, including white patches, redness, and ulceration on the oral mucosa 5, 4.
- The diagnosis of OLP is typically based on clinical examination and histopathological analysis of biopsy specimens 5, 4.
- The condition can be associated with other systemic diseases, and a thorough medical history and physical examination are essential for diagnosis and management 4.
Management and Treatment
- The management of OLP typically involves a combination of topical and systemic treatments, depending on the severity and extent of the disease 6, 3.
- The goal of treatment is to reduce pain and discomfort, and to prevent complications such as malignant transformation 5, 4.
- A step-by-step approach to treatment, taking into account the type, extent, and severity of the disease, is recommended 6.