From the Guidelines
Yes, oral lesions can be associated with lichen sclerosus, although they are less common than genital or skin lesions. Oral lichen sclerosus typically presents as white, patchy lesions on the lips, gums, tongue, or inside of the cheeks, which may be painful or cause a burning sensation 1. These lesions can lead to scarring or changes in the texture of oral tissues. If oral lichen sclerosus is suspected, a biopsy may be necessary for definitive diagnosis, as recommended by studies 1.
Diagnosis and Treatment
Treatment usually involves topical corticosteroids, such as clobetasol 0.05% ointment, applied to the affected areas 2-3 times daily for 2-4 weeks, as suggested by guidelines for managing lichen sclerosus 1. In more severe cases, systemic medications like oral prednisone may be prescribed. It's essential to maintain good oral hygiene and avoid irritants like spicy foods, alcohol, and tobacco. Regular dental check-ups are crucial for monitoring the condition and preventing complications.
Management and Prevention
Lichen sclerosus in the mouth is believed to be an autoimmune condition, where the body's immune system mistakenly attacks its own tissues. The exact cause is unknown, but genetic factors and hormonal imbalances may play a role, as indicated by studies on the condition 1. While there is no cure, proper management can help control symptoms and prevent progression of the disease. Early histological confirmation by biopsy is recommended, and medical treatment with topical steroids may help arrest or delay the progressive nature of this disorder 1.
Key Considerations
- Maintain good oral hygiene
- Avoid irritants like spicy foods, alcohol, and tobacco
- Regular dental check-ups for monitoring and preventing complications
- Topical corticosteroids as first-line treatment
- Systemic medications for severe cases
- Biopsy for definitive diagnosis
- Long-term follow-up for patients with complicated or unresponsive disease 1
From the Research
Association between Oral Lesions and Lichen Sclerosus
- Oral lesions can be associated with lichen sclerosus, a chronic, inflammatory, mucocutaneous disorder that typically affects the genital and extragenital skin 2, 3.
- The oral manifestations of lichen sclerosus are rare, with only a few cases reported in the literature, and can appear as white macules, papules, or plaques on the labial mucosa, buccal mucosa, palate, and lower lip 2, 4.
- The association between anogenital and oral lichen sclerosus is also rare, with only 7 cases reported in a study of 72 cases of lichen sclerosus with oral/genital involvement 2.
Clinical and Histopathological Features
- Oral lichen sclerosus is often asymptomatic, but can cause pain, soreness, pruritus, and tightness when opening the mouth 2, 3.
- The histopathological criteria for oral lichen sclerosus include atrophy and sometimes hyperkeratosis of the epithelium, hydropic degeneration of basal cells, hyalinization of the lamina propria, lymphocyte infiltration beneath the zone of hyalinization, and scantiness of elastin 5, 6.
- The diagnosis of oral lichen sclerosus is typically made based on histological examination of a biopsy specimen 2, 3.
Treatment and Prognosis
- The treatment of oral lichen sclerosus is typically focused on relieving symptoms, and can include topical or intralesional corticosteroids 2, 3.
- In some cases, surgical excision or corticosteroid injections may be used to treat oral lichen sclerosus 6.
- The prognosis for oral lichen sclerosus is generally good, with no reported cases of malignant transformation 2, 3.