From the Guidelines
Oral lichen planus is primarily caused by a T-cell mediated autoimmune reaction, with factors such as hepatitis C infection, genetics, age, and IFN-based antiviral therapy playing a role in its development. The exact cause of oral lichen planus is unknown, but it is believed to be an autoimmune disorder where the body's immune system mistakenly attacks the cells of the oral mucosa. Several factors may trigger or worsen oral lichen planus, including stress, certain medications, and genetic predisposition, as suggested by studies such as 1. According to 1, the association between oral lichen planus and hepatitis C infection has been widely described, and it is thought to be the result of a T-cell mediated autoimmune reaction.
Some key factors that may contribute to the development of oral lichen planus include:
- Hepatitis C infection, which has been linked to the condition in various studies, including 1
- Genetics, such as HLA-DR associations, which may play a role in the development of oral lichen planus
- Age, which may also be a factor in the development of the condition
- IFN-based antiviral therapy, which has been suggested to contribute to the development of oral lichen planus in some cases, as noted in 1
While there is no cure for oral lichen planus, treatments focus on managing symptoms and reducing inflammation, typically with topical corticosteroids or immunosuppressants. Regular dental check-ups are important for monitoring the condition, as there is a small risk of malignant transformation in some forms of oral lichen planus.
From the Research
Causes of Oral Lichen Planus
The exact cause of oral lichen planus (OLP) is not fully understood, but several factors are believed to contribute to its development.
- Abnormal immune response: OLP is thought to represent an abnormal immune response in which epithelial cells are recognized as foreign, secondary to changes in the antigenicity of the cell surface 2.
- Unknown antigens: The disease is believed to involve a T-cell mediated, epithelium-directed inflammation in response to unknown antigen(s) 3.
- Drug reactions: Certain drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can produce oral and cutaneous lesions that clinically and histologically resemble lichen planus 4.
- Other factors: Other factors, such as genetic predisposition, hormonal changes, and environmental factors, may also play a role in the development of OLP.
Types of Oral Lichen Planus
There are several types of OLP, including:
- Reticular form: The most common form of OLP, characterized by a lace-like pattern of white lines on the mucous membranes 2.
- Erosive form: A less common form of OLP, characterized by erosions or ulcers on the mucous membranes 2.
- Atrophic form: A less common form of OLP, characterized by thinning of the mucous membranes 2.
Triggers of Oral Lichen Planus
Certain factors can trigger or exacerbate OLP, including:
- NSAIDs: These drugs have been shown to be associated with the development of erosive lesions in OLP patients 4.
- Other medications: Certain medications, such as antihypertensive and oral hypoglycemic drugs, may also trigger or exacerbate OLP 4.
- Stress: Stress and anxiety may also trigger or exacerbate OLP symptoms.