Cirugia

Available online at www.sciencedirect.com

British Journal of Oral and Maxillofacial Surgery 46 (2008) 15–21

Oral mucosal disease: Lichen planus
Crispian Scully a,∗ , Marco Carrozzo b
a
bUniversity College London, Eastman Dental Institute, UK
University of Newcastle, UK

Accepted 19 July 2007
Available online 5 September 2007

Abstract
Lichen planus (LP) is a common disorder inwhich auto-cytotoxic T lymphocytes trigger apoptosis of epithelial cells leading to chronic
inflammation. Oral LP (OLP) can be a source of severe morbidity and has a small potential to be malignant.The diagnosis of OLP can be made from the clinical features if they are sufficiently characteristic, particularly if typical skin or other lesions
are present, but biopsy is recommended to confirm thediagnosis and to exclude dysplasia and malignancy.
OLP is treated with anti-inflammatory agents, mainly the topical corticosteroids, but newer agents and techniques are becoming available.
© 2007The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Keywords: Lichen planus; Oral; Skin

Introduction
Oral lichen planus (OLP) is a commondisorder that affects
stratified squamous epithelium virtually exclusively. It is seen
worldwide, mostly in the fifth to sixth decades of life, and is
twice as common in women than in men.1–3Aetiology and pathogenesis
OLP is a T cell-mediated autoimmune disease but its cause
is unknown in most cases.4 The increased production of
TH1 cytokines is a key and early event in LP, it is geneticallyinduced, and genetic polymorphism of cytokines seems
to govern whether lesions develop in the mouth alone
(interferon-gamma (IFN- ) associated) or in the mouth and
skin (tumour necrosisfactor-alpha (TNF- ) associated).5
Activated T cells are then attracted and migrate towards the
oral epithelium, further attracted by intercellular adhesion
∗ Corresponding author at: Eastman Dental...