Oral Lichen Planus: A Comprehensive Review

Oral lichen planus (OLP) is a typical chronic lesion perceived as the analogous to
cutaneous lichen planus. The global population shows a prevalence of 0.2 - 2%, with
variation seen in different ethnic groups. OLP is considered as a result of deregulated
immunological phenomena leading to basal cell degeneration and apoptosis of epithelial
keratinocytes of oral mucosa. This destruction is mediated by CD8 + cells, possibly
triggered by a number of factors such as hepatitis C virus (HCV), drugs and stress.
Although OLP has not been established as a predisposing factor for systemic conditions
such as diabetes mellitus, hypertension, thyroid diseases and other immunological
disturbances, however, literature supports their co-existence. It shows various clinical
forms ranging from the most common reticular, to erosive/atrophic, ulcerative/erosive
and bullous variant reported the least. Based on the clinical form, it shows a
resemblance to leukoplakia, lupus erythematosus and lichenoid reactions. Depending on
the severity and location of lesion, corticosteroid remains a mainstay in its treatment.
Considering the tendency of erosive OLP form to undergo malignant transformation,
makes it important to diagnosis and understand its profile. With a known fact of existing
ethnic variation, very few surveys have been done considering OLP among the Saudi
Arabian population. Thus, the article aimed to present the most recent update on OLP
epidemiology, etiopathogenesis, clinical manifestations and management.