Oral lichen planus (OLP) is a chronic inflammatory condition that affects the mucous membranes inside the mouth. It is believed to be an autoimmune disorder, where the body’s immune system mistakenly attacks the cells of the oral mucosa, leading to inflammation and the development of characteristic lesions.

Here are some key points about oral lichen planus:

1. Symptoms: OLP typically presents with various symptoms, which may include:

• White, lacy patches (reticular lesions) on the inside of the cheeks, tongue, or gums.
• Red, swollen patches (erythematous lesions) or ulcers in the mouth.
• Burning sensation or discomfort, particularly when consuming spicy or acidic foods.
• Pain or sensitivity to hot, cold, or spicy foods.
• Dry mouth (xerostomia) or altered taste sensation (dysgeusia).

1. Clinical Presentation: Oral lichen planus lesions can vary in appearance and may manifest as:

• Reticular lesions: Fine, white lines or lacy patches that may intersect and form a network-like pattern.
• Erosive or ulcerative lesions: Red, raw areas of tissue that may be painful and prone to bleeding.
• Bullous lesions: Fluid-filled blisters or vesicles that may rupture and form painful erosions.

1. Diagnosis: Diagnosis of oral lichen planus is typically based on clinical examination and may involve:

• Visual inspection of the oral cavity to identify characteristic lesions.
• Biopsy of suspicious lesions for histopathological examination, which can reveal characteristic changes such as basal cell degeneration, lymphocytic infiltration, and the presence of Civatte bodies (liquefied degenerated basal cells).

1. Causes: The exact cause of oral lichen planus is not fully understood, but it is believed to involve an autoimmune reaction triggered by various factors, including:

• Genetic predisposition: Certain genetic factors may increase susceptibility to developing lichen planus.
• Immune system dysfunction: Abnormal immune responses may lead to inflammation and tissue damage in the oral mucosa.
• Environmental factors: Factors such as stress, trauma, infections, medications, or allergic reactions may trigger or exacerbate lichen planus lesions.

1. Treatment: Treatment of oral lichen planus aims to alleviate symptoms, reduce inflammation, and prevent complications. Management options may include:

• Topical corticosteroids: Application of corticosteroid gels, creams, or ointments directly to the affected areas to reduce inflammation and promote healing.
• Systemic corticosteroids: Oral corticosteroid medications may be prescribed for severe or widespread cases of oral lichen planus.
• Immunosuppressive agents: Medications such as cyclosporine, tacrolimus, or mycophenolate mofetil may be used to suppress immune system activity and reduce inflammation.
• Oral hygiene measures: Gentle oral hygiene practices, including regular brushing and flossing, and avoidance of irritating foods or substances.
• Symptomatic relief: Use of topical anesthetics, oral rinses, or saliva substitutes to alleviate pain, dry mouth, or discomfort associated with lichen planus lesions.
• Follow-up care: Regular monitoring by a dentist or oral medicine specialist to evaluate treatment response, monitor for disease progression, and detect any potential complications or malignant transformation.

In summary, oral lichen planus is a chronic inflammatory condition of the oral mucosa characterized by the presence of white, lacy patches, red erosions, or ulcerations. It is believed to be an autoimmune disorder with various triggers and may require a multidisciplinary approach for diagnosis and management. Treatment aims to alleviate symptoms, reduce inflammation, and improve oral health and quality of life for individuals affected by this condition.