Oral Lichen Planus

August 22, 2012

A biopsy confirmed that the white mucosal discoloration and scattered small erosions were the result of lichen planus. Eradication may be attempted with potent topical steroids or oral steroids.

A 63-year-old man presented with the chief complaint of stinging, burning, and pain in his mouth. These symptoms were worsened by eating fruit or drinking carbonated beverages.

Key point: Areas of white mucosal discoloration were found throughout the gingival surfaces and the undersurface of the tongue. Scattered small erosions were also present. A biopsy of a 2-mm specimen confirmed the suspected diagnosis of oral lichen planus and excluded leukoplakia.

Treatment: Application of potent topical corticosteroids or administration of oral corticosteroids, is indicated. Unresponsive patients may require oral cyclosporine (2 to 4 mg/kg/d).

Note: The reason to attempt eradication is the small, but real, risk of evolution into cutaneous squamous cell carcinoma. The patient should avoid acidic foods, thereby reducing symptoms.