Description

Oral lichen planus (LIE-kun PLAY-nus) is an ongoing inflammatory condition that affects mucous membranes inside the mouth. There are several different types of lichen planus affecting the mouth, but the two main types are:

  • Reticular. This type appears as white patches in the mouth and can look of lace. It is the most common type of oral lichen planus. It usually has no symptoms related. And usually do not need treatment or lead to further complications.
  • Erosive. This type appears as red, swollen tissues or open sores. It can cause a feeling of burning or pain. A healthcare professional should check the oral lichen planus regularly, as it can lead to cancer of the mouth.

Oral lichen planus can't be passed from one person to another. The condition occurs when the immune system attacks the cells of the oral mucous membranes for reasons that are not known.

Usually, the symptoms can be managed. But people who have oral lichen planus need regular check-ups. That's because oral lichen planus — especially the erosion of type — can increase the risk of getting cancer of the mouth on the affected areas.

Symptoms

The symptoms of oral lichen planus affects the mucous membranes of the mouth.

Appearance

The signs vary according to the type of oral lichen planus. For example:

  • Reticular. This type appears as white spots and can look of lace.
  • Erosive. This type appears as red, swollen tissues or open sores.

Location

The signs of the disease may appear in the:

  • On the inside of the cheeks, the most common location.
  • The gums.
  • In the tongue.
  • Inside the tissue of the lips.
  • In the palate.

Pain or other discomfort

The white, lacy patches of reticular oral lichen planus may not cause pain, aching, or other discomfort when they appear on the inside of the cheeks. But the symptoms of the erosion of oral lichen planus, which may occur along with red, swollen patches or open sores include:

  • Burning sensation or pain.
  • Sensitivity to heat, acidic or spicy foods.
  • The bleeding and irritation with the brushing of the teeth.
  • The inflammation of the gums, also known as gingivitis.
  • Painful, thickened patches on the tongue.
  • Pain when talking, chewing, or swallowing.

Other types of lichen planus

If you have oral lichen planus, lichen planus can affect other parts of your body, including:

  • Of the skin. Depending on the color of the skin, lichen planus usually appears as purplish or purple, flat-topped bumps that are often itchy.
  • The genitals. Lichen planus on the genitals of females often cause pain or burning and discomfort while having sex. The spots are usually red in color and eroded. Depending on the color of the skin, sometimes they look like the white areas. Lichen planus, which can also occur on the male genitals.
  • The ears. Lichen planus of the ears can cause hearing loss.
  • Of the nose. Frequent nasal bleeding and long-lasting congestion can occur.
  • The scalp. When lichen planus, which appears on the scalp, it can cause short-term or long-term hair loss. This hair loss can be permanent if not treated.
  • Nails. Although it is rare, lichen planus of the nails of the feet or the hands can result in ridges on the nails, thinning, or splitting of the nails, and short-term or long-term loss of nails.
  • The eyes. Rarely, lichen planus may involve the mucous membrane of the surfaces of the eyes, causing scarring and blindness.
  • The esophagus. Lichen planus of the esophagus is rare. But when it happens, you can reduce the esophagus, or in the narrow shape, ringlike bands in the esophagus can make swallowing hard.

When to see a doctor

Consult your doctor or other health care professional if you have any of the symptoms listed above.

Causes

There is No known cause of oral lichen planus. But the T — lymphocyte- white blood cells that participate in inflammation appear to be activated in the oral lichen planus. This could mean that it is a immune status and may involve genetic factors. More research is needed to find the exact cause.

In some people, certain medications, the mouth of the injury, infection, or allergy-causing agents, such as dental materials may cause oral lichen planus. Stress may make the symptoms worse or come back once in a while. But these causes are not confirmed.

Risk factors

Anyone can get oral lichen planus, but is more common in middle-aged adults, especially women over the age of 50. Some factors can increase your risk of getting oral lichen planus, such as having a disease that decreases the immunity or the taking of certain medications. But more research is needed.

Complications

Severe cases of oral lichen planus may increase the risk of:

  • A great amount of pain.
  • The loss of weight or not getting enough nutrition.
  • The stress or anxiety.
  • Depression.
  • The healing of the ulcer or other affected points.
  • Secondary oral candidiasis or fungal infections.
  • The mouth cancer.

Diagnosis

Your health care professional can make a diagnosis of oral lichen planus based on:

  • Talk with you about your dental and medical history and the medicines that you are taking.
  • Going over the symptoms occur in your mouth and in other places in your body.
  • Looking at your mouth and other areas as needed.

Your health care professional may also request laboratory tests, such as:

  • A biopsy. In this test, a small sample of tissue taken from one or more points in their mouth. This example is studied under a microscope to see if oral lichen planus is present. Other, more specialized, microscopic examination may be needed to find the proteins of the immune system commonly associated with oral lichen planus.
  • Cultures. A sample of cells from your mouth with a cotton swab. The sample is examined under a microscope to look at a secondary fungal, bacterial or viral infection.
  • Blood tests. These tests may be done to find the conditions such as hepatitis C, which can rarely be associated with oral lichen planus, and lupus, which may be seen as the oral lichen planus.

Treatment

Oral lichen planus is a disease for life. In the milder forms may disappear by themselves, but the flare-up later. Because there is no cure, treatment focuses on healing and relieve pain or other symptoms that worry you. Your health care professional watches his condition to find the best treatment, or discontinue the treatment as necessary.

If you do not have pain or other discomfort, and only the white lace signs of oral lichen planus in the mouth, you may not need any treatment. For more severe symptoms, you may need one or more of the following options.

Symptomatic treatment

Treatments such as anesthetic agents applied to the skin, can give relief for a short period of time in areas that are very painful.

Corticosteroids

Medicines called corticosteroids can reduce the inflammation associated with oral lichen planus. Your health care professional may recommend one of these ways:

  • The medicine is placed in the skin. Apply the mouthwash, ointment or gel directly to the mucous membrane — the preferred method.
  • Medication that you take by mouth. Take corticosteroids in pill form for a limited time.
  • Medicine that is taken as a shot. This medication is injected directly into the affected area.

The side effects vary depending on the method you use. Talk with your health care professional to weigh the potential benefits and side effects.

The immune response of the medicines

Medicines called immunosuppressants may be used to improve severe symptoms of oral lichen planus and to reduce pain. But they are only for people who do not have weakened immune systems because these medicines can weaken or change the immune response of the body. Comes in the following forms:

  • Ointments or gels applied to the skin. In ointment or gel, as these immune responses medications can effectively treat oral lichen planus. Examples include tacrolimus (Protopic) and pimecrolimus (Elidel). While these drugs have a united states Food and Drug Administration alert due to a clear link with cancer, which is commonly used for oral lichen planus. Talk with your health care professional about any potential risk.
  • Systemic medicine. Severe oral lichen planus which also relates to other areas, such as the scalp, genitals, or the esophagus, systemic medications that weaken the immune system can be suggested, to weigh the benefits and the risks.

The use of some medications, such as steroids are placed on the skin, can cause the overgrowth of yeast. This is known as a secondary infection. During the treatment, schedule regular follow-up visits with your primary healthcare professional to the verification of the secondary infections and treatment. Not to treat the secondary infections can worsen oral lichen planus.

Ask your doctor or other health professional about the benefits and risks of the use of drugs in any form.

Dealing with triggers

If the oral lichen planus seems to be tied to a trigger, such as a medicine, an allergen, or stress, your health care professional may recommend how to deal with the trigger. For example, the suggestions may include trying to take another medicine instead, see an allergist or dermatologist for more tests, or learning stress management techniques.

Lifestyle and home remedies

In addition to the regular medical and dental treatment, these self-care measures can make the oral lichen planus symptoms better or help prevent episodes of severe symptoms come back from time to time:

  • Keep your mouth clean. Doing so can relieve symptoms and help prevent infection. Floss daily and gently brush your teeth at least twice a day using a mild toothpaste without much, if any, to add flavor.
  • Change your diet. Cut spicy, salty or acidic foods if they cause symptoms or worse. Choose foods that are soft to help limit the pain. And the use of caffeine or stop using it.
  • Avoid irritants. Do not use alcohol or tobacco. Also stop the habits that can damage the inside of your mouth, such as chewing on your lip or cheek.
  • Learn how to manage stress. Because stress can make the symptoms or cause symptoms to come back, you may need to build skills to prevent or manage stress. Your healthcare provider may refer you to a mental health professional who can help you find out what is causing the stress, create tension management plans and / or the care of other mental health problems.
  • Consult your dentist or other health care professional on a regular basis. See your dentist twice a year for checkups and cleanings, or more often than directed. Due to the long-term treatment for oral lichen planus is often necessary, talk with your health care professional about how often you should be seen to keep track of how the treatment is working and to get the cancer screening.

Preparing for your appointment

It is likely to start by seeing your primary healthcare professional or dentist. You may be referred to a specialist in diseases of the gums and dental disease, also known as a periodontist, or a specialist in diseases of the skin, also known as a dermatologist.

What you can do

To prepare for your appointment:

  • Bring copies of all medical reports and test results that I've had about this condition.
  • Ask if there is something that you need to do before the appointment, such as a limit to your diet.
  • Make a list of the symptoms that you are taking, including those that do not seem to be related to his mouth.
  • Make a list of the personal information, including any of the main stress factors, or recent life changes.
  • Make a list of all the medications, vitamins, herbs, or other supplements you are taking and the dose.

Also, prepare questions to ask your health care professional. Some basic questions to ask include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes?
  • What kinds of tests do I need?
  • What is the best course of action?
  • What are the options to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • You should see a specialist?
  • Is there a generic option for the medicine you're prescribing?
  • Is there any printed material I can have? What sites do you recommend?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your healthcare provider is likely to ask several questions, such as:

  • When he made his start to see the wounds or other areas of concern in your mouth?
  • Do you have sores or spots similar in any other part of your body?
  • Do you feel any pain, a burning sensation or discomfort in the mouth?
  • How bad is the pain?
  • Have you recently started taking new medications?
  • Not to take vitamins, herbs and other dietary supplements or over the counter drugs?
  • Do you have any allergies?
  • Have you had any new or unusual stress in your life?
  • What other health problems you have?

Your healthcare provider will likely ask more questions based on your responses, symptoms, and needs. Prepare questions to make the most of your appointment time.

Symptoms and treatment of Oral lichen planus