Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Mar:103 Suppl:S25.e1-12. doi: 10.1016/j.tripleo.2006.11.001. Epub 2007 Jan 29.


Several therapeutic agents have been investigated for the treatment of oral lichen planus (OLP). Among these are corticosteroids, retinoids, cyclosporine, and phototherapy, in addition to other treatment modalities. A systematic review of clinical trials showed that particularly topical corticosteroids are often effective in the management of symptomatic OLP lichen planus. Systemic corticosteroids should be only considered for severe widespread OLP and for lichen planus involving other mucocutaneous sites. Because of the ongoing controversy in the literature about the possible premalignant character of OLP, periodic follow-up is recommended. There is a spectrum of oral lichen planus-like ("lichenoid") lesions that may confuse the differential diagnosis. These include lichenoid contact lesions, lichenoid drug reactions and lichenoid lesions of graft-versus-host disease. In regard to the approach to oral lichenoid contact lesions the value of patch testing remains controversial. Confirmation of the diagnosis of an oral lichenoid drug reaction may be difficult, since empiric withdrawal of the suspected drug and/or its substitution by an alternative agent may be complicated. Oral lichenoid lesions of graft-versus-host disease (OLL-GVHD) are recognized to have an association with malignancy. Local therapy for these lesions rests in topical agents, predominantly corticosteroids.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Diagnosis, Differential
  • Graft vs Host Disease / complications
  • Graft vs Host Disease / therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lichen Planus, Oral / diagnosis
  • Lichen Planus, Oral / etiology
  • Lichen Planus, Oral / therapy*
  • Lichenoid Eruptions / diagnosis
  • Lichenoid Eruptions / therapy
  • Retinoids / therapeutic use


  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Retinoids