The Importance of Recognition and Management of Oral Lichen Planus: Navigating Epidemiology, Pathogenesis, Cancer Risk, and Advances in Management

Head Neck. 2025 Nov;47(11):3172-3184. doi: 10.1002/hed.70012. Epub 2025 Aug 25.

Abstract

Background: Oral lichen planus (OLP) is a chronic inflammatory disorder classified as an oral potentially malignant disorder (OPMD) due to its association with an increased prevalence and a risk of progressing to oral squamous cell carcinoma (OSCC) of up to 5%.

Methods: We conducted a comprehensive literature review to update the epidemiology, etiology, pathogenesis, diagnosis, and management of OLP using PubMed and Web of Science databases up to April 2025.

Results: OLP is a T-cell-mediated disorder, with CD4+ and CD8+ T cells playing a key role in its pathogenesis. Its multifactorial nature involves genetics, infections, immune dysregulation, allergens, stress, autoimmune diseases, and medications. Treatment options include topical corticosteroids as the first-line therapy, along with systemic medications and emerging therapies that show promise in management.

Conclusions: Regular monitoring and early intervention are crucial due to OLP's malignant potential. Further research is needed to refine treatments and assess long-term efficacy.

Keywords: etiology; management; oral lichen planus; oral potentially malignant disorder; risk factors.

Publication types

  • Review

MeSH terms

  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / etiology
  • Humans
  • Lichen Planus, Oral* / diagnosis
  • Lichen Planus, Oral* / epidemiology
  • Lichen Planus, Oral* / etiology
  • Lichen Planus, Oral* / therapy
  • Mouth Neoplasms* / epidemiology
  • Mouth Neoplasms* / etiology
  • Risk Factors