Oral lichen planus

What is an oral lichen planus?

The oral lichen ruber planus is also called lichen ruber mucosae, because it affects the mucous membranes (mucous membrane = mucosa). It is one of the most common accidental skin diseases worldwide. It usually occurs in people between the ages of 30 and 60.

In addition to the oral mucosa, the tongue and lips are also affected. Furthermore, the mucous membranes of the genitals and anus also show abnormalities. The oral lichen ruber planus occurs as a special form of the conventional lichen ruber planus.

This means that the usual skin areas are also affected: Wrists, back of the knee, the lower legs and the lower back. A rare variant of the oral lichen ruber planus is the so-called lichen planus erosivus mucosae. It is characterized by a special painfulness.

The causes

No exact cause for the development of the oral lichen ruber planus could be found so far, which is why it is called an idiopathic origin (coincidence). Virus infections with hepatitis B or C are now suspected as risk factors for the normal lichen ruber planus. Dental metals (metal substances in dental treatment) and spices may also play a role. Mercury, chromium, cobalt nickel, amalgam and gold are suspected in dental metals. Thermal stimuli are also discussed.

The symptoms

The oral lichen ruber planus usually manifests itself with pain at the affected mucous membrane sites. These can be almost unbearably painful in the special form Lichen planus erosivus mucosae. The general symptoms of the lichen ruber planus are usually also present.

Sometimes affected persons also complain of severe itching in the other skin areas. These phases of itching occur in relapses. In the course of the disease, the tongue may shrink (atrophy) with loss of the taste buds and thus the ability to taste.

The diagnosis

First and foremost it is a gaze diagnosis by an experienced dermatologist. He combines the affected body parts with the typical appearance of the mucous membrane changes. These are called Wickham’s stripes.

It is a whitish, net-shaped arborizing pattern in the form of a branch growth at the crown of a tree (“arborizing”). There are no papules on the cheek mucous membrane and tongue (important in differentiations to other diseases). In the course of the disease the tongue shrinks (atrophy) with loss of the taste buds.

and painful erosions. The examiner must distinguish whether it is also a contact allergy to prosthetic substances and ask whether a specific venereal disease exists (secondary syphilis). If the picture is unclear, an examination of the cells can be ordered, as the so-called heat shock proteins HSP-60 are suspected to be involved in the disease process.