[Oral lichen planus - an overview of aetiology and treatment].

Abstract

Introduction: Oral lichen planus (OLP) is a chronic inflammatory, T cell-mediated autoimmune disease of the oral mucosa that primarily affects middle-aged women. A typical clinical feature is a network of white lines (Wickham's striae) on the buccal mucosa. In addition to asymptomatic forms, painful erosive-atrophic variants also occur, which require treatment. Diagnosis is usually clinical, but a biopsy may be needed if the presentation is atypical. In terms of differential diagnosis, drug reactions and contact hypersensitivities must be considered. The exact pathogenesis remains unclear, though immunologic, genetic, and viral factors (especially hepatitis C) are discussed. Topical corticosteroids are the first-line treatment. In therapy-resistant cases, options include tacrolimus, methotrexate (MTX), apremilast, or systemic corticosteroids. Maintaining good oral hygiene, eliminating potential triggers (e. g., amalgam), and tailoring therapy to individual symptoms are essential components of effective management. Due to the risk of malignant transformation to squamous cell carcinoma, regular follow-up is essential.