Lichen planus – A refractory autoimmune disorder

Authors : G . Manmohan, K Aishwarya Yadav, G Madhulika, Sunil Chaudhry*

DOI : 10.18231/j.ijced.2023.003

Volume : 9

Issue : 1

Year : 2023

Page No : 20-27

Lichen planus (LP) is a chronic inflammatory mucocutaneous disease of unknown aetiology with an estimated incidence of 0.5%–4.0% having a female preponderance at a ratio of 1.5:1. Oral lichen planus (OLP) is commoner than the cutaneous form and tends to be more persistent and more refractory to the treatment. The prevalence of oral lichen planus in Indian population is around 3% with more female predilection. Oral lesions occur in 50%–70% of the patients with lichen planus. LP is considered to be a T-cell-mediated autoimmune skin disease, in which CD8+ cytotoxic T lymphocytes are major mediators. TNF-? and IL-10, interferon-gamma (IFN-?), IL-4, and IL-8, have been suggested to have an important role in the pathogenesis of OLP. The complications of Lichen Planus include post-inflammatory hyperpigmentation, scarring alopecia, dyspareunia, oesophageal stenosis & possible malignant transformation. Mucocutaneous site biopsy can confirm the diagnosis when taken from the edge of a plaque. There is no cure for Lichen Planus, the management is often performed with the use of antihistamines, corticosteroids, retinoids, immunomodulators, phototherapy and immunosuppressives. Inconsistent results are shown by griseofulvin and chloroquine derivatives. (further prospective studies are needed).
 

Keywords: Oral lichen planus (OLP), Autoimmune, Steroids, Methotrexate, Tacrolimus, Phototherapy, Surgical excision, Laser usage


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