Lichen planus is a common, chronic inflammatory disease of the skin and mucous membranes. The cause of lichen planus remains unknown. The disease affects equally members of all races. Women are affected somewhat more than men and the majority of sufferers are between 30 and 60 years of age, although lichen planus becomes increasingly common as age advances. The most common mouth lesions are characterised by white lines on the cheek mucosa, but these may also appear on the tongue, gums, lips, floor of mouth or palate. Oral lichen planus may also present as red areas of the mucosa or ulcers. Occasionally, the oral lesions may appear as white plaques. The mouth lesions may be painless or may have an unpleasant feeling of roughness; the red or ulcerated areas may be painful and they are frequently aggravated by certain foods. A biopsy is helpful in establishing the diagnosis. No treatment is necessary when the mouth lesions are painless. Topical corticosteroid ointment is most frequently prescribed for discomfort associated with oral lesions. The disease follows a course of remissions and exacerbations and it may persist for many years. Periodic long-term review is recommended.
The skin lesions appear as small, flat, shiny raised lesions which are red-purple. The skin lesions are itchy and they are typically found on the forearms and wrists, the back, the sides of the neck and the shins. The mouth may be affected without the skin rash. The skin rash is best diagnosed by a dermatologist
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Dr Daphne Ong BDSc (Melb)
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