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What is it about ?
the lichen planus is a condition of the skin and mucous membranes. Oral lichen planus is the form that affects the oral mucosa. It is believed to be an autoimmune disease, a condition caused by a disruption of the immune system itself. Inflammatory cells, which normally fight off bacteria and viruses, for example, affect the own cells of the oral mucosa. But the precise cause of the disease is not yet entirely clear.
A series of conditions can go hand in hand with lichen planus-like lesions. An allergy to dental amalgam or gold fillings and certain medications can also cause a problem with the mucous membranes. This is what we call ” lichenoid reactions “. the lichen planus is not contagious or hereditary.
What is its frequency?
the lichen planus oral mucosa probably occurs in 1 to 2% of the population. Usually, the condition develops in middle-aged people, and more often in women than in men.
How to recognize it?
The appearance of lesions can vary greatly, and they come in different types: spots, blisters, indurations, sores, blisters, etc. There are usually plaques with a network of white streaks on the inside of the cheeks, on the tongue or in the gum area. The characteristic feature of the lesions is that they are symmetrical, so they appear on both sides of the tongue. Wounds or small ulcers can also develop at the level of the lesions. Sometimes these lesions do not cause any complaints and are discovered quite by chance during a dental check-up. But one lichen planus of the oral mucosa may also be particularly painful, especially if there are sores or small ulcers appear. Often, fungal infection (yeast infection) appears at the same time in the mouth.
In case of lichenoid reactions, the lesions resemble those of lichen planus, but they do not have the same characteristics. Often there is only one lesion.
In some cases, skin problems can arise. Smooth, flat, purplish red and often itchy blisters then appear on the body, usually on the inner side of the wrists, lower back and ankles, with whitish streaks visible on their surface. Deformed nails (eg thinning or striation of the nail) occur in 10% of cases. Skin problems are usually temporary, but can sometimes turn chronic. In contrast, lesions to the oral mucosa often persist for a long time.
How is the diagnosis made?
The lesions described are characteristic of lichen planus of the oral mucosa. The doctor usually makes the diagnosis on the basis of his observations. A biopsy, which involves removing a piece of oral mucosa for laboratory examination, can confirm the diagnosis. The doctor will also check for other lesions on the skin.
What can you do ?
- Avoid drinks containing caffeine (e.g. coffee or cola) as well as irritating or strongly flavored foods (e.g. tomatoes and citrus fruits). They can make it worse mucosal damage.
- Maintain good oral hygiene. Go regularly to the dentist for a check-up.
- Avoid smoking and avoid alcohol in the presence of long-standing and extensive mucosal lesions, as this slightly increases the risk of developing oral cancer.
What can your doctor do?
the lichen planus oral mucosa is often difficult to treat. If the condition does not cause complaints, it is usually unnecessary to treat it. The measures explained above may then be sufficient. In case of pain, wounds or small ulcers, you can use a cortisone cream to relieve the symptoms. In this case, it is important to first detect the possible presence of yeast infection concomitant and treat them. In the event of particularly painful lesions, you can possibly temporarily use an anesthetic cream. If the effect of a cortisone cream is not enough, you can apply a tacrolimus cream. The problem with using creams on the mucous membranes is that they are difficult to apply and only stay put for a brief moment. They are quickly eliminated and swallowed by saliva. If the lesions persist for a long time and cause numerous complaints, the doctor may consider initiating treatment with cortisone tablets.
In some cases, lesions do not heal until after the amalgam or gold fillings are removed. There are indications that a lichen planus can develop as a reaction to certain medications. If it is suspected that this is the case in you, it may be advisable to temporarily stop the medicine in question, in consultation with the doctor.
About 0.1 to 3% of lesions per lichen planus in the oral mucosa become malignant in the long term and can lead to oral cancer. This is why it is important that the doctor continues to monitor the lesions present. If necessary, a biopsy can be taken.
Want to know more?
- Tips for unparalleled oral hygiene – Christian Mutuality
- Visiting your dentist – Christian Mutuality
- Stop smoking. It’s possible – Tabacstop
- Alcohol, the point on your consumption – Stop or else?
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- Alcohol aid – Le Pélican & Le center ALFA
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