Oral lichen planus - Patient profile, disease progression and treatment responses

Background. Oral lichen planus, or OLP, is a common mucocutaneous immunolog ical disease. The objective of this study was to describe the patient profi le, disease progression and treatment responses. Methods. The authors conducted a retrospective, descriptive study using inf ormation from patient records at a tertiary referral centre. The study incl uded 229 patients with OLP who were seen in the oral medicine clinic at the University of California, San Francisco, between September 1996 and August 2000, for the first time or for a follow-up visit. Signs and symptoms at v arious clinic visits were quantified. Responses to treatment and disease pr ogression were determined by comparing scores with baseline scores. Results. The mean age at onset of the disease was 55 years, and 154 (67 per cent) of the patients were female. Symptoms generally correlated directly w ith the severity of OLP forms, which ranged from reticular to erosive. Cort icosteroids were effective in reducing symptoms, healing ulcers and reducin g erythema. At last follow-up, 65 percent of the patients had the same type of OLP seen initially or the disease had progressed to a more severe type, while 35 percent of patients had less-severe forms than that seen at the i nitial visit. Four patients (1.7 percent) developed oral squamous-cell carc inoma during the follow-up period. Conclusions. OLP is a chronic disease with no known cure. Symptoms can impr ove with corticosteroids; however, the lack of long-term (that is, lifetime ) treatment compliance and the adverse side effects of the drugs limit opti mal results. Clinical Implications. Patients with OLP should be treated if symptoms are significant. Follow-up-including supervision of medication use and monitori ng of side effects, as well as periodic examinations for possible malignant transformation-is necessary.