White patches in the mouth, sometimes associated with an itchy skin rash
- Most common between the ages of 30 and 60
- More common in females
- Genetics and lifestyle are not significant factors
Oral lichen planus is a rare condition in which small, white patches develop on the inside of the cheeks and sometimes elsewhere in the mouth. The patches often have a lacy pattern. In most people these white patches are painless, but sometimes they develop into persistent ulcers that can be very painful.
Oral lichen planus usually occurs in episodes that may last months or even years and frequently recurs after treatment. The condition occurs most often in people between the ages of 30 and 60 and affects more women than men. A few people who have oral lichen planus may also develop the general skin condition lichen planus, in which an itchy rash appears on the skin, most commonly on the wrists. In very rare cases, oral lichen planus may develop into mouth cancer.
What are the causes?
Often no cause can be found, but oral lichen planus may be due to an abnormal immune response and may occur with other immune disorders, such as systemic lupus erythematosus. Oral lichen planus is sometimes due to an adverse reaction to amalgam tooth fillings or particular drugs, including gold-based antirheumatic drugs and some of the drugs used to treat diabetes mellitus. Stress sometimes triggers the symptoms.
What might be done?
If you have white patches in your mouth that last longer than 3 weeks, you should consult your doctor or dentist. It may be possible to make a diagnosis from your symptoms, but to confirm the diagnosis and exclude other disorders, a sample of tissue from the affected area may be taken under local anaesthesia and examined microscopically.
If the symptoms are only mild, no treatment may be necessary. However, a topical corticosteroid in an oral paste may be given to relieve pain. Oral lichen planus sometimes disappears spontaneously after several years.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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