Ingafou, Mohamed Saleh Hammad; (1998) Clinical studies of oral lichen planus. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This study examined general features, clinical, aetiological, histopathological and therapeutic aspects of oral lichen planus (OLP) in a large cohort of affected British patients. The clinical features of this group of patients were found to be similar to previously studied patients of other countries. OLP being a chronic disease of middle aged and elderly persons with a slight female predilection. The majority of the patients having symptomatic disease. OLP lesions are usually multiple and often have symmetrical distribution. Reticular and erosive OLP were the most common presentations, however other types of clinical manifestations such as plaque-like, papular, ulceration or bullae may be present simultaneously. The most commonly affected sites were the buccal mucosa and tongue. The current work failed to establish any notable association between systemic disease and risk of development of OLP. Likewise indirect immunofluorescence studies did not aid in distinguishing patients with "lichenoid drug reactions" from those with idiopathic OLP. Furthermore no association between HCV infection and risk of OLP in UK patients was found. Chronicity was notable, few patients having total resolution of disease. Malignant transformation was observed in 1.9% of patients, but the present data could not delineate any specific predictive features for such changes. There is no effective cure for OLP, hence pain control and reduction of oral discomfort are the main aims of the currently applied medications. Of note however while fluticasone propionate cream or topical cyclosporin in a novel adhesive agent may provide some resolution of disease, benzydamine hydrochloride spray is not an effective means of controlling pain of symptomatic OLP.

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