Lichen planus is classified as an autoimmune disease. Autoimmune diseases occur when the body’s defense system, made up of white blood cells that usually fight off infections, attack normal parts of the body. Lichen planus of the skin usually causes red, itchy bumps, and as the bumps heal they may leave brown spots behind. Allergic-type reactions to some blood pressure, heart, and arthritis medications can cause lichen planus. In these cases, once the medication is stopped, lichen planus goes away. Understanding Oral Lichen Planus Oral lichen planus can occur anywhere inside the mouth, but is usually seen on the inside of the cheeks and appears as thin white lines, patches, or dots. It is most common between the ages of 30 and 60. While it appears in about one to two percent of the population, women get oral lichen planus twice as often as men. Lichen Planus and Mouth Cancer Oral lichen planus that appears as white spots or fine lines is probably not related to mouth cancer, but in about 40 percent of cases a more serious type develops. This “erosive” lichen planus causes painful sores and ulcers in the mouth. It’s possible that about 1 percent to 5 percent of these cases may turn into oral cancer. “We commonly see lichen planus inside the cheeks of women, and this is not the population or the area where we see oral cancer,” says William M. Lydiatt, MD, director of head and neck surgical oncology at University of Nebraska Medical Center. “It may be that the erosive form combined with longstanding chronic irritation can become oral cancer, but the evidence is not very strong.” While lichen planus very rarely leads to oral cancer, irritation of lichen planus by tobacco and alcohol, poorly fitting dentures, and poor oral hygiene can turn lichen planus into the erosive type. It is probably the combination of these irritants over time along with erosive lichen planus that leads to oral cancer. Managing Lichen Planus Once you have been diagnosed with oral lichen planus, you should be checked by an oral specialist two to four times a year. Your doctor will make note of any changes and take some tissue to look at under the microscope if necessary to make sure there are no signs of oral cancer. It’s also important to get regular dental care and maintain good oral hygiene. Although there is no medication to cure the condition, treatments are available to relieve the soreness of erosive lichen planus. Ask your doctor or dentist what they recommend. If you have lichen planus, you should also be careful to avoid:
All tobacco and alcohol products. These can cause lichen planus to become more serious and may lead to oral cancer. Do not drink alcoholic beverages or use any mouthwash solutions that contain alcohol.Stress. Some doctors believe that there is a relationship between stress and flare-ups of lichen planus. And stress management is always a good thing; so take steps to manage your stress levels and you may reduce your risk of lichen planus while you enjoy a more relaxed outlook on life.
Taking precautions and getting routine checkups will go a long way toward relieving worries about lichen planus and may help prevent those rare cases of mouth cancer from developing.
