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Instructor: Dr. Heddie Sedano
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LICHEN PLANUS: LECTURE (p. 2)

LP has a moderate predilection for women. Forty percent of patients present dermatologic and intraoral lesions, 35% only skin lesions and 25% only oral lesions. LP affects patients over 30 years of age but mostly after 50 years of age. LP has been occasionally reported in children and adolescents. Clinically LP may present in a variety of patterns, the most frequently recognized are: reticular, plaque-like and erosive.


FIG1. Classical appearance of a reticular lichen planus in the buccal mucosa. Note the interlacing striae of Wickham. The other side was equally affected.
FIG2. The annular variety of lichen planus with elevated white striations surrounding areas of normally appearing mucosa.
Reticular LP is characterized by interlacing hyperkeratinized (whitish) strands known as Wickham's striae, developing on an slightly erythematous, or normal appearing mucosa. This reticular, lace-like pattern is quite typical for this type of LP. The condition is usually symptomless, although some patients may complain of a burning sensation or a metallic taste. Oral lesions occur most frequently bilaterally on the buccal and vestibular mucosa, followed in frequency by the lateral border and dorsum of the tongue, gingiva and lip mucosa. LP lesions can also be seen on the palatal gingiva as well as on the soft palate almost always associated with similar lesions on other oral mucosas.

A clinical variation of the reticular LP is known as annular LP which is characterized by interlacing rings of whitish striations also almost always bilateral and on the buccal mucosas. Symptoms may be present in those cases of reticular LP which undergo erosion or atrophy. The oral manifestations may last for several days, weeks, or months. Recurrences are common.

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