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Instructor: Dr. Heddie Sedano
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LICHEN PLANUS: LECTURE (p. 3)


FIG3. Plaque-like lichen planus of the tongue characterized by large areas of a white-bluish color. 		Plaque LP clinically resembles areas of leukoplakia, characterized by flat or slightly elevated whitish areas, mostly on the dorsal surface of the tongue or the buccal mucosa. Careful observation of these lesions will reveal a tendency to striae formation at the periphery of the central mass. When in the tongue it tends to have a slight pale sky-blue tinge.

FIG4. Erosive lichen planus in the maxillary and mandibular gingiva. Note erythema, careful inspection of the periphery reveals a faint lacing.
FIG5. Gingival erosive LP. Note erythema and a faint whitening at the periphery of the lesion. These two patients had difficulty eating and brushing their teeth.
The erosive variety of LP is clinically characterized by a mixture of erosive erythematous areas and whitish pseudomembranes. When in the gingiva or the buccal mucosa, it tends to form small striations at the periphery of the lesion. Gingival erosive LP may affect the four quadrants and often is diagnosed as desquamative gingivitis. This term should be considered a transitory diagnosis until a biopsy and laboratory test confirm or rule out the diagnosis of LP. Patients with this variety of LP complain of burning sensation especially when eating spicy foods or drinking alcohol, bleeding may also be present especially upon palpating or during tooth brushing. Erosive LP tends to remain for life and at times might become secondarily infected. When the oral manifestations are severe there is constant, mild to moderate pain as well as inability to eat properly.
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