LICHEN PLANUS
LICHEN PLANUS (See Section 14)
• Incidence: 40% to 60% of individuals with LP have oropharyngeal involvement.
• Findings:
• Milky-white papules.
• Wickham striae: Reticulate (netlike) patterns of lacy-white hyperkeratosis (buccal mucosa [Fig. 33-6], lips, tongue, and gingivae).
• Hypertrophic LP: Leukoplakia with Wickham striae usually on the buccal mucosa.
• Atrophic LP: Shiny plaque often with Wickham striae in surrounding mucosa.
• Erosive/ulcerative LP: Superficial erosions with overlying fibrin clots that are seen on the tongue and buccal mucosa; can be painful (Fig. 33-6). Should follow carefully for development of squamous cell carcinoma (1% to 3% of cases), particularly in drinkers, smokers, the immunosuppressed, or those infected with HPV.
• Bullous LP: Intact blisters (rupture and result in erosive LP).
• Desquamative gingivitis: Bright red gingiva (Fig. 33-7).
FIGURE 33-6 • Lichen planus: Wickham striae Poorly defined violaceous plaque with lacy, white pattern on the buccal mucosa.
FIGURE 33-7 • Lichen planus: Desquamative gingivitis The gingival margins are erythematous, edematous, and retracted. The lesions were painful, making dental hygiene difficult, resulting in plaque formation on the teeth.