Oral Lichen Planus-A Challenging Case

Introduction

Lichen Planus has been classified as both a cell-mediated immune response as well as an autoimmune condition. A target antigen in the reaction has not been identified. The mechanism of action and exact classification of the condition is not fully understood. Histologically, evidence of T-cell destruction of basal cells is observed. Tumor Necrosis Factor-Alpha (TNF-a) is thought to have major involvement in this reaction. Lichenoid reactions resemble Lichen Planus both clinically and histologically but differs due to evidence of local irritant or use of certain systemic medications. Local factors could be dental materials which could include but not be limited to gold crown, PFM crown, amalgam restorations and oral hygiene products [1]. Management of oral lichen planus and lichenoid reactions poses a challenge due to lack of full understanding of the etiology. Additionally, the multifactorial probable causes of these reactions contribute to the complexity of management [2]. Oftentimes, management of symptomatic lesions and trials of varying treatment options is necessary to determine effective modes of therapy for an individual patient.

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