Lichen planus involving the oral cavity may present with one or more clinical patterns.
Clinical patterns recognized by the World Health Organization:
The ulcerated pattern is considered by some to be a later phase of the bullous pattern.
second most common
violet-erythematous area with whitish striae forming a network; may be hyperpigmented (postinflammatory hyperpigmentation)
few to multiple mucosal erosions with or without a pseudomembrane
bilateral involvement; buccal mucosa, lateral tongue, lips
usually associated with reticular lesions
painful with burning sensation triggered by foods, smoke or irritants; may have metalic taste
seen in smokers
one to multiple lesions with flat to irregular whitish surface; may resemble leukoplakia
symmetrical with whitish striae at the periphery
dorsal surface of tongue and buccal mucosa
may be diffuse in the oral mucosa; may prefer gingiva or dorsum of tongue
painful with burning sensation triggered by foods, smoke or irritants
small whitish papules 0.5 mm in diameter
vesicles and/or bullae early, painful ulcerations later
buccal mucosa, usually adjacent to second and third mandibular molars, lateral portion of tongue
very painful with burning sensation triggered by foods, smoke or irritants
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