Lichen planus (lichen ruber planus) - a chronic inflammatory disease of the skin and mucous membranes, manifesting the formation of keratinized papules

This disease is more common in women aged 40-60 years. When lichen planus along with skin lesions are often diagnosed with mucosal changes in the mouth and red border of the lips.

Simultaneous lesions of the skin and oral mucosa were detected in 25% of patients, and isolated localization of the mucous membrane of the mouth without skin lesions - 75% of patients. Lichen planus may be localized in other mucous membranes: genitalia, anus, conjunctiva, esophagus, stomach, urethra.

Etiology not fully understood. There are neurogenic, viral, immunoallergic, hereditary, intoxication theory of the origin of the disease. Lichen planus usually occurs with chronic gastrointestinal disease, hypertension, diabetes, neuroses, imbalance of the immune system. The majority of patients showed a significant increase in the permeability of the vessel walls and reducing immunological reactivity. An important role in the development of exacerbations of lichen planus of the oral mucosa is an injury (sharp edges of teeth, poor-quality prostheses, galvanic phenomena, allergic reaction to plastic prostheses, etc.).

The main morphological element of defeat - keratinized papule circular or polygonal shapes up to 2 mm in diameter. The skin papules usually flat, waxy luster, have a pinkish or sinyushnokrasny color. On the oral mucosa due to keratinization of the epithelium and the constant maceration they acquire belovatosery color, standing out against a background of normal or erythematous mucosa. A characteristic feature of lichen planus - papules tendency to merge in a pattern that resembles lace mesh, snowflakes, tree branch, sometimes ring band. Papules slightly above the mucosal level, giving it a certain roughness. On the back and the side surface of the papules language, merging, giperkeraticheskie often form plaques of different sizes, resembling leukoplakia; papillae smoothed in this field.

Smokers have more severe papules and large, sometimes they accumulate leukoplakia patches. On the red border of lips papules may coalesce to form a strip of whitish color, in some cases, the host star-shaped. Lichen planus on the red border of the lips and mucous membranes sometimes leads to glandular cheilitis. The most typical localization of lichen planus of the mucous membranes of the cheeks in a place fit molars with the capture of transient folds on the sides and back of the tongue with the transition to a lower surface in the molars. Less commonly affects the lips, gums, palate, floor of mouth.

Due to the variety of clinical manifestations of lichen planus in the oral cavity are following its forms: the typical (simple), ekssudativnogiperemicheskuyu, erozivnoyazvennuyu, bullous, hyperkeratotic.

A typical form occurs most frequently. Belovatoperlamutrovye papules are arranged individually or in the form of patterns, lace, leaves, fern, rings, strips on apparently intact oral mucosa. In this picture a typical lichen planus subjective feelings expressed minimal and can be manifested by a burning sensation, tightness, roughness, dryness of the oral mucosa. Quite often, the disease is asymptomatic and can be detected by accident when viewed from a dentist.

Ekssudativnogiperemicheskaya form is less common. Papules located on erythematous, edematous mucosa. This form is accompanied by a more pronounced painful sensations:

Burning, pain, aggravated by taking spicy food, conversation. Against the background of the inflamed, congested mucosa drawing papules may lose the clarity of its contours and even partially disappear, but in the process of reverse development, when reduced edema and hyperemia of the mucous membrane, drawing papules again manifested.