Oral lichen planus v buccal occlusion line

Oral lichen planus
Clinical features

  • White or grey streaks in a linear or lacy pattern particularly on the buccal mucosa and side of the tongue. Usually bilateral.
  • Soreness or a roughness in the mouth.
  • Usually occurs in adults over 40.
  • Trigger factors include drugs, contact sensitivity to dental amalgam, trauma and viral infections.

Management

  • Dental check to deal with any local physical trauma from teeth or dentures.
  • Discontinue aggravating medication.
  • Topical steroid such as betamethasone tablet.
  • Systemic steroids and/or azathioprine occasionally for painful or erosive oral LP.
  • Monitor progress monthly.

Buccal occlusion line
Clinical features

  • Trauma from repeated biting of the buccal mucosa.
  • Raised, linear lesion on the buccal mucosa along the 'bite' line.

Management

  • Dental advice to deal with any possible causes of trauma.
  • Biopsy if the diagnosis is in doubt.

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