Oral Med Revision - OLP

Question 1

type & appearance of the 6 types of OLP

Answer 1

1. reticular - white lace like pattern
2. atrophic - inflamed areas, thinned red epithelium
3. bullous - blistered appearance with ulceration
4. erosive - atrophic appearance with ulceration
5. plaque like - white plaques
6. papular - small white papules

Question 2

what is OLP / OLR

Answer 2

CD8+ T cell (cytotoxic) mediated basal keratinocyte destruction

Question 3

LP & LTR

Answer 3

common
affects 0.5-2%
female predilection
typically >40yrs
can affect skin & genitals
1% over 10yr risk of malignant change

Question 4

OLP vs OLR

Answer 4

oral lichen planus = idiopathic
oral lichenoid reaction = causative agent

Question 5

OLR causes

Answer 5

drugs = antihypertensives, antimalarials, NSAIDs, allopurinol, lithium
materials causing OLR = metals, AM
important to ask re systemic symptoms or recent cancer therapy, lupus, GVHD
crucial to say 1% risk of malignant transformation over 10yrs

Question 6

OLP / OLR mx

Answer 6

symptomatic relief
1. simple MW (HSMW)
2. LA - benzydamine, lidocaine
3. avoid trigger factors - spicy foods / fizzy drinks
4. steroid MW - betamethasone mw, beclomethasone inhaler or hydrocortisone oromucosal tablets
5. poss change rests from AM to comp
6. onward referral; biopsy / stopping cause in OLR
7. if managing in gdp rv regularly
8. inform of increased cancer risk but in this context risk of change is low