The Importance of Recognition and Management of Oral Lichen Planus: Navigating Epidemiology, Pathogenesis, Cancer Risk, and Advances in Management.

Abstract

Oral lichen planus (OLP) is a chronic inflammatory disorder classified as an oral potentially malignant disorder (OPMD) due to its association with an increased prevalence and a risk of progressing to oral squamous cell carcinoma (OSCC) of up to 5%. We conducted a comprehensive literature review to update the epidemiology, etiology, pathogenesis, diagnosis, and management of OLP using PubMed and Web of Science databases up to April 2025. OLP is a T-cell-mediated disorder, with CD4+ and CD8+ T cells playing a key role in its pathogenesis. Its multifactorial nature involves genetics, infections, immune dysregulation, allergens, stress, autoimmune diseases, and medications. Treatment options include topical corticosteroids as the first-line therapy, along with systemic medications and emerging therapies that show promise in management. Regular monitoring and early intervention are crucial due to OLP's malignant potential. Further research is needed to refine treatments and assess long-term efficacy.