Dear Kivanc, compliment, You have observed very well a frequent complication. The best information is given by Indian authors. Please impact on once: Indian J Dermatol Venereol Leprol. 2011 Jul-Aug, 77 (4) :418-29; quiz 430 doi: 10.4103/0378-6323.82389. Lichenoid tissue reaction / interface dermatitis: recognition, classification, etiology, and clinicopathological overtones. Sehgal VN, Srivastava G, Sharma S, Sehgal S, Verma P. The source is freely available via PMID: 21727689 [PubMed - indexed for MEDLINE]. To all this, my opinion. Dysplasia on the basis of licheniod tissues are local expressions of systemic disease. Corticoids delay only little. The recurrences occur at intervals of 1-5 turn-over rates. In former times we exfoliated the entire surface epithelium and connective tissue by cryosurgery. Today we destroy only the power, so the lichenoid tissues becomes flatter. We reduce the local (smoke toxins) and systemic (DM) problems and go on to mouthwash with tannins. I hope I could help with the literature. Take the best.

Dysplasia on the basis of licheniod tissues are local expressions of systemic disease.

Dear Heinz, what is the nature of that systemic disease, and how do you treat it?

Dear Marika, thank you for this question.

First I like to divide my answer into two parts: Part 1 is academic: I am teaching for over 40 years that all systemic diseases from the semiotic point of view must be classified into three categories: i) here appear under this category homologous-systems with known etiologies and easy. ii) in the heterologous category sums to those systems together, their etiologies (are unknown or diverse yet), or whose pathogenesis one can observe and measure. iii) the complex category lists on such systems, of which their etiologies and pathogeneses be perceived as belonging together. You will find patterns. Name them syndromes.

Part 2 is now practical: To i) Homologous system disorders therapy can be causal. Examples are mechanical traumas, dry mouth and toxin glut (pollutants, smoking, chewing tobacco). To ii) Heterologous system diseases (such as with fever drip), you can "slow down". Example lichen erythematosus. To iii) System complexes remain as patterns. Therapeutically they can be reduced as pattern following the therapy of homologous on one side and heterologous symptoms on the other side, treated individually. The result will be new and smaller pattern. You have to reduce the resulting pattern until there is a balance between the collection of symptoms and the progression of self-regulation of the body.

Lichen are complex systems. Their local pictures can be modified by systemic effects which belong to turn-over stimulations of the epithelial barrier. We follow the named therapy-traps, which I have described. This was and is my doctrine.