Fortunately, most of my OLP patients get remission more than active disease. To answer your question two of my patients ( a man and a woman) have been visiting me on a regular basis for relief of symptoms (erosive type). They are content with treatment but they wish to know the cause of the disease.

Dear Saurabh

Lichen planus is an unknown etiology mucocutaneous disorder, thus showing evidence of association with a cell-mediated immune response. In the oral mucosa, several clinical manifestations are observed, which difficulties diagnosis. The lichen planus is of particular interest to the dentistry practitioner due its controversial malignant potential and the possibility of being associated with hepatitis C.

Especially in the case of mucosa, the papules can remain for 1 year and painful. In the case of oral mucosal (oral lichen planus) salivation located complicates treatment. In this case the special formulas of cortisone and vitamin A and this treatment can be replaced by a more aggressive such as the extraction of the mucosa affected by the laser

http://www.ncbi.nlm.nih.gov/pubmed/?term=purslane+lichen+planus Purslane (a very common plant) has shown promise in treating oral lichen planus. I have one patient who is using Purslane now.

OLP, is to be managed the way LP is. Cause, exiting factors, and patient advice are important. Success may not be the same as for Cutaneous LP. It will be good if there is a coordinated treatment by the dermatologist and dentist for a better management.

Thanks to all for ur responses.

I would specifically like to know that for how long a patient of L.P. has been retained or followed.

One of my patients of reticular variety was followed up for 3 yrs with periods of remission and development of new lesions but without any cutaneous involvement.

Tobacco or kahaini may be responsible.

Fortunately, most of my OLP patients get remission more than active disease. To answer your question two of my patients ( a man and a woman) have been visiting me on a regular basis for relief of symptoms (erosive type). They are content with treatment but they wish to know the cause of the disease.

Thanks Najla for the specific answer. Can u elaborate on the time period of remission of your patients. And if the patient understands the nature of the disease, he/she would like to be under observational management but as the therapy takes a long time; drop out rate due to disinterest in the management or seemingly failure of therapy is also there.

It is important that your patients get the idea that erosive OLP has a malignant potential. It is up to you to explain this prognosis in whichever way. I think that by doing that, you guarantee that your patients keep coming back for observation. In my country, similar to many countries, corticosteroids, like dexamethasone elixir,are considered OTC. Patients can self-medicate when they get the erosions without the need to visit their physician. This makes it difficult sometimes to monitor patients clinical manifestations closely and accurately. So I can't give you accurate info on my patients' remission and active disease states. If our patients abide by a regular follow-up protocol, like 3-monthly or 6-monthly, life would be much easier.

In Poland topical steroids have to be prescribed. Reticular OLP is observed, Information for the patient is important ("we do not know the exact ethiologic agent of the disease"). Cutaneous lesions are extremely rare, but this may be explained by probable admission of individuals with lesions on the skin to the Dermatology Department. They have the hospital unit, so they treat more severe and refractory cases with systemic steroids and calcineurine antagonists.

We must explane to the patient that it is a disease that cannot be cured, but it will reappear occasionally. the treatment is corticosteroids. We administer low doses (depending on the extend and type of lesions) for a long period of time and we follow up the patient to adjust the dose according to the progress of the lesions. The oral lesions are the only lesions most of the time