Oral lichenoid lesion
Oral lichenoid lesions (see Oral lichenoid lesion due to contact hypersensitivity to an amalgam filling) are similar in appearance to idiopathic oral lichen planus.
Lichenoid mucosal reactions can be caused by:
- contact hypersensitivity to dental restorations
- hypersensitivity reactions to drugs,
particularly:
- drugs that lower blood pressure (eg beta blockers, angiotensin converting enzyme inhibitors, diuretics [particularly hydrochlorothiazide])
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- drugs that treat thyroid disorders
- medical conditions:
- hepatitis C infection, particularly in patients with the human leukocyte antigen HLA-DR6 allele (which is common in people of Mediterranean descent)
- thyroid disorders
- chronic graft-versus-host disease.
Refer patients with a suspected oral lichenoid lesion to an appropriate specialist for definitive diagnosis and management.
In the case of contact hypersensitivity to an amalgam filling, replacement of the implicated amalgam filling may result in partial or full resolution of the lesion. However, removal of all amalgam fillings is not recommended.
