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Oral lichen planus (OLP) is a disease with unclear etiology or pathogenesis, categorized by the World Health Organization as oral lichenoid lesions (OLL; interface mucositis or lichenoid mucositis) into a group of potentially malignant disorders. The diagnosis of OLP is challenging because the clinical and histopathologic features are frequently seen in OLP, OLL and/or other mucosal diseases with lichenoid characteristics. Furthermore, OLP has a dynamic nature. Finally, an early and precise diagnosis can play a decisive role, allowing timely treatment and thus improving the patient quality of life. This article summarizes the state-of-the-art regarding OLP and OLL and discusses the challenges faced on making an accurate diagnosis, aiming to provide a practical guideline for the postgraduates and oral physicians in reaching the diagnosis of these lesions., Oralni lihen planus (OLP) je bolest nejasne etiologije ili patogeneze. Prema Svjetskoj zdravstvenoj organizaciji kategorizira se kao oralne lihenoidne lezije (OLL; prijelazni mukozitis ili lihenoidni mukozitis) u skupinu potencijalno zloćudnih bolesti. Dijagnosticiranje OLP-a je zahtjevno, jer se klinička i histopatološka obilježja često vide u OLP-u, OLL-u i/ili drugim bolestima sluznice s lihenoidnim značajkama. Nadalje, OLP ima dinamičnu narav. Konačno, rana i precizna dijagnoza može imati odlučnu ulogu i omogućiti pravodobno liječenje te time poboljšati bolesnikovu kvalitetu života. Ovaj pregled sažima današnja saznanja o OLP-u i OLL-u te raspravlja o izazovima kod postavljanja dijagnoze, a cilj je pružiti praktične smjernice za dijagnostiku ovih promjena za postdiplomante i liječnike oralne medicine.

Oral lichen planus (OLP) is a T-cell mediated disease directed to a still unknown antigen, which may affect oral mucosa. The aim of this study was to determine whether differences in anxiety, depression and stress could be seen in patients with OLP in acute stage and in remission, as well as in comparison with healthy control subjects. The study included 50 OLP patients aged 22-79 (mean age 61.04) years and 50 control subjects who had healthy oral mucosa aged 38-80 (mean age 58.70) years. Patients with OLP filled out the State-Trait Anxiety Inventory for Adults and Beck Depression Inventory II test in acute stage and in remission. Control subjects also filled out the same tests. On detailed medical history, study subjects were asked about the possible stressors, which might have happened in the previous year. Statistical analysis was performed by use of descriptive statistics and t-test. There were no differences in the level of anxiety, depression and stress between the two stages of OLP disease (acute vs. remission period). Patients with OLP were significantly more anxious, depressed and stressed in both OLP stages as compared with healthy controls. It might be that psychological disturbances precede OLP development rather than worsening the disease process itself., Oralni lihen planus (OLP) je bolest posredovana T-limfocitima na još uvijek nepoznati antigen, koja može zahvatiti oralne sluznice. Cilj ovoga istraživanja bio je ustanoviti postoje li razlike u anksioznosti, depresiji i stresu između bolesnika s akutnim OLP-om u odnosu na fazu remisije OLP-a i u usporedbi s kontrolnom skupinom. U ispitivanje je bilo uključeno 50 bolesnika s OLP-om (starosti 22-79 godine, prosječne dobi 61,04 godine) i 50 kontrolnih ispitanika (starosti 38-80 godina, prosječne dobi 58,70 godina). Svaki pacijent s OLP-om je ispunio STAI i Beck Depression Inventory II. test za vrijeme akutne faze i za vrijeme remisije. Za vrijeme uzimanja anamneze je svaki ispitanik upitan o mogućim stresnim događajima koji su se dogodili unatrag godine dana. Statistička analiza je napravljena uz upotrebu deskriptivne statistike i t-testa. Nije bilo razlika u razini anksioznosti, depresije i stresa u bolesnika s OLP-om između dvije faze bolesti (akutna faza u odnosu na remisiju). Bolesnici s OLP-om su bili značajno više anksiozni, deprimirani i u stresu u obje faze bolesti u odnosu na zdrave kontrolne osobe. Moguće je da psihološki poremećaji prethode nastanku OLP-a prije nego što pogoršavaju tijek OLP-a.