Oral Lichen Planus

Diagnosis

Oral lichen planus may cause one of more of the following signs and symptoms in the mouth and occasionally in the throat:

• Small, pale patches or raised, white patches (sometimes forming a lacy pattern)
• Shiny, red, slightly raised patches
• Red, open sores in the mouth that may gradually grow larger
• Pain, tenderness or burning in the mouth
• Dry mouth
• Metallic taste in the mouth

OLP often has no symptoms and so a dentist may be the first to notice OLP's typical white spots during a routine exam. Other times, patients note symptoms and seek care. After canker sores or oral yeast infections are ruled out, the patient may be referred to a dentist or dermatologist. To make a diagnosis, doctors inquire about symptoms and medical history, examine the mouth and other mucous membranes, skin and nails.

Tests

Doctors use several tests to determine the cause of symptoms.

Complete Blood Cell Count (CBC)

This common test provides a count of each blood cell type in a given volume of the blood. It measures the amount of hemoglobin, the percentage of blood that's composed of red blood cells, the number and kinds of white blood cells and the number of platelets.

Blood Tests

Blood tests are used to rule out hepatitis C (which can sometimes produce lichen planus) or lupus erythematosis and other look-alike diseases which cause mouth sores, skin rashes, and white spots.

Cultures

Yeast growth is common with OLP. Doctors may use yeast cultures.

Allergy Tests

Skin patch testing determines allergic reactions to certain foods, additives or sometimes substances in dentures or amalgams.

Biopsy

The physician removes a small sample of tissue from the affected area for examination under a microscope.