This document outlines the key differences between leukoplakia and oral lichen planus. Leukoplakia causes white patches inside the mouth and is linked to smoking, chewing tobacco, and heavy alcohol use. Oral lichen planus causes white patches or red sores in the mouth and its cause is unknown but linked to genetics and immune system. Both conditions are diagnosed through biopsy and can be treated by addressing causes like tobacco/alcohol and medications depending on severity.

1. DIFFERENCES B/W
LEUKOPLAKIA &
ORAL LICHEN PLANUS
BY : DR. ROHAN SHRIVASTAVA
B.D.S ( DENTAL SURGEON)

2. Leukoplakia :
 It is a condition that involves white patches
or spots forms inside of the mouth.
Oral Lichen Planus :
 Lichen planus is a chronic, or long-term,
disease affecting the skin and mucous
membranes, the thin layers of tissue that line
body cavities and secrete mucus.
When lichen planus appears in the mouth, it
is called oral lichen planus.

3. Etiology :
Leukoplakia :
• Heavy smoking.
• Use of chewing tobacco or snuff
• Chewing areca nut (also known as betel nut),
which grows in the tropics of Asia, the
Pacific, and parts of east Africa.
• Heavy use of alcohol.
Oral Lichen Planus :
 The exact cause of oral lichen planus is
unknown. Research suggests the condition is
related to your genetic makeup and immune
system.
 Some people develop oral lichen planus
after taking certain medications, such as
beta-blockers and nonsteroidal anti-
inflammatory drugs (NSAIDs). Diseases such
as hepatitis B and primary biliary
cirrhosis may also cause oral lichen planus.

4. Symptoms :
Leukoplakia :
 The symptoms of leukoplakia are one or more
white patches on the surface of the tongue,
underneath the tongue, or on the insides of the
cheeks. The patches cannot be rubbed off and
cannot be traced to any other cause. No pain or
other symptoms are present.
Oral Lichen Planus :
 For most people, oral lichen planus (reticular
type) appears as white patches or web-like
threads on the inside of the cheeks. These
patches and threads are raised slightly. This
type of lichen planus is usually not painful.
 In some cases, oral lichen planus (erosive type)
appears as bright red gum tissue. In severe
cases, ulcers develop on the gums of mucosal
tissues inside the mouth, or on the tongue.
Eating and drinking spicy, hot or acidic foods or
beverages can be painful for people with oral
lichen planus.

5. Diagnosis :
Leukoplakia :
 Before a diagnosis of leukoplakia is made, other
possible causes of the white patches are investigated.
These could include friction inside the mouth (caused
by something such as dentures), repeated biting of
the cheek, fungal infection or lichen planus,
 If no cause is found and the white patches are not
gone after two to four weeks, a biopsy (tissue sample)
is taken and sent to the laboratory for examination.
 If the biopsy still does not show a clear diagnosis, the
white patch may be confirmed as leukoplakia,
meaning that it has the potential to become
cancerous. (If cancer cells are actually found, this
means a diagnosis of cancer, not of leukoplakia.)
Oral Lichen Planus :
 Tissue biopsy.

6. Differential Diagnosis :
Leukoplakia :
 Yeast infection
 lichen planus
 keratosis due to repeated minor trauma
Oral Lichen Planus :
 cheek chewing/frictional keratosis
 lichenoid reactions
 Leukoplakia
 lupus erythematosus
 Pemphigus
 mucus membrane pemphigoid
 erythematous candidiasis
 chronic ulcerative stomatitis.

7. Treatment :
Leukoplakia :
 Medical management:
• Stop using tobacco and alcohol.
• Eat a diet rich in fruits and vegetables.
• Retinoids (vitamin A-based treatments used to treat
acne and psoriasis) taken by mouth may help reduce
lesions, but relapses and side effects are common.
• Oral (by mouth) Vitamin A and beta-carotene
supplements can help clear the white patches, but
they will appear again once the person stops taking
the supplements.
• Isotretinoin supplements have been found to be more
effective than beta-carotene in preventing cancerous
changes.
Oral Lichen Planus :
 Mild oral lichen planus may not need any treatment.
 Doctors usually treat more severe cases of oral lichen
planus with one or several medications, including:
• Lidocaine
• Tacrolimus
• Corticosteroids
• Dapsone
• Cyclosporine

8. Leukoplakia :
 Surgical management:
• Removing lesions with surgery.
• Removal of lesions by laser.
• Photodynamic therapy (use of light-activated
cancer drugs).
• Cryotherapy (use of freezing to remove lesions).
• Electrocauterization (use of an electrically
heated needle or other instrument to remove
lesions).