HJAR Mar/Apr 2025

54 MAR / APR 2025 I  HEALTHCARE JOURNAL OF ARKANSAS ORAL HEALTH gingivitis. The most common lesions are the reticular striations occurring bilaterally, af- fecting the buccal mucosa. Professional monitoring, along with an appropriate level of knowledge with respect to diagnosis and management of lichen planus, is needed due to potential transformation to oral malig- nancies. 12 Other systemic conditions such as lupus can mimic the striae on the buccal mucosa. Leukoplakia Leukoplakia is a descriptive term used to describe white lesions of questionable risk and unknown diagnosis. Ruling out other white lesions in the differential diagnosis first and then obtaining a biopsy is often warranted. These biopsies can range from hyperkeratosis, dysplasia, or malignancies. 13 The incidence of oral malignancy is 11.5 adults per 100,000 in the U.S., and oral cancer risk increases with age. 14 Squamous cell carcinoma Erythroplakia is the leukoplakia’s hypo- keratotic parallel, however red lesions are far more concerning than white lesions. Ninety percent of erythroplakias have oral dysplasia, carcinoma in situ, or invasive carcinoma on biopsy, and most erythroplakias show either high-grade dysplasia or squamous cell car- cinoma at the time of diagnosis. 15 It is im- perative that every red lesion that cannot be diagnosed as another type of oral lesion is biopsied. The best way to combat oral lesions that don’t go away in two weeks is to contact a dental healthcare professional. Early detec- tion of an oral malignancy and treatment of a potentially life-threatening illness is essen- tial not only for good oral heath, but overall health and quality of life. n Special thanks to Fred Church, DDS, for his collaboration on this article. Lichen planus Lichen planus is a mucocutaneous chronic inflammatory condition and is of autoim- mune etiology. Symptoms and presentations vary widely among patients. The lesions can range from asymptomatic to major ulcer- ation and swelling. Lesions are often over- laid with a lacy pattern of white lines called Wickham striae and are easily observed on the buccal mucosa. Treatment for asymptomatic oral lichen planus is not recommended due to the high incidence of treatment-related adverse ef- fects. Presentations of oral lichen planus are extremely diverse, which adds to the chal- lenge of differentiating it from other oral le- sions, especially oral cancer. Symptomatic lesions are treated with topical steroids as initial therapy. 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