The medication of patients with oral lichen planus and the association of nonsteroidal anti-inflammatory drugs with erosive lesions.

While the cause of lichen planus remains unclear, a number of drugs are known to produce oral and cutaneous lesions that clinically and histologically resemble lichen planus. In this study, the medication taken by 225 consecutive patients with oral lichen planus was compared with the drug histories of 202 age- and gender-matched control patients who were treated at the same clinics. Fifty-three percent of the patients with lichen planus and 44% of the control patients were taking one or more drugs (p greater than 0.05). However, 17% of the patients with lichen planus were taking nonsteroidal anti-inflammatory drugs (NSAID) compared with 9% of the control patients (p less than 0.05). There were no significant differences in the use of antihypertensive, oral hypoglycemic, or psychotropic drugs between the two groups. Almost 30% of the patients with the more severe erosive form of lichen planus were taking NSAID while fewer than 9% of the patients without erosions were taking this type of medication indicating a relationship between NSAID and the more severe form of lichen planus (p less than 0.01). Withdrawal from NSAID resulted in resolution or marked clinical improvement in the 12 patients tested. These results indicate that oral lichen planus may be aggravated or precipitated by NSAID and that withdrawal from the drug may benefit some patients.