Lichen sclerosus is a chronic mucocutaneous disease that most frequently involves the anogenital region of women. It can affect skin and oral mucosa although oral lichen sclerosus is an exceedingly rare condition. Oral lesions are porcelain-white or whitish, well-demarcated maculae or plaques. The most common sites are labial mucosa and lips, buccal mucosa, and gingiva. Most of the lesions are asymptomatic. However, a third of patients have symptoms including burning sensation, soreness, tightness of oral tissues, and aesthetic concerns.

Diagnosis of oral lichen sclerosus is based on anamnestic data, clinical appearance and histopathological features. Typical histopathological findings are atrophy of epithelium, hyperkeratosis, hyalinization and homogenization of collagen in the lamina propria, loss elastic fibers, and usually band-like lymphocyte infiltrate in deeper part of the lamina propria.

The objectives of oral lichen sclerosus therapy are symptom relief, resolution of lesions, prevention of destructive changes in oral tissues, and improvement of aesthetics. Treatment options are dependent on the site and the size of the lesions. Surgical excision, topical and intralesional glucocorticoids, and calcineurin inhibitors are mainly used as treatment and usually lead to partial or total improvement. In the gingiva, oral lichen sclerosus is not only an aesthetic concern due to gingival recessions or the white colour. Gingival lesions can lead to periodontal attachment loss with recessions and resorption of bone and even loss of teeth. Although malignancies in oral lichen sclerosus have not been documented, regular and long-term follow-up is recommended.