Oral Lichen Planus and Oral Lichenoid Lesion in Pediatric Patients: A Narrative Review of Published Case Reports

Background: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disorder that is well documented in adults but remains relatively uncommon in the pediatric population. Due to its rarity, knowledge regarding its epidemiology, etiology, clinical behavior, diagnosis, and management in children remains limited. Objective: To review the current literature regarding epidemiology, pathogenesis, clinical presentation, diagnosis, histopathological characteristics, treatment, and outcomes of OLP in pediatric patients. Materials and Methods: An electronic search of the literature was conducted in the PubMed, Scopus, and Cochrane Library databases to identify OLP-associated case reports in the pediatric population. The search was limited to English-written publications of the past decade. The initial PubMed search yielded 228 publications. Following restriction to studies published between 2016 and 2026, 97 records remained. Limiting the search to English-language publications resulted in 95 studies. Screening for patients younger than 18 years identified 51 potentially relevant publications. After title, abstract, and full-text review, 10 studies fulfilled the inclusion criteria. To ensure comprehensive literature coverage, supplementary searches were subsequently conducted in the Scopus and Cochrane Library databases, identifying three additional eligible studies after excluding the duplicates. Consequently, a total of 13 studies were included in the final review. Results: Pediatric OLP is considerably less common than adult disease. The available evidence suggests an immune-mediated pathogenesis, although the exact mechanism remains unclear. Clinical presentations include reticular, erosive, plaque-like, linear, and severe mucocutaneous forms, with the reticular subtype being the most frequently reported. Histopathological findings consistently demonstrate basal cell degeneration and a dense subepithelial lymphocytic infiltrate. Topical corticosteroids remain the most commonly prescribed treatment and are generally associated with favorable clinical outcomes. Conclusions: Although relatively uncommon, OLP should be considered in the differential diagnosis of persistent oral white lesions in children. Early diagnosis and appropriate management are essential for symptom control and prevention of complications. Additional research is needed to better understand disease pathogenesis and establish evidence-based treatment protocols for pediatric patients.