{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:06:52Z","timestamp":1792789612245,"version":"4.5.0"},"reference-count":34,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Grant-in-Aid for Scientific Research","award":["20592217"],"award-info":[{"award-number":["20592217"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Oral lichen planus (OLP) is a chronic, T cell-mediated inflammatory disorder classified by the World Health Organization as an oral potentially malignant disorder (OPMD). Despite decades of research, its precise etiology remains incompletely understood and involves a complex interplay between genetic predisposition, environmental triggers, and autoimmune-like responses. This review provides a comprehensive update on OLP pathogenesis, emphasizing the role of CD8 positive cytotoxic T lymphocyte-driven basal keratinocyte apoptosis and the skewing of the T-cell receptor (TCR) repertoire. We highlight the significance of the epidermal growth factor receptor (EGFR) signaling pathway as a molecular bridge between chronic inflammation and epithelial proliferation. Furthermore, we discuss a stepwise therapeutic approach that prioritizes the management of the oral microenvironment\u2014specifically Candida colonization and periodontal health\u2014before escalating to immunosuppressive agents. Finally, we explore emerging precision medicine frontiers, including IL-17\/IL-23 inhibitors and JAK inhibitors, alongside traditional Japanese Kampo medicine (Hange-shashin-to) and systemic adjuncts like Cepharanthine, offering a contemporary perspective on modern OLP management. This integrative framework redefines OLP not merely as a chronic inflammatory disorder, but as an immunologically sustained, microenvironment-driven, potentially malignant condition.<\/jats:p>","DOI":"10.3390\/ijms27083444","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T08:49:02Z","timestamp":1776070142000},"page":"3444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Molecular and Cellular Basis of Oral Lichen Planus: Bridging Pathogenesis and Modern Clinical Paradigms"],"prefix":"10.3390","volume":"27","author":[{"given":"Kenichi","family":"Kumagai","sequence":"first","affiliation":[{"name":"Department of Oral-Maxillofacial Surgery and Orthodontics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan"},{"name":"Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan"},{"name":"Department of Oral and Maxillofacial Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Kawasaki 211-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Kishi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Shonan East General Hospital, 500 Nishikubo, Chigasaki 253-0083, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2000-1660","authenticated-orcid":false,"given":"Taiki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Kawasaki 211-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihisa","family":"Horie","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Kawasaki 211-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"383","DOI":"10.4103\/jomfp.jomfp_386_21","article-title":"Diagnosis and management of oral lichen planus\u2014Review","volume":"25","author":"Gururaj","year":"2021","journal-title":"J. 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