Oral Lichen Planus in IBD Patients: A Paradoxical Adverse Effect of Anti-TNF-alpha Therapy.

INTRODUCTION AND AIMS: The efficacy of tumor necrosis factor alpha (TNF-alpha) inhibitors in the treatment of Inflammatory Bowel Disease (IBD) is well established. Many cutaneous and mucosal lesions have been described under anti-TNF-alpha therapy, some of them being considered as paradoxical. In this series we aimed to review the cases of oral lichen planus (OLP) in IBD patients under treatment with anti-TNF-alpha agents. METHODS: Histologic findings from oral lesions of IBD patients treated with anti-TNF were revised. RESULTS: Three female patients with IBD developed oral lichen planus (OLP) after starting anti-TNF-alpha therapy. Other etiologies were excluded. CONCLUSIONS: In light of the increasing use of TNF-alpha inhibitors the occurrence of OLP is a potentially emerging side effect, thus we recommend a careful monitoring for oral manifestations in IBD patients treated with anti-TNF-alpha agents.