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The mouth is involved In 50% of cases and is often the only affected area. The usual areas affected are the inside of the cheeks and the sides of the tongue, but the gums and lips may also be involved. The most common features are:

- Painless white streaks in a lacy or fern-like pattern

- Painful and persistent ulcers (erosive lichen planus)

- Diffuse redness and peeling of the gums (desquamative gingivitis)

In some cases oral lichen planus affecting the gums is due to contact allergy to mercury in amalgam fillings on nearby teeth. The cause can be confirmed by patch testing. In these patients the lichen planus may resolve on replacing the fillings with composite material. If the lichen planus is not due to mercury allergy removing amalgam fillings is very unlikely to result in cure.

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