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Abstract Oral lichen planus (OLP) is a non-infectious chronic inflammatory condition that involves the oral mucosal stratified squamous epithelium and the underlying lamina propria, which may be accompanied by skin lesions. This overview describes the current understanding of the immunopathologic mechanisms implicated in OLP. Oral lichen planus (OLP) is recognized as a non-infectious chronic inflammatory condition that involves the oral mucosal stratified squamous epithelium and the underlying lamina propria, which may be accompanied by skin lesions. The causes that initiate and/or perpetuate OLP (with or without skin lesions) are for the most part unknown. The prevailing theories revolve around dysregulated T cell-mediated disorder to exogenous triggers vs. a dysregulated response to autologous keratinocyte antigens (autoimmune), and definitive data, particularly the initiating triggers and the target antigens, necessary to resolve this dilemma are currently missing. Common difficulties in the study of OLP are related to the overlap between features of OLP and other oral mucosal conditions, to the highly variable application of diagnostic criteria, and the potential co-existence of additional non-OLP inflammatory conditions in the same patients. Nevertheless, the growing database of information about this disorder suggests certain immune response patterns. The accumulating knowledge will eventually facilitate a more reliable separation of this condition from other disorders that are typically included on the differential diagnosis list.