The group of antihypertensive medications commonly associated with the development of oral lichenoid lesions is Beta-blockers.

- Oral lichenoid lesions (OLLs) are mucosal reactions that resemble oral lichen planus clinically and histologically but are often triggered by certain medications or contact allergens.
- Among antihypertensive drugs, beta-blockers have been frequently reported to induce oral lichenoid reactions.
- These lesions typically present as white, reticular, or erosive patches on the oral mucosa and can cause discomfort or burning sensations.
- The pathogenesis involves a delayed-type hypersensitivity reaction to the drug or its metabolites, resulting in an immune-mediated mucosal injury.
- While other antihypertensive classes such as calcium channel blockers and ACE inhibitors have also been associated with lichenoid lesions, the strongest and most consistent evidence links beta-blockers to this adverse effect.
- Recognizing this association is critical because discontinuing or substituting the offending drug can lead to resolution of the lesions.

In summary:
- Beta-blockers are the most commonly implicated antihypertensive drugs in oral lichenoid lesions.
- These lesions mimic oral lichen planus but are drug-induced.
- Management includes identification and withdrawal of the causative medication.

Reference: Oral Medicine and Pathology, 3rd Edition, Volume 2, Chapter 15, Pages 250-255