Lichen Planus Associated With Chronic Hepatitis C: Difficult Diagnosis And Management of a Case

Abstract

Man, 61, came to the Universidade Vale do Rio Verde complaining of “pain in the tongue.” The patient had chronic hepatitis C and also reported difficulty in speaking and feeding and loss of taste sensation. Intraoral examination noted ulceration in almost all tongue areas and extreme symptoms associated with white plaques, which developed over 2 years. The clinical findings and medical history yielded primary diagnostic hypothesis of erosive lichen planus associated with secondary Candida infection. The patient was initially prescribed topical Nystatin; after 7 days an incisional biopsy was performed. Because the symptoms grew worse, dexamethasone was prescribed. The histopathological examination revealed an inflammatory process but did not yield a definitive diagnosis. The patient was prescribed systemic and topical dexamethasone and a new biopsy was performed. He is now being followed in our service. (Support: CNPq; Fapemig).