Case Of Lichen Planus Research Articles

Case of Unilateral Linear Lichen Planus with Bilateral Mucosal Involvement

Abstract A form of lichen planus (LP) which follows the Blaschkos line pattern known as linear LP, presents with lichenoid eruptions and violaceous papules in a linear distribution. It is a rare form of LP affecting <0.2% population with LP. We present a case of a 52-year-old female with hyperpigmented patches and plaques distributed linearly along the Blaschkos line in her right leg. From a clinical perspective, the lesions on the patient’s right leg resembled those of lichenoid epidermal naevus, which is a type of linear verrucous epidermal nevus but the dermoscopic findings and the presence of oral mucosa LP indicate that the patient has the uncommon variant of LP which is called linear LP. It is thus critical for clinicians to distinguish linear LP from other acquired dermatoses following the lines of Blaschko both clinically and dermoscopically.

JAK Inhibitor Baricitinib in the Treatment of Oral Lichen Planus: A Case Report

Baricitinib, a JAK1/2 inhibitor, has been expanding its role as a therapeutic agent with recent FDA approval for dermatologic use with alopecia areata. Clinical trials are underway for further use of baricitinib for severe atopic dermatitis and multiple off-label uses in inflammatory dermatologic conditions such as lichen planus have been suggested. Few reports exist of patients with concomitant alopecia areata and lichen planus treated with baricitinib. We present a case of refractory oral lichen planus with marked improvement within one month following treatment with once daily baricitinib. Our case adds to the growing body of literature regarding the therapeutic benefits of JAK inhibitors in the treatment of lichen planus.

Líquen plano cutâneo extenso de início recente na infância após infecção assintomática por COVID-19: relato de caso

ABSTRACT Objective: The objective of this study was to describe a case of cutaneous lichen planus (LP) that appeared following COVID-19 infection. Case description: We report a case of extensive cutaneous classic familial LP in a 4-year-old male child after an asymptomatic serologically confirmed COVID-19 infection. The patient developed intensely itchy, purple, flat-topped papules and plaques, mainly on the dorsal surface of the hands, feet, forearms, and shins. Histopathological examination of the skin biopsy showed vacuolar and apoptotic degeneration of the basal cell layer with a band-like lymphocyte infiltrate at the dermo-epidermal junction and confirmed the diagnosis of LP. Comments: LP could be considered among the differential diagnoses of pediatric post-COVID inflammatory skin lesions, either in the patients recovering from COVID-19 infection or in the suspicious asymptomatic cases in close contact with COVID-19-infected patients.

A Challenging Case of Oral Lichen Planus: A Comprehensive Review

Abstract Oral lichen planus (OLP) is a chronic mucocutaneous disorder affecting the oral mucosa. This case report presents a comprehensive assessment of a 64-year-old male patient with OLP, detailing the clinical presentation, diagnosis, and management. The patient’s chief complaint was a persistent burning sensation in the oral cavity for several months. Furthermore, he expressed the need to replace missing teeth. The patient was treated with a combination of topical corticosteroids, multivitamins, and systemic steroids, which yielded significant improvement in symptoms. This case highlights the importance of early diagnosis and effective management of Oral Lichen Planus,emphasizing the need for proper understanding and treatment of this oral condition.

Pembrolizumab-induced erosive lichenoid reaction in a patient with metastatic lung adenocarcinoma: A case report

Introduction: Immune-related adverse events induced by immune checkpoint inhibitors are quite common. Cutaneous lichenoid immune-related adverse events are among the most frequent. However, oral lichenoid adverse reactions are extremely rare. We herein describe a patient who was treated with pembrolizumab for metastatic lung cancer and developed an erosive oral lichenoid reaction induced by immunotherapy. Case presentation: An 87-year-old man treated with pembrolizumab for metastatic lung adenocarcinoma (stage IVa based on AJCC 2018) developed multifocal erosions of the oral mucosa mainly located on the buccal mucosa, palate, and inner portion of the lips with multiple small, irregular, hyperkeratotic areas. Histopathological examination showed epithelial necrosis and a dense band-like layer of an inflammatory infiltrate of lymphocytes and histiocytes within the upper dermis. Direct immunofluorescence was negative for both IgG and C3. A diagnosis of erosive oral lichenoid reaction of the mucosa induced by immunotherapy was established. Given the severity of the condition, pembrolizumab treatment was withheld and concomitant topical and systemic steroids were started. After 1 month, the drug-related toxicity was ameliorated and immunotherapy was re-introduced. Discussion: Only one other case of pembrolizumab-induced erosive lichen planus of the oral mucosa has been described to date. Previously reported drug-induced lichenoid rashes were mainly localized on the skin. Clinically, the main differential diagnoses of lichenoid erosive lesions are bullous immune-related disorders and should be excluded. In our patient, histological examination combined with negative results of both direct immunofluorescence and enzyme-linked immunosorbent assays confirmed the diagnosis of erosive lichenoid drug reaction. Conclusion: Clinicians should be aware of lichenoid involvement of the oral mucosa because related pain and food intake difficulties may seriously compromise treatment compliance. Prompt treatment of oral drug-related reactions may prevent interruption of immunotherapy and improve patients’ quality of life.

Oral lichen planus in a young patient: a case report with nine-year follow-up

Introduction: Oral lichen planus is an inflammatory condition that affects the stratified squamous epithelium of the oral mucosa. It occurs more frequently in female patients and it is rarely observed in children, adolescents, or young adults. This study aims to report a case of oral lichen planus in a young patient with a nine-year follow-up. Case report: A 19-year-old man reported to the Dentistry Department with a complaint of an asymptomatic white lesion on the dorsum and left lateral border of his tongue, which had appeared a few weeks before. Two weeks later, a second lesion, very similar to the previous one, appeared on the central region of his tongue. An incisional biopsy was performed. The histological slides were stained with hematoxylin-eosin and the expression of interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) was assessed by immunohistochemistry. No pharmacological treatment was prescribed. The clinical and histopathological findings were suggestive of oral lichen planus. The IL-1β/TNF-α expression was low. There was a spontaneous regression of the lesions after approximately one year. The nine-year follow-up showed no signs of recurrence. Conclusion: This case presents atypical features such as the age of the patient and the spontaneous remission of the lesions.

PA32 Severe lichen planus with co-localization of vitiligo: a rare and unusual case

Abstract A 13-year-old boy was seen in the urology clinic for hypo­pigmented patches on the glans penis. He underwent circumcision for presumed balanitis xerotica obliterans, but histological examination of the skin showed lichen planus (LP). This prompted a full skin check by the team, which showed similar patches on the scrotum, anus and ears. A referral was made to dermatology for further assessment. Closer history revealed a 1-year history of inflamed patches behind the ears that spread to the periorbital and penile regions. Concurrent patchy hair loss was noted over this time period; otherwise, he was asymptomatic, with no relevant past medical or family history. Full skin check revealed extensive areas of well-circumscribed erythema on the penis, peri-orbitally and within the conchal bowl of both ears. Areas of scarring alopecia were present with complete loss of the eyelashes. The severity of his condition warranted the immediate commencement of high-dose oral steroid therapy and a trial of protopic 0.1% ointment. A review 6 months later showed no further erythema but areas of clearly defined depigmentation where there was previously active LP, particularly across the nose and periorbitally, consistent with vitiligo. Ongoing follow-up at 1 year showed the stable appearance of these areas, despite ongoing use of topical calcineurin inhibitor. Co-localization of vitiligo in the context of LP is a rare entity, noted in only 10 case reports in the literature. The fact that both LP and vitiligo are common, each said to affect 1–2% of the general population, may mean that their association is merely a coincidence. However, a number of publications suggest that a causal link must be present as similar immunological mechanisms are shared by the two conditions. The aetiology of both LP and vitiligo is known. Various theories exist, including the autoimmune hypothesis, as both conditions are immunologically mediated. Another assumes inflammatory mediator release from ultraviolet damage, particularly on areas of photosensitive depigmented skin. A third supposes that photodamage induces Koebner phenomenon on vitiligo-affected skin, resulting in LP on these areas. No theory has been proven definitively. In most cases, vitiligo is described as the precursor disease; rarely, both diseases occur concomitantly and progress together. We present a rare case of LP preceding vitiligo. Our case not only demonstrates the importance of a full skin examination in diagnosing lesions, but provides further evidence that this association is more than coincidental. More studies into these conditions are needed to understand this phenomenon in its entirety.

Bullous Lichen Planus of Oral Mucosa: A Case Report

Oral bullous lichen planus is a rare form of lichen planus LP characterized by vesicles or bullae which frequently occur in the setting of pre-existing LP lesions. Histopathology corroborates the diagnosis which is based on clinical suspicion. Bullous lichen planus does not have a standard therapy. Dapsone acitretin topical and systemic corticosteroids are a few of the efficient options. A case of oral bullous lichen planus in a 36- year old female patient with extra oral lesions on the legs successfully treated with topical Triamcinolone acetonide is described here in this case report.

Vulvar lichen planus–induced vulvovaginal stenosis: A case report and review of the literature

The authors report a case of vulvar lichen planus-induced vulvovaginal stenosis along with a review of the current literature. The authors outline a case of a patient with biopsy-proven vulvar lichen planus who subsequently developed a vulvovaginal stenosis. Treatment was initiated with clobetasol ointment, oral prednisone, later transitioned to oral methotrexate and clobetasol, and then switched to acitretin. Collaboration with the patient's family physician and the hypertension clinic has been sought to remove medications associated with lichenoid reactions from the patient's regimen. Review of literature was conducted through Ovid MEDLINE. Only six cases of vulvar lichen planus-induced vulvovaginal stenosis had been found, suggesting the relative rarity of this severe disease presentation. The patient has achieved control with her current regimen, as well as some clinical improvement of the resulting vaginal stenosis. Vulvovaginal stenosis can be induced by vulvar lichen planus, and its management requires a multimodal and multidisciplinary approach.

RARE CASE OF ORAL LICHEN PLANUS IN PAEDIATRIC PATIENT

Lichen planus is a relatively common mucocutaneous lesion in adults but it is rarely seen in paediatric patients. Here we presenting a case of oral lichen planus in 10 years old boy. The diagnosis was made on the basis of clinical features only. Topical steroid therapy is most common given therapy in oral lichen planus. This case wastreated with novel treatment modality of topical tacrolimus 0.03% and patient responded well to the treatment.

Hypertrophic lichen planus of the vulva

AbstractVulvovaginal lichen planus is a type of chronic inflammatory dermatosis of the vulva, usually seen as a part of widespread lichen planus. The common clinical types of vulval lichen planus include papulosquamous, erosive, and pigmented types. Hypertrophic lichen planus of the vulva is a rare entity. We report a case of hypertrophic lichen planus of the vulva

Artificial pearl-induced penile annular lichen planus

Sir, Annular lichen planus is an uncommonly reported variant of lichen planus, especially on the penis [1]. Herein, we report a case of penile annular lichen planus induced by artificial pearls. A 42-year-old, circumcised male presented to our hospital with asymptomatic, annular lesions of the glans penis. Around one month prior to presentation, he reported a history of inserting artificial pearls inside his penis by stainless steel. He denied a history of drug intake or a personal history of hepatitis C. A physical examination revealed multiple, reddish-purple, annular plaques with central atrophy on the glans penis (Fig. 1a). Inguinal lymph nodes and other mucocutaneous lesions were absent.

Toluene-induced erythrodermic lichen planus

Lichen planus is an inflammatory disease that affects the skin and mucous membrane. The exact etiology is unknown, but it is considered an immunologically mediated disease toward unrecognized antigen possibly located at the basal cell layer. Many clinical variants are recognized. Lichen planus-like lesions can be seen in chronic versus host disease, drugs, and chemicals. Here, we report a new case of a male patient who was exposed to toluene-containing compounds after which he developed an erythrodermic eczematous and lichenoid eruption, which is to the best of our knowledge, the third case of toluene-induced lichen planus reported worldwide and the first case in our country.

ORAL LICHEN PLANUS: CASE REPORT

Lichen planus is a chronic and T cell–mediated inflammatory disorder of the skin and mucous membranes. This case report describes a case of oral lichen planus in an 82-year-old female patient. The patient's history revealed severe pain and burning sensation in the entire oral cavity. On intraoral examination, diffuse lesions in the form of erythematous areas were seen interspersed within white keratotic areas present on the lateral border of tongue and buccal mucosa bilaterally. Based on the patient's history and clinical findings, the lesion was provisionally diagnosed as oral erosive lichen planus. Histopathologic examination of the biopsied tissue confirmed the diagnosis of lichen planus. The patient was treated with systemic corticosteroid. Complete remission of lesions was observed after 2 months of treatment. The patient was monitored continuously and at 8 months of follow-up did not present exacerbation of the lesions.

Nail lichen planus of a single fingernail successfully treated with intralesional triamcinolone acetonide

Several cutaneous inflammatory diseases can affect the nails, leading to alterations that can be severe and can determine functional and psychosocial consequences. Lichen planus, a benign inflammatory disorder of not well understood etiology, is one of them. Nail manifestations in lichen planus may be isolated or appear in a more generalized involvement of the skin. Currently nail lichen planus is very difficult to treat, and there aren’t therapies fully accepted by the scientific community. Topical therapy does not lead to significant improvements and intralesional steroids are considered as a first line therapy. I present a case of nail lichen planus involving just one nail of a hand, successfully treated with intralesional triamcinolone acetonide.

Lichen Planus and the Vulvovaginal Gingival Syndrome. Report of a Case and Review of the Literature

<h3>Introduction</h3> Lichen planus is a dermatologic disease that affects both skin and mucosa. Cutaneous lesions of lichen planus present as small polygonal violaceous papules that present most often on the flexor surfaces of the extremities. These lesions may also be present on the vulvar skin and the hair-bearing aspects of the vulva. Lichen planus of the mucous membranes may affect buccal or gingival mucosa and the vulvar vestibule and vagina. Examination of the mouth reveals the white, lacy pattern of hyperkeratotic striae present on buccal mucosa, often bilaterally. The gingiva may be diffusely swollen, erythematous, and exhibit desquamation. In 1982 Pelisse first reported the vulvovaginal gingival syndrome and lichen planus. The main clinical manifestations of the syndrome are a triad of vulvar, vaginal and gingival lichen planus. <h3>Case Report</h3> A sixty-five year old female was referred to the oral surgeon for evaluation of red patches in her mouth. The patient reported that she had a biopsy of her vulvar for which a diagnosis of lichen sclerosis et atrophicus was made. A biopsy of her maxillary gingiva was submitted to the oral pathology laboratory and diagnosed as lichen planus. The vulvar biopsy was sent for comparison. After consultation with Dermatopathology the diagnosis of lichen planus and the vulvovaginal gingival syndrome was made. <h3>Conclusion</h3> We report a case of severe erosive vulvovaginal lichen planus that preceded the onset of gingival lichen planus by nine months. Not uncommonly, patients with severe oral lesions displayed mild genital disease and patients with asymptomatic gingival disease suffered with severe erosive vulvovaginal disease. The diagnosis of vulvovaginal gingival syndrome requires multidisciplinary evaluations by various medical specialists. We have reviewed the literature of this rather rare condition and report an additional case, with the intention of making the practicing clinician aware of this unusual clinical entity.

Dysphonia of exceptional origin: lichen planus of the vocal fold \u2014 a case report of a very uncommon area affected by lichen planus

BackgroundLichen planus is an immune-mediated chronic inflammatory condition of unknown origin that affects the skin and the mucosa. Lichen planus in the larynx is not common, and there are few cases reported in literature. We report an unusual case of lichen planus in the vocal fold.Case presentationWe present a case of a 62-year-old Caucasian male with a 2-month history of persistent dysphonia and a smoking habit of about 10 cigarettes per day. He has no previous history of systemic disease, and he was not taking any drug for treatment. Fiber-optic laryngoscopy showed a single white rough lesion in the middle third of the right vocal fold. The diagnosis was performed with direct laryngoscopy. Complete excisional biopsy was used as a treatment method. Chest X-ray and blood test were normal. The biopsy reported lichen planus and mild dysplasia. The voice quality improved after the laryngeal microsurgery, and a close follow-up was advised.ConclusionsThere are few cases of lichen planus in the vocal fold reported in the literature, presenting as a unilateral and isolated lesion or concomitant with oral and genital lesions. Other cases mainly report lesions that affect more than one area of the larynx, with undefined margins or with marked cicatrization. Oral or topical corticosteroids, in this case, were not required because of total extirpation of the lesion but may be necessary in case of recurrence. Although lichen planus of vocal fold is very uncommon, it should be consider in differential diagnosis of leukoplakia of the larynx and once diagnosed could be manage with corticosteroid drugs avoiding aggressive treatment.

A Case of New-Onset Lichen Planus after COVID-19 Vaccination.

The COVID 19 vaccination campaign has been underway for about a year now, and there are now many skin reactions associated with the administration of these vaccines in the literature. In view of the forthcoming third dose, we believe it is important to report our experience.

A case of annular atrophic lichen planus in a child and review of the literature

Lichen planus (LP) is an inflammatory disease affecting both adults and children that may present with numerous rare morphologies. LP and its many subtypes can prove difficult to treat and often leave patients with dyspigmentation. Additionally, pruritus associated with LP can be distressing to patients. The aim of this report is to highlight an uncommon subtype, annular atrophic lichen planus, which uniquely presented in a child, to emphasize the importance of early disease recognition and finally, to demonstrate successful treatment with topical monotherapy with clobetasol propionate ointment.

Holistic Management F Holistic Management For Severe Oral Lichen Planus: A Case al Lichen Planus: A Case Report

Oral lichen planus (OLP) is an immunologically mediated mucocutaneous disease associated with various factors including systemic diseases, with a higher prevalence in females than males. The majority of OLP cases are accompanied by symptoms of discomfort and/or pain. Treatment of OLP can be challenging due to its unknown aetiology and involvement of multiple contributing factors. Objective: Our aim is to report a long-term follow-up case of oral lichen planus with holistic management approach. This report will provide some options to clinicians who are having difficulties in managing OLP cases especially with the medications. Case Report: This case report discusses a female patient who suffered OLP with no definitive treatment prior to referral to us. A thorough history of her problem including psychosocial factors and dietary pattern were obtained. Clinically, the oral mucosa presented characteristics similar to erosive oral lichen planus. Patient reluctance towards pharmacotherapy due to her comorbidities was a challenged in managing her OLP. Hence, a non-pharmacotherapeutic solution was offered by considering psychology and dietary pattern. Conclusion: A severe oral lichen planus with ulcerative background could be managed holistically and not just through a pharmacotherapeutic approach.