Oral bullous lichen planus: Case report and review of management

Abstract

A 34-year-old female patient with the chief complaint of burning sensation in the oral cavity associated with generalized pruritis, scalp and skin lesions diagnosed as Bullous lichen planus and treated with systemic prednisolone, levamisole, benzydamine oral rinse. Patient is in follow up since 1 year and free of lesions. Here we report the case and review current modalities in the management of oral lichen planus.

The myriad presentations of lichen planus

“…It is commonly seen during fi fth to sixth decade of life and is twice as common in women as in men. [7,8] Oral lichen planus is a painful and debilitating disease with a bilateral presentation, and the management is often aimed at palliation rather than cure. [9] Oral lichen planus can be broadly classifi ed into three types.…”

Case reports of two clinical forms of oral lichen planus with review of literature

“…These striations are surrounded by an erythematous zone, which shows the inflammation of the subepithelial layer. [2] Most commonly seen is buccal mucosa and vestibular region and rarely seen on mucosal side of lips, tongue, and gingiva. [9] …”

“…[4] The differential diagnosis for erosive lichen planus includes lichenoid drug reactions, [2] non-homogenous leukoplakia, erythematous candidiasis, erythema multiforme, pemphigus vulgaris, bullous pemphigoid, secondary syphilis, and lupus erythematosus. [1] Corticosteroids are effective treatment modality to reduce signs and symptoms of erosive lichen planus.…”

“…In symptomatic OLP, topical corticosteroids such as 0.05% fluocinonide, [2] betamethasone, [4] hydrocortisone hemisuccinate, fluticasone propionate spray and betamethasone sodium phosphate mouth rinse, [5] mometasone furoate, [7] and clobetasol propionate 0.05% are available in different forms such as orabase, ointment, sprays, or aqueous solution which have shown effectiveness to relieve pain and burning sensation in erosive lichen planus in many reported literatures. [8] Clobetasol propionate (0.05%) orabase paste tray application with nystatin 100,000 IU/ml has been found to be effective for severe erosive gingival lesions and was also found to be as useful as tacrolimus 0.1% in treatment.…”

“…Most common in middle aged and rare in children. [2] Females are affected more than males. [3] Reticular lichen planus is usually asymptomatic, but erosive type is associated with pain and burning sensation of the mucosa.…”