Oral lichen planus – case report

Abstract

This paper presents the case of a 58-year-old heavy smoker female who came to our clinic with acute pain, as well as mastication and feeding difficulties. The macroscopic examination revealed oral erosive lesions and ulcerations. The polymorphic aspect of the lesions required the differential diagnosis of oral erythroplakia or carcinoma, which were excluded by biopsy. At the same time, we assessed the expression of S100 protein, Ki67 and the cluster of differentiation (CD) 4, CD8 (T-cell) and CD20 (B-cell) immune cell markers by immunohistochemical analysis. As a result, after the clinical and pathological assessment, the diagnosis of oral lichen planus was established, and a therapy plan was conducted. We observed a favorable clinical evolution after the administration of corticosteroids and immunomodulatory agents.

Reticular Oral Lichen Planus of the Buccal Mucosa: A Classical Presentation

“…A slight female predilection (1.5:1) has been reported [6]. OLP etiology remains unclear; stress, drugs (antimalarials, ACEIs, thiazide diuretics, NSAIDs, quinidine, beta-blockers, and tumor necrosis factor alpha (TNFα) inhibitors), dental fillings, genetic factors, immunity, and hyper-sensitivity reactions have been suggested to be contributing factors to its pathogenesis [7]. Additionally, contact allergens and viruses, especially the hepatitis C virus (HCV), have been reported to be associated with LP development [8][9][10].…”

“…Although the clinical feature of reticular OLP is specific, a wide differential diagnosis must be considered. It includes in the first place lichenoid mucositis (drug related or caused by the contact with restorative dental materials) which may also present clinical and histological presentations that mimic reticular OLP, leukoplakia, lupus erythematosus, pemphigus vulgaris, and mucous membrane pemphigoid [1,7].…”

“…If asymptomatic, reticular OLP does not necessitate treatment and routine periodically assessments are essential to observe the disease activity and to rule out any potential malignant transformation [1,7]. When symptomatic, like in the discussed case, topical corticosteroids are used.…”