Background: Lichen planus is a chronic muccocutaneous inflammatory disorder. Oral lichen planus (OLP) has certain specific characteristics in its clinical presentation, but can also be presented in forms resembling other diseases. This may introduce difficulty in the diagnostic process. It has been reported that OLP affects between 0.1 to 4% individuals, predominantly women and people over 40 years old. Case Report: A 46-yearold woman complained of a non-healing ulcer present for 1.5 months. Intraorally, multiple white striae with prominent central areas of brownish hyperpigmentation were apparent on the right and left buccal mucosa, right and left buccal sulcus, and lateral and dorsum of the tongue. A biopsy was completed and the histopathology features confirmed the diagnosis of OLP. For the initial treatment, a topical corticosteroid was prescribed, followed by steroid mouthwash. Response to this treatment was positive. OLP has been frequently reported to affect women over the age of 40, with psychological stress as a primary predisposing factor. The clinical presentation is characteristic of Wickham's striae with erosive areas. However, a biopsy and histopathological examination is mandatory to confirm the diagnosis. The clinical feature of pigmented OLP has been reported and confirmed by microscopic finding of band-like lymphocytic appearance which is the pathognomonic features of OLP, along with basal cell liquefaction degeneration, and melanin in continence at the lamina propria. Conclusion: Pigmented OLP is a variant of erosive OLP. Anamnesis, clinical presentation, and histopathological examination confirm diagnosis.

Background: Chronic osteomyelitis; defined as osteomyelitis that is present for more than four weeks, can be difficult to manage. We present a case of chronic osteomyelitis managed using a targeted antibiotic regime only. Surgery was not required. Case Report: A 67-year-old female patient presented complaining of recurrent right-sided mandibular swelling and associated lip numbness, following extraction of the lower right second premolar. She was allergic to penicillin.On examination, she had right-sided facial swelling and a sublingual extraoral fistula. She had swelling both buccal and lingual to the extraction site.Dental panoramic tomography (DPT) radiograph showed a 1 cm diffuse moth-eaten radiolucency in the lower right premolar region. A computed tomography (CT) scan of the mandible showed osteomyelitis of the mandible, involving the inferior alveolar nerve canal. To confirm the diagnosis, SW underwent urgent bone biopsy, which revealed a chronic osteomyelitis process.Culture and sensitivity revealed a rare combination of microorganisms -Candida dubliniensis, Streptococcus anginosus and Streptococcus mitis. We liaised with the microbiology team who recommended an initial six-week course of clarithromycin and fluconazole. Later, a four-week course of linezolid was prescribed. SW was monitored closely and a final DPT showed substantial reduction in the radiolucent area. Conclusion:Although osteomyleitis is uncommon in developed countries, it is prevalent and often difficult to distinguish from osteoradionecrosis, if correctly identified and managed then this can prevent disease progression and surgical intervention. A close relationship with the microbiology team aided effective management of this case.

Background: Lichen planus is a chronic muccocutaneous inflammatory disorder. Oral lichen planus (OLP) has certain specific characteristics in its clinical presentation, but can also be presented in forms resembling other diseases. This may introduce difficulty in the diagnostic process. It has been reported that OLP affects between 0.1 to 4% individuals, predominantly women and people over 40 years old. Case Report: A 46-yearold woman complained of a non-healing ulcer present for 1.5 months. Intraorally, multiple white striae with prominent central areas of brownish hyperpigmentation were apparent on the right and left buccal mucosa, right and left buccal sulcus, and lateral and dorsum of the tongue. A biopsy was completed and the histopathology features confirmed the diagnosis of OLP. For the initial treatment, a topical corticosteroid was prescribed, followed by steroid mouthwash. Response to this treatment was positive. OLP has been frequently reported to affect women over the age of 40, with psychological stress as a primary predisposing factor. The clinical presentation is characteristic of Wickham's striae with erosive areas. However, a biopsy and histopathological examination is mandatory to confirm the diagnosis. The clinical feature of pigmented OLP has been reported and confirmed by microscopic finding of band-like lymphocytic appearance which is the pathognomonic features of OLP, along with basal cell liquefaction degeneration, and melanin in continence at the lamina propria. Conclusion: Pigmented OLP is a variant of erosive OLP. Anamnesis, clinical presentation, and histopathological examination confirm diagnosis.