A Rare Case Report: Five Variants of Lichen Planus in a Young Male Patient

Abstract

Lichen planus is a common dermatological condition. It is described as a chronic inflammatory mucocutaneous disease that has characteristic clinical and histopathological findings. Classical lichen planus lesions occur as purple, pruritic polygonal papules or plaques with a lace-like pattern of whitish markings on the surface. Despite the large number of variants that exist with different clinical manifestations from the classic form, histopathology features are fairly similar among the subtypes and can aid in the diagnosis. Although most cases of lichen planus are often self-limiting with spontaneous resolution expected within one to two years, early diagnosis and treatment are encouraged to control severe pruritus and painful mucosal erosion, but most importantly to minimize the potential for malignant transformation in long-standing lesions. The main objective of this paper is to report the first case of five cutaneous variants of lichen planus occurring simultaneously in a young male patient.

Ulceration and a White Lesion of the Tongue in a Male HIV Positive Patient: A Journey on the Avenue of Differential Diagnoses in Search of a Solution

“…The differential diagnosis of white oral lesions, the clinical context and personal history exclude nicotinic stomatitis, uremic stomatitis and chemical burns [16]. Lichen planus is a T-cell-mediated autoimmune disorder that has been associated with HIV, HBV and atypical forms of lichen; however, the macroscopic appearance of the lesions in the presented case is different from the characteristics of the clinical forms of oral lichen, which are reticular, papular, atrophic/erosive, ulcerative or bullous [32].…”

Actinic Lichen Planus: Significance of Dermoscopic Assessment

“…Histopathological findings are similar to those found in classical LP and show a linear band-like infiltrate (mostly lymphocytes), saw-toothed rete ridges, and dense hypergranulosis with orthokeratosis. The earliest feature seen in histopathology is degenerated keratinocytes, known as Civatte bodies [ 5 ].…”

“…Although, owing to rebound and the high risk of relapse, a longer duration of corticosteroids is best avoided. Other options include hydroxychloroquine, metronidazole, azathioprine, systemic retinoids, dapsone, cyclophosphamide, interferon alpha-2b, cyclosporine, and tetracycline [ 5 ]. Strict sun protection should be advised to all patients of actinic LP in the form of protective full-sleeved clothing, equipment like a hat or an umbrella, and a broad spectrum sunscreen that should ideally be re-applied every three hours during peak solar radiation.…”