Bullous Type Lichen Planus: A Rare Case Report

Abstract

Objective: Oral bullous lichen planus (BLP) is an uncommon form of lichen planus that affects just 1% of the oral mucosa. It is seen in oral mucous, palate, buccal mucous, and occasionally in the tongue. The purpose of this case report is the importance of including lichen planus in the differential diagnosis of leukoplakia-like lesions.

Case: The presentation included lateral parts of the tongue, sublingual, and hyperkeratotic areas on the cheek, as well as asymptomatic bullous lichen planus phenomena, clinical and histological characteristics that have been present for 5 years. Systemic corticosteroid was given to the patient who had no skin symptoms.

Conclusion: Burning sensation, the BLP's common clinical symptom, which is infrequently observed in the oral mucosa, may not be visible in all patients. In addition, BLP can be confused with leukoplakia when observed in plaque form. Histopathological examination is mandatory for definitive diagnosis in terms of malignant potential

Keywords

• Bullous lichen planus
• leukoplakia
• white lesion

Büllöz Tip Liken Planus: Nadir Bir Olgu Sunumu

Abstract

Amaç: Oral büllöz liken planus (BLP), liken planusun nadir görülen bir formu olup, oral mukozada %1 oranında görülmektedir. Oral mukozada damak, bukkal mukoza ve nadiren dilde görülür. Bu olgu sunumun amacı lökoplaki benzeri görülen lezyonların ayırıcı tanısında, liken planusun da bulundurulması gerektiğinin önemidir.

Olgu Raporu: Bu sunumda 5 yıldır var olan, dilin lateral kısımları, dil altı ve yanakta hiperkeratotik alanlar şeklinde izlenen asemptomatik büllöz liken planus olgusu, klinik ve histopatolojik özellikleri sunuldu. Herhangi bir cilt bulgusu olmayan hastaya sistemik kortikosteroid tedavisi başlandı.

Sonuç: Oral mukozada çok nadir olarak izlenen BLP’un yaygın klinik belirtisi olan yanma hissi her hastada görülmeyebilir. Ayrıca BLP plak formunda izlendiğinde lökoplaki ile karıştırılabilir. Malignite potansiyeli açısından kesin tanı için histopatolojik inceleme zorunlu olup, bu sayede doğru tanıya gitme süreci hızlandırılmalıdır.

Keywords

• Büllöz Liken Planus
• lökoplaki
• beyaz lezyon

References

1. [1] Schlosser, B. J. 2010. Lichen planus and lichenoid reactions of the oral mucosa. Dermatologic therapy, 23(3), 251-267.
2. [2] Chainani-Wu, N., Silverman Jr, S., Lozada-Nur, F., Mayer, P., & Watson, JJ. 2001. Oral lichen planus: patient profile, disease progression and treatment responses. J Am Dent Assoc, 132 (7), 901-909.
3. [3] McCartan, BE., Healy, C. 2008. The reported prevalence of oral lichen planus: a review and critique. J Oral Pathol Med., 37 (8), 447-453.
4. [4] Mollaoglu N. 2000. Oral lichen planus: a review. British Journal of Oral and Maxillofacial Surgery, 38,370–377.
5. [5] Gunhan Ö. ed. 2015. Oral Maxillofacial Pathology. Quintessence Publishing, İstanbul, 461s.
6. [6] Liakopoulou, A., Rallis, E. 2017. Bullous lichen planus–a review. Journal of dermatological case reports, 11(1), 1.
7. [7] Babu, A., Chellaswamy, S., Muthukumar, S., Pandey, B., Jayaraj, M., Francis, S. 2019. Bullous lichen planus: Case report and review. Journal of pharmacy & bioallied sciences, 11(Suppl 2), 499s.
8. [8] Karthikeyan, K., Jeevankumar, B., Thappa, DM. 2003. Bullous lichen planus of the glans penis. Dermatol Online J, 9(5):31.

9. [9] Shirasuna, K. 2014. Oral lichen planus: Malignant potential and diagnosis. Oral science international, 11(1), 1-7.
10. [10] Huber, M. A. 2010. White oral lesions, actinic cheilitis and leukoplakia: confusions in terminology and definition: facts and controversies. Clinics in dermatology, 28(3), 262-268.
11. [11] Patil, A., Prasad S., Ashok L., Sujatha GP. 2012. Oral bullous lichen planus: Case report and review of management. Contemp Clin Dent., 3(3):344-8.
12. [12] Huang C., Yan X., Yang L., Zhang J., Tian J., Li J., Wang C., Tu Y. 2007. A retrospective and comparative study of familial and non-familial bullous lichen planus. J Huazhong Univ Sci Technolog Med Sci., 27(3):336-8.
13. [13] Cheng, YSL., Gould, A., Kurago, Z., Fantasia, J., Muller, S. 2016. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol, 122(3):332-54
14. [14] Gawkrodger, DJ., Stavropoulos, PG., McLaren, KM., Buxton, PK. 1989. Bullous lichen planus and lichen planus pemphigoides--clinicopathological comparisons. Clin Exp Dermatol, 14(2):150-3.
15. [15] Ismail, S. B., Kumar, S. K., Zain, R. B. 2007. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. Journal of oral science, 49(2), 89-106.
16. [16] Regezi J. A, Sciubba J. J., Jordan R. C. K. ed. 2017. Oral Pathology: Clinical Pathologic Correlations, 7th, completely revised and enlarged edition. Elsevier Health Sciences, St. Louis. 402s.
17. [17] Asch, S., Goldenberg, G. 2011. Systemic treatment of cutaneous lichen planus: an update. Cutis, 87(3):129-34.
18. [18] Srivastava, VK. 2014. To Study the Prevalence of Premalignancies in Teenagers having Betel, Gutkha, Khaini, Tobacco Chewing, Beedi and Ganja Smoking Habit and Their Association with Social Class and Education Status. Int J Clin Pediatr Dent, 7(2):86-92.