Case presentation about oral lichen planus step by step from history to the final dignosis

1. Umm Al-Qura University Faculty of Dentistry Dr. Reham Al-Haratani

4. Extra-oral Examination:

7. INTRA-ORAL EXAMINATION

8. d. Radiographic Findings

9. Description of lesion

12. So…regarding the buccal mucosa (lesion): -Location: Irregularly distributed, bilaterally. -Texture: Smooth.. Does not disappear upon rubbing nor stretching. -Color & Shape: Brown pigmentations + white striations (characteristic Wickham’s striae).

13. -Size: Brown pigm. All over. White striations extend from retromolar area up to the commissures. - Lingual gingiva of lower anterior teeth. -Painless - No discomfort upon eating nor swallowing.

18. Last follow-up was on Sunday 8 - 4 - 2007 Showing stability without any progression Follow Up

19. Treatment Plan… Further follow up every 6 months - 1 year

20. Background: Autoimmune chronic mucocutaneuos condition. Age: middle-aged persons Gender: female predilection Etiology: T-cell-mediated autoimmune disease. Clinically: Types Reticular ASYMPTOMATIC Erosive (ulcerations) Atrophic (erythema) Bullous (blisters) SYMPTOMATIC – Pre-malignant About Lichen Planus

23. OLP associated with patchy brown melanin deposits 28 % have coincident skin lesions..polygonal papules with white lines on surface

24. HISTOLOGY: 1. Hyperkeratosis. 2. Acanthosis. 3. Saw-tooth Rete Ridges (shortened). 4. Basal cell degeneration (liquefaction). 5. Band-like lymphocitic infiltration.

26. Oral Lichen Planus and Hepatitis C and B viruses : is there a real association?