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Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia

Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia

Published on: August 9, 2024

Conjunctival lichen planus simulating ocular surface squamous neoplasia.

Jerome C Ramos-Esteban¹, Lynn Schoenfield, Arun D Singh

¹Cole Eye Institute, Pathology Department, Cleveland Clinic, OH, USA.

|September 23, 2009

Summary

Conjunctival lichen planus can mimic ocular surface squamous neoplasia (OSSN). Surgical biopsy confirmed this rare condition, highlighting the importance of histopathology for accurate diagnosis in challenging conjunctival lesions.

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Area of Science:

Ophthalmology
Dermatology
Pathology

Background:

Conjunctival lichen planus is a rare condition.
It can present with symptoms mimicking other ocular surface diseases.

Observation:

A 32-year-old man presented with a conjunctival mass resembling ocular surface squamous neoplasia (OSSN).
Clinical examination revealed an elevated, pigmented conjunctival lesion with a feeder vessel.

Findings:

Histopathology confirmed conjunctival lichen planus, characterized by hyperkeratosis, parakeratosis, acanthosis, and a band-like lymphocytic infiltrate.
The lesion's clinical presentation was highly suggestive of OSSN, necessitating further investigation.

Implications:

This case underscores that conjunctival lichen planus can manifest as a focal lesion.
Excisional biopsy is crucial for diagnosing this rare entity when it clinically mimics OSSN.