Hypertrophic lichen planus on lip mimicking SCC

Area of Science:

• Dermatology
• Oral Medicine
• Immunology

Background:

• Lichen planus (LP) is a common inflammatory condition affecting skin, hair, nails, and mucous membranes.
• Oral LP can manifest in various forms, but lip involvement is infrequent.
• Typical lip LP presentations include streaks, papules, and erosions, with hypertrophic plaques being unreported.

Observation:

• A 45-year-old male presented with a verrucous hyperkeratotic plaque on his lower lip, clinically resembling squamous cell carcinoma.
• Oral examination revealed characteristic reticulated white patches on the buccal mucosa.
• Biopsy of the lip lesion confirmed lichenoid dermatitis.

Findings:

• The patient was diagnosed with hypertrophic lichen planus of the lip, a rare clinical presentation.
• The verrucous hyperkeratotic plaque mimicked malignancy, highlighting diagnostic challenges.
• Associated oral lesions aided in the final diagnosis.

Implications:

• Increased awareness of rare hypertrophic LP lip presentations is essential for accurate diagnosis.
• Differentiating hypertrophic lip LP from oral squamous cell carcinoma requires careful clinical evaluation and biopsy.
• Prompt diagnosis of unusual LP variants facilitates timely and appropriate management.