Erosive Lichen Planus With Ocular Involvement: A Case Report

Area of Science:

• Ophthalmology
• Dermatology
• Autoimmune Diseases

Background:

• Lichen planus is a chronic autoimmune inflammatory disorder affecting skin and mucous membranes.
• Ocular involvement is rare, often misdiagnosed, and can lead to vision impairment if untreated.
• Early identification and interdisciplinary management are vital for preventing irreversible damage.

Purpose of the Study:

• To highlight the importance of considering systemic erosive lichen planus (ELP) in patients with chronic ocular surface inflammation.
• To emphasize the role of ophthalmologists in recognizing systemic inflammatory disorders.
• To underscore the need for prompt diagnosis and multidisciplinary care for ocular lichen planus.

Main Methods:

• Case report of a 69-year-old woman with chronic conjunctivitis post-cataract surgery.
• Systemic evaluation including oral ulcers, skin plaques, and nail abnormalities.
• Diagnosis confirmed by oral and nail biopsies, treated with azathioprine and corticosteroids.

Main Results:

• Patient presented with chronic conjunctivitis, visual decline, and mucocutaneous lesions consistent with ELP.
• Treatment with azathioprine and oral corticosteroids led to significant improvement in ocular inflammation, lesions, and visual acuity.
• Sustained remission was observed after 1 year of follow-up.

Conclusions:

• Systemic erosive lichen planus (ELP) should be considered in patients with chronic ocular surface inflammation and mucocutaneous lesions.
• Ophthalmologists are key in identifying systemic inflammatory disorders and coordinating care.
• Prompt diagnosis, long-term follow-up, and immunosuppressive therapy are essential to prevent scarring and vision loss.