A rare case of isolated erosive ulcerative lichen planus of the vermilion zone

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Abstract

Unlike oral lichen planus (LP), isolated LP of the vermilion zone is a rare disease. It has a higher risk of malignization compared to other LP types, especially with the long course of the disease, which is to be related to frequent injuries and insolation of the area. In its turn, erosive/ulcerative form of LP under adverse circumstances (smoking, external irritants, immunosuppression, etc.) may antedate leukoplakia or transform into cancer; this clinical type of oral LP is difficult to differentiate from invasive squamous cancer. We describe a  clinical case of isolated erosive LP of the vermilion of the lower lip, long lasting and resistant to therapy. Due to persisting erosion on the lip, we performed an assessment by immunohistochemistry and histology to exclude squamous cell carcinoma. After the malignancy had been excluded and the diagnosis has been made, the patient was administered the treatment with aromatic retinoid acitretin, which was effective and led to complete epithelialization of the lesion. In patients with a long lasting, persistent LP of the vermilion, diagnostic biopsy should be performed to exclude malignization before administration of treatment.

 

About the authors

Yu. V. Molochkova

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: yulia.molochkova@yandex.ru
MD, PhD, Senior Research Fellow, Dermatovenereology and Dermatooncology Department Russian Federation

M. A. Amkhadova

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru
MD, PhD, Professor of the Course of Surgical Stomatology and Implantology, Chair of Jaw and Face Surgery and Surgical Stomatology, Postgraduate Training Faculty Russian Federation

Yu. N. Perlamutrov

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: fake@neicon.ru
MD, PhD, Professor, Head of the Chair of Skin and Venereal Diseases Russian Federation

M. A. Bobrov

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru
MD, Research Fellow, Department of Pathological Anatomy Russian Federation

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Copyright (c) 2018 Molochkova Y.V., Amkhadova M.A., Perlamutrov Y.N., Bobrov M.A.

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