Journal of

Case Reports and Images in Dentistry

 
     
Case Report
 
Vesicular lesion of gingiva diagnosed as bullous lichen planus: Management with combination therapy
Khushboo Goel1, Ashish Shrestha2, Vinay Marla3, Iccha Maharjan4
1MDS, Assistant Professor, Department of Periodontology and Oral Implantology, College of Dental Surgery, B.P Koirala Institute of Health and Sciences, Dharan, Sunsari, Nepal.
2MDS, Associate Professor, Dr. Ashish Shrestha, Department of Oral Histology and Pathology, College of Dental Surgery, B.P Koirala Institute of Health and Sciences, Dharan, Sunsari, Nepal.
3MDS, Assistant Professor, Dr.Vinay Marla, Department of Oral Histology and Pathology, College of Dental Surgery, B.P Koirala Institute of Health and Sciences, Dharan, Sunsari, Nepal.
4MDS, Assistant Professor, Dr. Iccha Maharjan, Department of Oral medicine and radiology, College of Dental Surgery, B.P Koirala Institute of Health and Sciences, Dharan, Sunsari, Nepal.

Article ID: 100015Z07KG2017
doi:10.5348/Z07-2017-15-CR-1

Address correspondence to:
Dr. Khushboo Goel
MDS, Periodontology and Oral Implantology, College of Dental Surgery
B.P Koirala Institute of Health and Sciences
Dharan 56700
Nepal

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How to cite this article:
Goel K, Shrestha A, Marla V, Maharjan I. Vesicular lesion of gingiva diagnosed as bullous lichen planus: Management with combination therapy. J Case Rep Images Dent 2017;3:1–5.


Abstract
Introduction: Oral lichen planus is a T cell mediated autoimmune disease which often affects middle-aged adults. Amongst the reticular, atrophic and erosive types, bullous form of lichen planus is rarely observed.
Case Report: A case of 60-year-old male complaining of discomfort in lower front gingiva with occasional fluid filled vesicles in same area and buccal mucosa. Based on clinical and histopathological findings the case was diagnosed as bullous lichen planus. Management of bullous form of oral lichen planus is challenging and there is no reliable effective treatment. The mainstay of therapy remains topical and oral corticosteroids but there are limited data on the potential efficacy of newer agents. Here we report a case which was managed with low dose corticosteroids (betamethasone) combined with an immunomodulator (pentoxifylline) which achieved clinical success with no recurrence and minimal side effects during one year follow-up.
Conclusion: This case provides evidence that low dose corticosteroids combined with immunomodulator improved clinical outcome in bullous form of disease. Early diagnosis and treatment can help prevent the complication and reduce morbidity in this rare entity.

Keywords: Autoimmune disease, Betamethasone, Bullous lichen planus, Pentoxifylline


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Author Contributions
Khushboo Goel – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ashish Shrestha – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Vinay Marla – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Iccha Maharjan – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Khushboo Goel et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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