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Case presentation

Case presentation. Patient : a 22 years old soldier was referred to the oral medician department of Mashhad dental school. Pain and mouth sore during meals Gingival discoloration Aphtae With 5 months duration. Chief complaint. 2medical 1 dental visits during the past 5 months. history.

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Case presentation

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  1. Case presentation

  2. Patient : a 22 years old soldier was referred to the oral medician department of Mashhad dental school

  3. Pain and mouth sore during meals • Gingival discoloration • Aphtae • With 5 months duration. . . . . . . . Chief complaint

  4. 2medical 1 dental visits during the past 5 months history

  5. First G.P: • Mouth wash chlorhexidin • Tetracyclin • Diphenhydramin Second G.P: • CBC • ESR • FBS • U1A • Trigliserid • thyroid Dentist : refer to dental school Si TIBC ferritin

  6. Patient and his family didn’t have any systemical and infection’s diseases only he had 5 kg loose weight

  7. Oral lesion

  8. Lower lip • linear or reticular pattern of keratosis (Wickham striae)

  9. Lower vestibul • Reticular pattern of keratosis near the right mandibular canin

  10. Lower vestibul • Reticular pattern of keratosis near the right mandibular canin

  11. Rigthbuccalvestibul • Papular pattern of keratosis near the first and secound lower molar and a maplike ulcer near the canin

  12. Left buccalvestibul • A maplike pseudomembranous and aphthouslike ulcer

  13. Left buccalvestibul • Reticular pattern of keratosis from first premolar to the secound molar

  14. palatal • Papular pattern of keratosis near the left first and secound molars on palatal

  15. palatal • Papular pattern of keratosis near the right first and secound molars on palatal

  16. Upper lip • Reticular pattern of keratosis

  17. gingivae • Desquamative gingivitis from right maxilary canin to secound premolar

  18. gingivae • Desquamative gingivitis near the left maxilary canin and first premolar

  19. Clinical diagnosis

  20. Guess what?!!

  21. Erosive and keratotic lichen planus Lichh..en planuusss…!!!!

  22. Lichen planus • Oral lichen planus (OLP) is a: • chronic inflammatory disease • bilateral white striations, papules, or plaques • on the buccal mucosa, tongue, and gingivae. • Erythema, erosions, and blisters may or may not be present

  23. causes • autoimmune disease • unknown

  24. Plaquelike oral lichen planus on the buccal mucosa on the left side

  25. Ulcerative oral lichen planus on the dorsum of the tongue

  26. Reticular oral lichen planus on the buccal mucosa on the left side.

  27. Wickham striae Fordyce granules

  28. Differential diagnosis

  29. Lichenoeid reaction Lupus erythematosus Overlaps syndrom Differential diagnosis

  30. treatment

  31. Biopsy Tab dexamethasone Drop nystatin

  32. Takns for attention

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