Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient
<b>Background:</b> Lichen planus (LP) is a chronic inflammatory disease that can present with significant morbidity, particularly in children. Erosive lichen planus (ELP), its rare destructive subtype, can be particularly difficult to diagnose and manage. We present a rare pediatric case...
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MDPI AG
2024-12-01
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| author | Carolyn Szwed Olivia Gudziewski Marta Sar-Pomian Malgorzata Olszewska Lidia Rudnicka Joanna Czuwara |
| author_facet | Carolyn Szwed Olivia Gudziewski Marta Sar-Pomian Malgorzata Olszewska Lidia Rudnicka Joanna Czuwara |
| author_sort | Carolyn Szwed |
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| description | <b>Background:</b> Lichen planus (LP) is a chronic inflammatory disease that can present with significant morbidity, particularly in children. Erosive lichen planus (ELP), its rare destructive subtype, can be particularly difficult to diagnose and manage. We present a rare pediatric case of ELP with multisite involvement and discuss the differential diagnosis. <b>Case <b>Presentation</b>:</b> A 12-year-old boy presented with painful erosions and ulcers on the lateral tongue and dystrophic nails. His six-year history of tongue and nail lesions prompted several comprehensive examinations. Laboratory tests did not reveal any abnormalities. Histopathological examination of the tongue lesions was representative of ELP. Line-field confocal optical coherence tomography (LC-OCT) examination of the tongue lesions showed features that strongly correlated with histopathology. The patient was later hospitalized due to dysphagia and esophageal food impaction, during which esophageal ELP was confirmed. The patient was initially managed with topical corticosteroids. He was later started on systemic therapy in the form of methotrexate and low-dose naltrexone to address his symptoms and disease presentation. <b>Conclusions:</b> This case highlights the complexities of diagnosis and management of ELP in pediatric patients. A multidisciplinary approach and regular follow-up are necessary to manage symptoms, prevent complications, and improve quality of life. |
| format | Article |
| id | doaj-art-84bbebd2cbb44ef0afd821ec3003e3a6 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-84bbebd2cbb44ef0afd821ec3003e3a62025-01-10T13:16:31ZengMDPI AGDiagnostics2075-44182024-12-011513510.3390/diagnostics15010035Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric PatientCarolyn Szwed0Olivia Gudziewski1Marta Sar-Pomian2Malgorzata Olszewska3Lidia Rudnicka4Joanna Czuwara5Department of Dermatology, Medical University of Warsaw, 02-006 Warsaw, PolandDepartment of Dermatology, Medical University of Warsaw, 02-006 Warsaw, PolandDepartment of Dermatology, Medical University of Warsaw, 02-006 Warsaw, PolandDepartment of Dermatology, Medical University of Warsaw, 02-006 Warsaw, PolandDepartment of Dermatology, Medical University of Warsaw, 02-006 Warsaw, PolandDepartment of Dermatology, Medical University of Warsaw, 02-006 Warsaw, Poland<b>Background:</b> Lichen planus (LP) is a chronic inflammatory disease that can present with significant morbidity, particularly in children. Erosive lichen planus (ELP), its rare destructive subtype, can be particularly difficult to diagnose and manage. We present a rare pediatric case of ELP with multisite involvement and discuss the differential diagnosis. <b>Case <b>Presentation</b>:</b> A 12-year-old boy presented with painful erosions and ulcers on the lateral tongue and dystrophic nails. His six-year history of tongue and nail lesions prompted several comprehensive examinations. Laboratory tests did not reveal any abnormalities. Histopathological examination of the tongue lesions was representative of ELP. Line-field confocal optical coherence tomography (LC-OCT) examination of the tongue lesions showed features that strongly correlated with histopathology. The patient was later hospitalized due to dysphagia and esophageal food impaction, during which esophageal ELP was confirmed. The patient was initially managed with topical corticosteroids. He was later started on systemic therapy in the form of methotrexate and low-dose naltrexone to address his symptoms and disease presentation. <b>Conclusions:</b> This case highlights the complexities of diagnosis and management of ELP in pediatric patients. A multidisciplinary approach and regular follow-up are necessary to manage symptoms, prevent complications, and improve quality of life.https://www.mdpi.com/2075-4418/15/1/35erosive lichen planuspediatricstongue ulcersdystrophic nailsesophagusLC-OCT |
| spellingShingle | Carolyn Szwed Olivia Gudziewski Marta Sar-Pomian Malgorzata Olszewska Lidia Rudnicka Joanna Czuwara Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient Diagnostics erosive lichen planus pediatrics tongue ulcers dystrophic nails esophagus LC-OCT |
| title | Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient |
| title_full | Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient |
| title_fullStr | Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient |
| title_full_unstemmed | Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient |
| title_short | Diagnostic Difficulties of Erosive Lichen Planus in a Pediatric Patient |
| title_sort | diagnostic difficulties of erosive lichen planus in a pediatric patient |
| topic | erosive lichen planus pediatrics tongue ulcers dystrophic nails esophagus LC-OCT |
| url | https://www.mdpi.com/2075-4418/15/1/35 |
| work_keys_str_mv | AT carolynszwed diagnosticdifficultiesoferosivelichenplanusinapediatricpatient AT oliviagudziewski diagnosticdifficultiesoferosivelichenplanusinapediatricpatient AT martasarpomian diagnosticdifficultiesoferosivelichenplanusinapediatricpatient AT malgorzataolszewska diagnosticdifficultiesoferosivelichenplanusinapediatricpatient AT lidiarudnicka diagnosticdifficultiesoferosivelichenplanusinapediatricpatient AT joannaczuwara diagnosticdifficultiesoferosivelichenplanusinapediatricpatient |