Difficulties in diagnosis of oral lichen planus and discoid lupus erythematosus: A case report

Introduction: Similarity exist between clinical and histopathological features of erosive oral lichen planus (EOLP) and discoid lupus erythematosus (DLE). Case report: A 49-year-old woman presented to the Oral Medicine Clinic of Cipto Mangunkusumo General Hospital Jakarta with a 2-week-old pain on the right and left cheeks, which worsened when she ate spicy food and smoked. There were erosive areas with radiating white striae and dark pigmentations that spread from the commissure to the retromolar pads of the buccal mucosa. Based on intra-oral clinical features, the working diagnosis was EOLP with differential diagnoses were DLE and erythroleukoplakia. EOLP and DLE have similar clinical feature which is erythema or erosive areas with radiating keratotic striae. But the result of histopathological examination was consistent with lichen planus. Oral lesions were treated with topical dexamethasone. Conclusion: EOLP and DLE have similar clinical and histopathological features that cause difficulties in diagnosis. Therefore, elaborating the result of both clinical and histopatological features is very important in the diagnosis of EOLP and DLE. In this case report the histopathological examination establish the diagnosis of EOLP.