Oral lichen planus: Impact of psychological stress due to environmental changes

Introduction: Oral lichen planus is a common inflammatory dermatological disease of the oral cavity. It is characterized by bilateral white striation (Wickham's striae) or plaque on the buccal mucosa, tongue, or gingiva, and has a unique multifactorial etiology in which stress may play an important role. We report a case of oral lichen planus caused by psychological stress in response to environmental change and describe our treatment approach. Case Report: A 30-year-old male patient came to Universitas Indonesia Dental Hospital with a chief complaint of a burning sensation during spicy food consumption and thickened white plaque on the buccal mucosa, mucobuccal fold, and tongue. He also complained of tongue rigidity in the morning. These symptoms started 6 months earlier after he moved to Jakarta where city life and hot weather made him uncomfortable. The systemic disease was not indicated in the laboratory results. Treatment with topical steroids initially and environmental changes later improved the patient's symptoms and clinical lesion. Conclusion: Environmental change that leads to psychological stress might trigger oral lichen planus. Successful treatment, in this case, required appropriate anamnesis to identify and eliminate the triggering factor and select a pharmacological therapy.