A Rare Case of Isolated Ocular Lichen Planus

Case Report

Austin Ophthalmol. 2024; 8(1): 1055.

A Rare Case of Isolated Ocular Lichen Planus

Hajar Tahiri¹; Fouzia Hali¹; Khadija El Kafi²; Mohamed Belhadji²; Farida Mernissi³; Soumiya Chiheb¹

¹Department of Dermatology, Ibn rochd university hospital, Casablanca

²Department of Ophthalmology, Ibn rochd university hospital, Casablanca

³Department of Anatomical Pathology, Ibn rochd university hospital, Casablanca

*Corresponding author: Tahiri Hajar Department of Dermatology, Ibn Rochd Uuniversity Hospital, Casablanca Tel: +212 6 10 800 807 Email: tahirihajar33@gmail.com

Received: January 29, 2024 Accepted: February 24, 2024 Published: March 02, 2024

Keywords: Blepharitis; Lichen planus; Cyclosporine; Blindness

Introduction

Lichen planus is a chronic inflammatory condition that can affect the skin, mucous membranes, hair, and nails. Its overall prevalence varies from 0.1% to 4% of the global population. Mucosal lichen planus primarily affects the oral mucosa, followed by the genital mucosa, esophagus, and nasopharynx in decreasing order of frequency, with a well-established clinical appearance and histological features that aid in diagnosis [1].

Ocular involvement is a rare occurrence, mainly documented through clinical cases. It can affect various components of the eye, giving rise to a diverse and nonspecific clinical presentation. Symptoms may encompass a spectrum from redness, irritation, and visual disturbances to conditions such as conjunctivitis, blepharitis, and corneal issues. This diversity in symptoms often contributes to diagnostic delays, ultimately leading to chronic and irreversible alterations in the ocular surface's integrity, and thus significant morbidity.

Case Report

We report a case of an 88-year-old patient who was referred from the department of ophthalmology for evaluation of chronic recurrent blepharitis of unknown origin, refractory to multiple topical and oral treatments (including antibiotics, corticosteroids, and cyclines). A medical history review revealed diabetes and hypertension, as well as bilateral cataract surgery six years ago. The patient reported ocular pain, hyperemia, and decline in visual acuity.

The ophthalmologic examination revealed in the right eye a visual acuity of 1/10 with severe blepharitis, symblepharon formation, conjunctival hyperemia with epitheliopathy, corneal neovascularization, and secondary cataract (Figure 1 & 2). In the left eye, visual acuity was limited to counting fingers at a distance, with blepharitis, conjunctival fornix obliteration with symblepharon, conjunctival hyperemia, and axial corneal dystrophy, making it difficult to assess the remainder of the eye (Figure 3 and 4). An exhaustive dermatological examination revealed actinic cheilitis without involvement of the skin, oral mucosa, genital mucosa, or phanerous.