Management of Oral Lichen Planus in a Patient With Comorbidities: A Case Report

Oral lichen planus is an inflammatory, immune-mediated mucocutaneous disease characterized by multiple clinical presentations, mainly reticular and erosive types. The association between lichen planus and diabetes mellitus has been widely accepted, which can aggravate the disease severity and affect treatment outcome. A 42-year-old male of Asian descent presents with type 2 diabetes mellitus and hyperlipidemia, having pain and burning sensation, which was exacerbated by hot and spicy foods. Intraoral clinical examination revealed bilateral white striations and erosive lesions on the buccal mucosa, gingiva, and labial vestibule; the clinical diagnosis was consistent with reticular and erosive lichen planus with desquamative gingivitis. The resistance to prior therapy and increased intensity of symptoms were exacerbated by immune dysregulation and persistent inflammation due to type 2 diabetes mellitus. The patient was treated with multiple therapies, including intralesional, topical, and systemic steroids, resulting in relief of symptoms, and significant clinical improvement was observed after six weeks. The management of lichen planus with systemic comorbidities emphasizes the significance of a customized treatment plan and interdisciplinary care. Despite the potential for malignant transformation, it is important to implement long-term follow-up.