TUG OF WAR: EFFICACY V/S SIDE EFFECTS- MANAGEMENT OF EROSIVE LICHEN PLANUS

Oral lichen planus (OLP) is a chronic immune-mediated mucocutaneous disorder commonly affecting middle-aged and elderly individuals, with a higher prevalence in females. Early diagnosis and follow-up play a vital role along with other systemic disease to improve overall health. This case showcases a case of elderly 70-year-old female patient with a chief complaint of burning sensation and ulceration in the oral cavity for three months, aggravated by spicy and hot foods. Medical history revealed hypertension, diabetes mellitus, rheumatoid arthritis, and varicose veins for which the patient was treated since 5years based on the clinical appearance and histopathological diagnosis erosive lichen planus was considered. A management included steroid sparing agent methotrexate on which patient was already on with dose alteration in consultation with the rhuematologist and 6 week follow up was done, the lesion was completely resolved. Moreover, all the medical conditions were controlled and overall quality of life of patient was improved and regular follow-up due to the potential for malignant transformation. The highlights of the case were, a tug of war between the efficacy of steroids despite the web of comorbidities.