Oral Lichen Planus in a 12-Year-Old Child: A Clinicopathological Case Report

Oral lichen planus (OLP) is a chronic immune-mediated disorder of the oral mucosa and is uncommon in children. This case report describes the clinical manifestations, diagnostic assessment and conservative management of OLP in a 12-year-old girl. The patient reported a six-month history of persistent bilateral buccal burning, aggravated by hot and spicy foods, and pain in the right mandibular posterior region for 10 days. The burning sensation was continuous and of moderate intensity, with a reported Visual Analogue Scale score of 7/10, and was associated with reduced appetite. Intraoral examination revealed bilateral buccal mucosal lesions comprising erythematous areas, focal pigmentation and non-scrapable reticular white striations. The right lesion measured approximately 2 × 2 cm, and the left lesion measured approximately 2 × 3 cm. Routine haematological investigations were within normal physiological limits. Incisional biopsy demonstrated hyperparakeratinised stratified squamous epithelium, irregular saw-tooth rete ridges and a dense band-like chronic inflammatory infiltrate beneath the epithelial–connective tissue interface. Clinicopathological correlation supported a diagnosis of bilateral OLP. Management included topical 0.1% triamcinolone acetonide in a mucoadhesive oral preparation, an antioxidant supplement, oral hygiene advice, avoidance of irritating foods and recommendations for regular follow-up. This report highlights the diagnostic importance of recognising characteristic bilateral mucosal changes in children and interpreting histopathological findings alongside the clinical presentation.