Lichen planus is one of the most common chronic relapsing diseases of skin and oral mucosa. Stress is considered to be an important factor for oral lichen planus development and flare-up. An association of oral lichen planus with hepatitis has also been shown. A 59-year-old male patient hospitalized in the hepatology department was referred to a dentist with the complaints of oral mucosa pain, burning sensation and dry mouth. The hyperemia of buccal and lingual mucosa, multiple whitish popules merging into reticular pattern and painful erosions were determined. The dental diagnosis was oral lichen planus, combination of papular, reticular and erosive forms (flare-up). Associated conditions were hepatic cirrhosis of viral etiology, multinodular euthyroid goiter and stress. Systemic therapy included: pancreatic enzymes, antidepressant,
hepatoprotective, bactericidal, antibacterial broad spectrum and other drugs. The topical therapy included: Bluem oral rinse, vitamin A, kenalog orabase, solcoseryl dental adhesive paste. After 21 days oral mucosa was of pale pink color. Whitish papules, regionally merging into a characteristic pattern were identified on the buccal mucosa, on the tongue dorsum several papules were defined. The 6-months follow-up demonstrated no worsening. This case report demonstrates the possibility of achieving of significant improvement with prolonged remission period of oral lichen planus in patient with hepatitis C with the use of topical corticosteroids and epithelial agents in conjunction with the treatment provided by hepatologist and psychotherapist.
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