Lichen planu and cicatrizing conjunctiviti: characterization of five cae

Purpoe To report the clinical and immunopathologic feature and the repone to therapy in a erie of ix patient with cicatrizing conjunctiviti due to lichen planu. Deign Retropective cae erie. Method All ix patient were een in an ocular pemphigoid clinic. Clinical, immunopathologic, and erologic feature were evaluated and therapeutic repone in each patient wa monitored. Reult All ix patient had evidence of conjunctival carring. Five patient had lichen planu of the oral mucoa and gingiva; one patient had involvement of the kin. Hitologic finding conited of thickened epithelium and an interface lymphocytic infiltrate along the lamina propria. In three patient, electron microcopy of the conjunctiva revealed thickening, fragmentation, and duplication of the baement membrane zone. Direct immunofluorecence examination of the conjunctiva and oral mucoa demontrated linear and haggy fibrinogen depoition along the baement membrane zone, confirming the diagnoi of lichen planu. All ix patient were placed on immunouppreive therapy with control of the dieae. However, only one patient wa able to dicontinue the anti-inflammatory medication and have the lichen planu remain in remiion. Concluion Lichen planu hould be included in the differential diagnoi of cicatrizing conjunctiviti. Performing appropriate invetigation to ditinguih conjunctival lichen planu from other autoimmune dieae uch a mucou membrane pemphigoid i critical to managing the patient with cicatrizing conjunctiviti appropriately. Oral cycloporine effectively controlled the conjunctival lichen planu in four of the ix cae.