Images in Clinical Medicine
Oral Lichen Planus as a Clinical Sign of Graft-versus-Host Disease
N Engl J Med 2003; 349:2223December 4, 2003
- Article
A 19-year-old woman had acute lymphocytic leukemia. While she was in her first remission, she underwent bone marrow transplantation. Three months later, she had an oral eruption consistent with lichen planus–like hyperkeratotic striae of the tongue, which is an indication of chronic graft-versus-host disease. The white coating on the tongue could not be rubbed off. Culture and microscopical examination of the scraped material did not show active candidiasis. As the graft-versus-host disease worsened, the skin, liver, and gastrointestinal system became involved. In conjunction with acute lichen planus, there were erythema and pseudomembranous ulcerations in the oral cavity, as well as atrophy of the coating of the tongue and disappearance of the tongue's papillae.
Three years after transplantation, all oral signs had markedly diminished, even though the patient had discontinued antirejection treatment and her tongue papillae had reappeared. Three months later, a recurrence of leukemia was diagnosed, and the patient died.
Mordechai Findler, M.D., D.M.D.
Adi A. Garfunkel, D.M.D.
Hadassah Hospital, Jerusalem 91120, Israel- Citing Articles (1)
Citing Articles
1
Christian Kunte, Istrid Erlenkeuser-Uebelhoer, Silke Michelsen, Karla Scheerer-Dhungel, Gerd Plewig. (2005) Behandlung des therapieresistenten erosiven, oralen Lichen ruber mit extrakorporaler Photopherese (ECP). Treatment of therapy-resistant erosive oral lichen planus with extracorporeal photopheresis (ECP). Journal der Deutschen Dermatologischen Gesellschaft 3:11, 889-894
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