Journal of Advanced Clinical & Research Insights (2015), 2, 226–228 226 Journal of Advanced Clinical & Research Insights ● Vol. 2:5 ● Sep-Oct 2015 CASE REPORT Oral lichen planus in child: A rare case report Shivayogi M. Hugar 1 , Ravindranath Reddy 2 , Niraj Gokhale 1 , Shweta S. Hugar 3 1 Department of Pedodontics and Preventive Dentistry, KLES VK Institute of Dental Sciences, Belgaum, Karnataka, India, 2 Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Nizamabad, Telangana, India, 3 Department of Periodontics, KLES VK Institute of Dental Sciences, Belgaum, Karnataka, India Abstract Lichen planus is a mucocutaneous disease that predominantly afects older patients and occurs less commonly in the pediatric population. This lesion is extremely rare in childhood, and only a few cases have been cited in literature. The treatment was initiated by psychological counseling of parents and the child. The patient was put on topical steroids (triamcinolone acetonide), multivitamins, and antioxidant therapy. A routine comprehensive dental treatment was done, and a regular follow-up was done every week for a period of 3-month. Outcome: At the end of 4 weeks, all lesions resolved and the child was put under follow-up regime for 6 months and no new lesions were detected. Keywords Children, lichen planus, mucocutaneous lesions, triamcinolone acetonide Correspondence Dr. Shivayogi M. Hugar, Department of Pedodontics and Preventive Dentistry, KLES VK Institute of Dental Sciences, Nehru Nagar, Belgaum - 590 010, Karnataka, India. Phone: +91-9986436448. E-mail: dr.hugarsm@ gmail.com Received 25 July 2015; Accepted 07 September 2015 doi: 10.15713/ins.jcri.83 Introduction Lichen planus is a common chronic inlammatory disease of skin and mucous membranes. It was the irst described by Erasmus Wilson in 1869. The etiology of the condition remains obscure, but it appears to be complex and multifactorial. It afects only 0.5- 2% of the population. Although it is widely recognized in adults, its occurrence is very low in children a number of etiological factors may be responsible like genetic, immunological, systemic diseases, graft versus host disease, infective agents, medication, hypersensitive dental materials, and stress. [1,2] The pathogenesis may involve the modiied basal keratinocytes which may trigger an immune response, and the recruitment of T-lymphocytes may be encouraged by the exaggerated expression of cell surface adhesion molecules. [3] According to Andreason’s classiication, it can be classiied into reticular, papular, plaque, erosive, atrophic, and bullous. [4] The typical cutaneous lesions of lichen planus present as lat-topped, purple, polygonal, pruritic papules, and plaques mostly covering the lexor surfaces of the arms, wrists, ankles, and legs. [2,5] Oral lesions consist of bilaterally symmetrical, radiating white or gray velvety thread like papules in linear annular or retiform arrangements forming typical lacy reticular patches. A tiny white elevated dot is normally present at the intersection of white lines - Wickhams striae. [6] The frequency of occurrence of oral lichen planus is buccal mucosa - 80%, tongue - 65%, lips - 20%, palate - 10%. Kobnerization (isomorphic appearance) is commonly seen in oral lichen planus which may develop as a consequence of numerous types of trauma, such as burns, lacerations, friction, or ultraviolet light. [7] The inclusion criteria for juvenile lichen planus are: [4] • ≤20 years old • Clinical evidence of oral lichen planus • Oral biopsy conirmation • If no oral biopsy was performed, a clinical description of “reticular” or “reticulate,” “striae” or “lacy” oral lesions was required • No evidence of mucosal contact with the dental restorative material, no exposure to medications known to induce oral lichenoid reactions. Case Report A 9-year-old girl of Asian origin born to non-consanguineous parents reported to the Department of Pedodontics and Preventive Dentistry with a chief complaint of decayed upper right posterior teeth. The patient’s medical and dental history