Journal of Cosmetics, Dermatological Sciences and Applications, 2012, 2, 234-238 http://dx.doi.org/10.4236/jcdsa.2012.23044 Published Online September 2012 (http://www.SciRP.org/journal/jcdsa) Post Radiotherapy “Isolated LP of the Lips” in a Non-Hodgkin Lymphoma Patient: A Possible Relation Hamdi H. Shelleh 1 , Husni S. Al Hateeti 2 , Hamad A. Al Fahhad 3 , Sarosh A. Khan 4 , Latif A. Khan 2 , Khalid Bahamdan 5 1 Dermatology Department, Nagran General Hospital, Najran, KSA; 2 Hematology, MRCP, London, UK; 3 Dermatology, Najran Uni- versity, Najran, KSA; 4 Medicine, On-Line Physician Academy, Sirangar, India; 5 Dermatology, King Khalid University, Abha, KSA. Email: hhs_s2000@hotmail.com Received May 21 st , 2012; revised June 30 th , 2012; accepted July 12 th , 2012 ABSTRACT We report upon a case of 62 years old Saudi male with non-Hodgkin lymphoma who developed lichen planus (LP) on the inner aspect of the upper lip six months after finishing radiotherapy. The diagnosis of LP was confirmed by histo- pathology. Literature review reveals few countable similar reports of “post radiotherapyoral LP (OLP)”. However, the isolated location of lichen planus on the upper lip per se in this case merits reporting being exceptional and reported before as isolated lichen planus of the lips (ILPL). We assume, after screening literature, that this is the first report of post radiotherapy ILPL in Arabian Gulf countries, though it may be underestimated and underreported. The etiological relation between radiotherapy and LP is discussed. Keywords: LP; OLP; Isolated Lichen Planus of the Lip; ILPL; Lymphoma; Radiotherapy Induced LP 1. Introduction OLP is a chronic T-cell mediated inflammatory disease of the oral mucosa of unknown etiology which rarely un- dergoes spontaneous remission; rather, it has the poten- tial to become malignant [1]. Isolated LP of the lip is a known condition which was first reported in 1995 [2]. Several reports succeeded, in which the lower lip was the mostly involved site, but in some the upper lip was. This condition may be underestimated and therefore under- reported in medical literature. This may explain the scar- city of this entity in literature, and justify reporting it from this region. 2. Case Report A 62 years old Saudi male (Figure 1), attended skin OPD with black ulcerative lesion on the oral aspects of upper lip since 4 months. The lesion was painful while eating especially when ulcerations existed. He was mar- kedly anxious for his lesion as he had had a past history of lymphoma and was scared of a possible linkage be- tween both. He was not on drugs and had no other skin lesions elsewhere. Likewise, he was not a smoker, and denied any tobacco chewing. The history of lymphoma started since March 1999 as a submandibular enlarged lymphnode with general body aches, fever, decreased appetite, and rapid weight loss. The patient was referred to King Faisal Specialist Hospital (KFSH), Riyadh, where he was examined, biopsied and diagnosed as “grade I follicular small cell non Hodgkin lymphoma” according to the final report given to him. Aspirate of bone marrow was positive for malignant cell suggesting the dissemina- tion the disease. This was confirmed by emittion tomo- graphy scanning which proved positive in submandibular region, sternum, ribs, lumber spine V and sacral I. On an- other visit in April 2001 there was progression of the dis- ease in the mediastinum. On December 2001 he presented with a new painful swelling on the right scapular region Figure 1. Superficial ulcerations on reticulate hyperpig- mented erythematous ill defined surface limited to the inner aspect of upper lip. Copyright © 2012 SciRes. JCDSA