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   A 55 years old female Mrs. R. S. (Patient Ref. No. L6189), reported to the clinic for complaints of oral lichen planus since 2 years. She had raised, reddish lesions of the buccal mucosa that had come up after she had started wearing dentures. There would be intense burning pain in the lesions on eating spicy food and she had to eliminate spices completely from her diet due to these complaints. She had developed lesions on the gums and tongue in the past but these had got better after the application of local steroids.   She was a known case of diabetes mellitus and hypothyroidism since last 15 years and was on regular treatment for the same. She also had hypertension, ischemic heart disease and hypercholesterolemia for which she was on regular treatment. She also had complaints of pain in the neck region that would radiate to both the upper arms. This complaint had been for last 12 years but had increased since the last 4-5 months. She had history of prolapsed intervertebral disc 25 years ago and it had recovered but she would occasionally get low backache when she would exert herself. Along with these, she also complained of hair loss leading to reduced quantum of hair since the last 5-6 years. She would lose about 50 hair a day. She was a lady with a large body frame and was slightly obese. Her appetite was normal and she had craving for sour foods, sweets and spicy things. She would be frequently constipated and would require straining to pass stools. She was menopausal since 8 years. She had 2 children: 30 years old male and 25 years old female, both being full-term normal deliveries. Both her children were settled abroad and she was staying with her husband. She was a teacher by profession and her husband had his own business. She was very particular about the way she would want things to be done. She would dislike it if work was not done properly as it should be done and this would provoke her anger. She was also very particular about timings and would be punctual in everything that she would do. She said that she had become irritable since the onset of her health complaints. She had a sympathetic nature and would not be able to see others in trouble; she would constantly brood about their problems. She had the tendency to constantly keep thinking about something or the other all the time. She had much loathing for life, especially when she would be angry. She loved to travel. She had a tonsillectomy at the age of 15 years and had undergone cauterization of warts in the past. There was history of following diseases in the family: hypertension (father), ischemic heart disease and diabetes mellitus (mother) and bronchial asthma (sister). She had recently completed a course of local steroids about 3 months before she reported to us. She was on regular medication for hypertension, diabetes, ischemic heart disease and hypothyroidism. A biopsy of her buccal mucosa had confirmed the diagnosis of oral lichen planus. She was prescribed Carcinosin 200 based on the above history and was asked to report after 6 weeks. At the end of 6 weeks her complaints of oral lichen planus were much better than before. She said that she could be more lenient in her eating habits now and this was something that she had not experienced since last 2 years. She no longer had to constantly worry about being aggravated after taking certain kinds of foods. The burning of the oral lesions had significantly reduced and the lesions had almost disappeared (as seen in the photographs on this page). Her other complaints of pain in the neck region, knees and back were better than before. Her hair loss was same as before with not much improvement. She had to continue treatment for some more time for complete cure of the oral lichen planus. |
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