Ear and Eye Involvement in Lichen Planus: An Underrecognized Association
Yosra Ben Kraiem *
Department of Dermatology-Venereology, Ibn Sina University Hospital, Mohammed V University of Rabat, Rabat, Morocco.
Hyba Taounza
Department of Dermatology-Venereology, Ibn Sina University Hospital, Mohammed V University of Rabat, Rabat, Morocco.
Syrine Hamada
Department of Dermatology-Venereology, Ibn Sina University Hospital, Mohammed V University of Rabat, Rabat, Morocco.
Nadia Ismaili
Department of Dermatology-Venereology, Ibn Sina University Hospital, Mohammed V University of Rabat, Rabat, Morocco.
Mariame Meziane
Department of Dermatology-Venereology, Ibn Sina University Hospital, Mohammed V University of Rabat, Rabat, Morocco.
Karima Senouci
Department of Dermatology-Venereology, Ibn Sina University Hospital, Mohammed V University of Rabat, Rabat, Morocco.
Laila Benzekri
Department of Dermatology-Venereology, Ibn Sina University Hospital, Mohammed V University of Rabat, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Aims: To describe a case of generalised lichen planus with concomitant auricular and ocular involvement and to emphasise the importance of recognising atypical extra-cutaneous manifestations.
Presentation of Case: A 50-year-old woman with no significant medical history presented with generalised lichen planus of six months’ duration, progressive hearing loss, and increased tearing. Examination demonstrated diffuse pruritic violaceous papules and plaques, a whitish reticular network on the buccal mucosa, and Wickham’s striae on dermoscopy. Audiometric testing confirmed bilateral hearing loss, more pronounced on the right side. Ophthalmological assessment identified moderate ocular dryness with decreased visual acuity in the left eye. No alternative cause of the auditory or ocular findings was identified during the reported work-up. The patient received systemic corticosteroid therapy at 1 mg/kg/day together with dexamethasone-tobramycin eye drops. After two months, cutaneous disease activity and pruritus decreased, with concurrent improvement in auditory and ocular symptoms.
Discussion: Auricular and ocular involvement in lichen planus is uncommon and may be overlooked because symptoms can be insidious. External auditory canal disease may progress to stenosis and hearing impairment, whereas ocular involvement may affect the ocular surface and lacrimal pathways.
Conclusion: Targeted enquiry about hearing and ocular symptoms, with appropriate multidisciplinary assessment, may facilitate earlier recognition of these uncommon manifestations and reduce the risk of persistent functional impairment.
Keywords: Lichen planus, auricular involvement, ocular involvement, hearing loss, ocular dryness, Wickham's striae, mucosal disease, external auditory canal