Journal of Disease and Global Health

Aim: This case report describes a symptomatic presentation of reticular oral lichen planus (OLP) and emphasises the therapeutic effectiveness of topical corticosteroid therapy, together with the importance of multidisciplinary management for symptom control.

Case Presentation: A 35-year-old female patient presented with a three-month history of persistent burning sensation in the oral cavity, which intensified after the consumption of spicy and hot foods, with a VAS score of 8/10. The patient had no significant medical history, deleterious habits, trauma or cheek-biting habit. Intraoral examination revealed characteristic bilateral interlacing white striations involving the buccal mucosa, extending from the oral commissure to the pterygomandibular region. Similar striae were also noted on the upper and lower left labial mucosa. The lesions were non-scrapable and non-tender on palpation, with no signs of induration. Two small keratotic white patches were also present on the dorsal surface of the tongue. Based on the clinical features, a diagnosis of reticular OLP was considered. The patient was managed with topical clobetasol propionate 0.05%, applied three times daily for 15 days, together with dietary modification and referral for psychological evaluation to address stress- and sleep-related concerns.

Discussion: Oral lichen planus is a chronic immune-mediated disorder characterised by T-cell-mediated epithelial injury. Although the reticular variant is commonly asymptomatic, patients may experience a burning sensation due to mucosal hypersensitivity or external irritants. Topical corticosteroids remain the mainstay of treatment because of their potent anti-inflammatory action.

Conclusion: The present case was reported to demonstrate the clinical features of symptomatic reticular oral lichen planus and to describe the patient's response to topical corticosteroid therapy during follow-up.