Lichen Planus Pemphigoides (LPP) Limited to the Oral Cavity: A Rare Case Report and Literature Review

Lichen planus pemphigoides (LPP) is a rare autoimmune vesiculobullous disorder and its exclusive presentation in the oral cavity is an even more remote occurrence. We describe an 85 year old woman with a symptomatic soft palatal erosion, which compromised her ability to wear a maxillary prosthesis. She had been diagnosed with and treated for lichen planus affecting her buccal mucosa three years prior to the onset of the lesion on palate. Persistence of the palatal lesion and its lack of response to local steroid therapy prompted a repeat biopsy for histopathological and direct immunofluorescence examination both of which confirmed LPP diagnosis. In oral lichen planus pemphigoides (OLPP) treatment is empirical. In this patient, a combination of systemic and topical steroids was effective in resolving the palatal ulceration. This case report highlights the importance of monitoring patient's response to therapy and appropriate diagnostic work up when signs and symptoms persist or change character