Introduction
Oral Lichen Planus (OLP) is a chronic inflammatory disease that affects the mucous membranes of the oral cavity.[1] The exact cause of oral lichen planus is not fully understood, but it is believed to be an immune-mediated condition. T-lymphocytes (especially CD8+ cytotoxic T cells) infiltrate the basal layer of the oral epithelium, attacking basal keratinocytes which may be perceived as foreign due to genetic, infectious, or chemical triggers.[2] Potential triggers are genetic predisposition, stress, dental restorative materials (e.g., amalgam) , drugs (e.g., NSAIDs, beta-blockers, antimalarials) , infections (e.g., Hepatitis C, HPV), Autoimmune associations (e.g., lupus, Sjögren's syndrome).[3] OLP most commonly affects middle-aged women, and often presents bilaterally and symmetrically in the oral mucosa. Common sites are buccal mucosa, tongue, gingiva, palate, lips. Reticular, Erosive, Atrophic, bullous, papular are the different forms of oral lichen planus. The lesions of LP pigmentosa are bilateral and involve sun-exposed areas which are mostly seen in Indians and darker-skinned individuals.[4] Conversely, the lesion of LP pigmentosa inversus typically affects the intertriginous and flexural areas which are mostly seen in whites and lighter-skinned Asians.[5]
Management of the Lichen planus (LP) includes the use of systemic corticosteroid therapy, topical steroid creams and ointments, and oral antihistamines. The prognosis for life has improved dramatically from modern management but still, the response to the treatment is not good enough to prevent reproduce of a skin lesion in LP. In Ayurveda, most skin diseases are collectively described under a broad heading of Kushta Roga (~skin disease). According to Ayurveda, any disease will manifest when there is an imbalance between three Dosha i.e. Vata, Pitta, and Kaphadosha in the body. These vitiated Doshas affect the basic tissue of the body called Dhatu resulting in the manifestation of various diseases. In Ayurveda skin disease is considered under Kushtharoga, due to the similarity in signs and symptoms of this lichen planus mostly resemble with Charmakushtha which is a type of Kshudrakushtha.[6] Chrama Kushtha is dominant of Vata and Kaphadosha, these Dosha also vitiated to Rakta (~blood), Tvacha (~skin), Mamsadhatu (~muscle), and Lasika (~ tissue fluid).[7]
Indulging in etiological factors leads to vitiation of Vata, kapha, and Rakta. Vitiated Vata and Kapha producing symptoms like itching, bumps on skin while vitiated Raktadhatu was responsible for producing symptoms like reddish-blackish discolouration of bumps over legs and thighs, burning sensation over lesions. The condition was diagnosed as Charma Kushtha under heading of Kushtha based on clear clinical presentation. Charma kushtha is one such disease explained under heading of Kshudrakushtha (~disease of skin). The classical symptoms of Charma Kushtha described in Ayurveda resembles Lichen planus. In this paper a patient diagnosed with Lichen Planus (LP) was managed successfully by Ayurvedic treatment on lines of Kushthachikitsa (~treatment of skin disease) was discussed.
Materials and Methods
Place of study
OPD NO. 12385, of Dept. Of Kayachikitsa, School of Ayurveda, D. Y. Patil Deemed to Be University, Nerul, Navi Mumbai Maharashtra, India 431601.
Case Report
A 38-year-male patient on date of 20/11/2024 came to Ayurveda hospital with complaints of patient firstly developing a burning sensation on buccal mucosa and dorsum of tongue during chewing food. The complaint got aggravated by eating spicy food. Afterward he developed pain from chewing. Due to above complaints, he had consulted an allopathic dentist. Though allopathic treatment was continued, he got symptomatic relief only when medicine was continued. Afterward he reported discomfort and burning sensation in buccal mucosa and dorsum of tongue on consumption of spicy food and drinks, so he came with these complaints for betterment.
He was not having any kind of addiction and no family histories found to be significant. White radiating striae were present on left and right buccal mucosa. The striae were non scrapable and did not disappear on stretching. Mild to moderate plaque accumulation and extrinsic stains were present on dorsum of tongue. There were no signs of ulceration. Diagnostic Focus and Assessment. The diagnosis was done on basis of symptoms, general oral examination and histopathological biopsy report.
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