title: Lacrimal canalicular duct scarring in patients with lichen planus.
abstract: BACKGROUND
  Lichen planus (LP) is a mucocutaneous inflammatory disease that affects multiple sites, including the skin, oral cavity, vulva, and vagina and can result in scarring and stricture formation. It has also been shown to cause lacrimal canalicular blockage in a series of patients attending an ophthalmology clinic. We describe a cohort of women with vulvovaginal LP who also had signs of lacrimal canalicular scarring on examination.
  
  
  METHODS
  We report 9 cases of LP with scarring of the conjunctiva around the lacrimal ducts. Seven of 9 women had symptoms of epiphora, and in 2 women lacrimal canalicular scarring was an incidental finding. Seven of 9 cases were diagnosed by an ophthalmologist. All women had biopsy-proven LP at 1 mucocutaneous site each. Seven of 9 women had vulvovaginalgingival syndrome, which is a subgroup of severe erosive LP.
  
  
  CONCLUSIONS
  Given the strong association between erosive mucocutaneous LP and multisite scarring sequelae, it is not unexpected that ocular inflammation may lead to lacrimal duct stenosis. We believe that this complication has been underreported among patients with LP and that an ophthalmological history and examination of the punctum of the lacrimal duct should be sought, especially in patients with the erosive subtype of LP.
authors.affiliation: St. John's Institute of Dermatology, Guy's and St Thomas' National Health Service Foundation Trust, Westminster Bridge Road, London SE1 7EH, England. naomi.webber@doctors.org.uk
authors.forename: Naomi K
authors.initials: NK
authors.lastname: Webber
authors.forename: Jane F
authors.initials: JF
authors.lastname: Setterfield
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Lewis
authors.forename: Sallie M
authors.initials: SM
authors.lastname: Neill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002921:Cicatrix / Q000209:etiology*; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology*; D007767:Lacrimal Duct Obstruction / Q000209:etiology / Q000473:pathology; D008010:Lichen Planus / Q000150:complications*; D008875:Middle Aged; D014623:Vaginal Diseases / Q000150:complications; D014845:Vulvar Diseases / Q000150:complications