title: Isolated ocular lichen planus in a child.
abstract: Lichen planus (LP) is an autoimmune inflammatory condition of the skin and mucous membranes, of unknown aetiology, that infrequently involves the eye. Ocular LP has not been described in children. We present the case of an 8-year-old girl with severe, filamentous dry eyes and persistent conjunctival hyperemia with bilateral progressive conjunctival symblepharon. Her conjunctival biopsy showed heavy linear fibrinogen deposits along the basement membrane without IgG, IgA, IgM, or C3 deposition, consistent with LP. No skin or other mucosal lesions were present, suggesting a diagnosis of isolated conjunctival LP. Oral and topical cyclosporine combined with methotrexate and low-dose oral steroids led to sustained disease remission. To our knowledge, this is the first case of isolated ocular LP in a child.
authors.affiliation: Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. Electronic address: estera_igras@hotmail.com.
authors.forename: Estera
authors.initials: E
authors.lastname: Igras
authors.affiliation: Department of Ophthalmic Pathology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
authors.forename: Susan
authors.initials: S
authors.lastname: Kennedy
authors.affiliation: National Centre for Paediatric Rheumatology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: Emma Jane
authors.initials: EJ
authors.lastname: MacDermott
authors.affiliation: Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland; Department of Ophthalmology, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Conor C
authors.initials: CC
authors.lastname: Murphy
mesh_terms: D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D002648:Child; D003229:Conjunctival Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008010:Lichen Planus / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D008727:Methotrexate / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D005340:Fibrinogen; D011239:Prednisolone; D008727:Methotrexate