Introduction
Lichen planus (LP) is a common inflammatory, chronic disease of the skin
and mucosae1. It is
caused by a T cell-mediated immune response directed towards
keratinocytes expressed on their surface heterogeneous antigens of
different nature: toxic (e.g. from drugs), viral (e.g. HBV and HCV) or
haptenic. Usually LP involves the skin, typically on flexural surfaces
of the limbs, but also the mucosae are frequently affected, in the oral
and genital district2.
Even if 0,3-0,8% of the population is reported to present some form of
lichen planus, the otic localization of LP is thought to be extremely
rare and only two single case
reports3,4and two small case
series5,6are published in the scientific literature, for a total of 24 reported
patients.
The specific management strategy for this rare disease is unclear and
medical and surgical therapies have been proposed. Otic LP, indeed,
presents two main problems: the stenosis of the external auditory canal
and an associated conductive hearing
loss4,6.
We report a case of oticus LP with mixed hearing loss; the clinical
presentation, diagnostic issues and treatment are discussed. Moreover,
we propose a new approach for the treatment of this disease.