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.