A 68-year-old retired Assistant Commissioner in Railway Police Force, Mr. J.P. (PIN: 28161) visited Life Force for the treatment of his prevailing ailment of Oral Lichen Planus from which he was suffering for two years. The patient started the treatment for his oral lichen planus on 5th March 2016. The patient had the lesions of oral lichen planus present inside his right cheek, left cheek, and ventral aspect of the tongue along with white lacy eruptions inside his cheeks and ulceration over his tongue with burning. He could only have bland food. His lesions were spreading. 

He had done histopathology and his biopsy reports dated 13th October 2015 showed evidence of parakeratotic stratum corneum overlying spongiotic epidermis with basal layer vacuolization with evidence of upper dermal band like lymphohistiocytic infiltration with a few eosinophils Consistent With Oral Lichen Planus. 
He was experiencing an increase in his complaints after eating spicy food. 

The patient had following allopathic medicines as listed below.

1. Capsule Becosules (Multivitamin) OD for 2 months, stopped 4 months back 
2. Tab Betnesol forte (Betamethasone) 0.25 TDS for 2 months, stopped 4 months back. 
Before starting his homeopathic treatment, he was taking 
1.Tab Dapsone 100 mg since the last 3 months 
2. Dento gel Ointment (Benzalkonium Chloride) OD since the last 3 months 
3.Tacroz (Tacrolimus) Ointment BD from the last 3 months.
He was also having complaints of Diabetes from 17 years that were managed with allopathic medicines. Also, he was a known case of Hypertension, which was managed with allopathic medicines for 10-12 years. 

He was following a vegetarian diet. His appetite was average. Thermally, he was ambi-thermal. Physically, he was average. He was enjoying a sound sleep and had no particular dreams about anything.

Six years back his son-in-law had expired. This was the major stressor in his life. He mixed easily with people. As far as irritability was concerned, he shouted over trivial matters. He was straight-forward. He was fastidious and wanted things always to be kept in place and neat. He was gentle, confident, and expressive.
He was having hydrocoele in the year 1997 that was operated. 
His father was having Diabetes. 

After meeting the patient and studying the case in detail, Dr. Shah prescribed him Oral Lichen Planus’ research-based molecules for one and a half months. 

Follow-Ups:
On the first follow-up after 1.5 months on 12th April 2016, the patient reported an amelioration of 30% to 40% in his relief from the complaints of his lesions of oral lichen planus. He was experiencing relief in all the symptoms of recurrent ulcers and cracks at an angle of the mouth and was experiencing burning only after having a mild spicy food. 

After 3 months of the treatment on the second follow-up on 24th May 2016, the patient reported that his relief from oral lichen planus was better by 10% to 20% from one week, but he was experiencing an increase in his complaints in the last one month. He was having no new lesions and no spread. Symptomatically, his recurrent ulcers and cracks at an angle of mouth were as it is. His discomfort of burning after having mild spicy food was also as it is. He had stopped Tab Dapsone 100 mg from 5 weeks that he was taking for the last two months.

After 4.5 months of the treatment during his third follow-up on 5th July 2016, there was an improvement of 50% in his overall condition with oral steroids. No new spots and no new spread were observed. Symptomatically, his recovery from the lesions under the tongue was better up to 20%. Lesions present on his buccal mucosa, in which the left side was more than the right side, were also 20% better in terms of recovery. The lesions on the inner side of his lower lip were as it is. The cracks at the angle of his mouth were also 20% better and were occurring on and off. His burning only after having mild spicy food was as it is. The burning pain was lasting for 15-20 minutes. 

After six months of the treatment on 24th August 2016, the patient reported that there was an overall increase in his complaints for 1 month after steroid withdrawal. He had stopped using steroids as below.

1. T. Betsone (steroid) 50mg 1 tab OD Sat & Sun, since June 2016 (taken for 3 weeks so far), was stopped since 1 month 
2. Tacroz (Tacrolimus) Ointment BD, which he was using since the last 4 months, was stopped from one month 
3. LA TESS (Triamcinolone acetonide buccal paste) OD used from 4 months, was stopped from one month. 

Symptomatically, new lesions had appeared from one month due to steroids withdrawal effect and the spread of the disease too occurred. His lesions under the tongue, buccal mucosa (left > right), and the inner side of the lower lip had also increased since one month after steroids withdrawal. His cracks at an angle of the mouth and burning only after having mild spicy food had also increased for one month due to the steroid withdrawal effect. Burning pain, which was lasting for 15-20 mins, had increased. The problem in eating hot/cold food had started affecting him. 

After seven and a half months on 5th October 2016, the patient reported with an overall improvement of 20%. No new spots and no spread of the disease had occurred. Lesions under the tongue, buccal mucosa (L>R), the inner side of the lower lip, and cracks at an angle of the mouth (by using Vaseline lip care cream) were also better 20%. But, burning only after having mild spicy food, the burning pain lasting for 15-20 minutes, and the problem in eating hot/cold food were as it is. 

After nine months of treatment on 17th November 2016, the patient reported with a good 75% recovery from all his lesions. His relief from new lesions was 50% better. No new spots had developed. The spread had also decreased to 50%. Symptomatically, the relief from the lesions under the tongue, buccal mucosa (L>R), and in the inner side of the lower lip was 50% better. Cracks at the angle of the mouth (by using Vaseline lip care cream) were completely better 25%. Burning only after having mild spicy food along with burning pain that used to last for 15-20 minutes was as it is. The relief from the discomfort after eating hot/cold food was also 50% better.

After 10.5 months on 29th December 2016, the patient reported with a good 50% recovery from all his lesions. The recovery from new lesions was 50% better, and no new spots had appeared. The spread had also decreased to 50%. Symptomatically, lesions under the tongue were 25% better. The relief from the lesions under buccal mucosa (L>R) and those in the inner side of the lower lip was 50% better. Cracks at an angle of the mouth (by using Vaseline lip care cream) were 25% better. Burning only after having mild spicy food along with burning pain lasting for 15-20 mins as it is. The relief from the problem after eating hot/cold food was also 25% better. 

After 12 months on 28th February 2017, the patient reported with a good 50% recovery from all his lesions. New lesions were 50% better, and no new spots had occurred. The spread was also decreased to 50%. Symptomatically, lesions under the tongue were 25% better. Lesions under buccal mucosa (L>R) and those on the inner side of the lower lip were 50% better. Cracks at an angle of the mouth (by using Vaseline lip care cream) were 25% better. Burning only after having mild spicy food along with burning pain lasting for 15-20 mins was as it is. The relief from the problem after eating hot/cold food was also 25% better. 

After 14 months on 28th April 2017, the patient reported with a good 50% recovery from all his lesions. The discomfort of burning after eating spicy food as it is. No new lesions and no new spots had occurred. The spread had stopped. Symptomatically, lesions under the tongue were 25% better. Lesions under buccal mucosa (L>R) were better by 50%, and those on the inner side of the lower lip were better by 25%. Cracks at an angle of the mouth by using Vaseline lip care cream were better by 25%. Burning only after having mild spicy food along with the burning pain lasting for 15-20 minutes was as it is. The relief from the problem in eating hot/cold food was also better by 75%.

After 16 months on 28th June 2017, the patient reported with a good recovery from all his lesions, but burning after eating spicy food was as it is. No new lesions and no spread had occurred. Symptomatically, relief from the lesions under the tongue was better than 90%. Lesions under buccal mucosa (L>R) and the inner side of the lower lip were as it is. Cracks at an angle of the mouth by using Vaseline lip care cream were 100% better. Burning only after having mild spicy food along with burning pain lasting for 15-20 mins was as it is. The relief from the problem after eating hot/cold food was also better by 100% 

After 18 months on 31st August 2017, the patient reported with no further recovery, but the lesions were better and redness under lips and burning were as it is. No new lesions and no spread had occurred. Symptomatically, the relief from the lesions under the tongue was better by 90%. Lesions under buccal mucosa (L>R) and at the inner side of the lower lip were as it is. Cracks at an angle of the mouth by using Vaseline lip care cream was 100% better. Burning only after having mild spicy food along with burning pain lasting for 15-20 mins was as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 20 months on 1st November 2017, the patient reported with no further recovery, but his lesions were better and redness under the lips and burning were as it is. No new lesions and no spread of the disease had occurred. Symptomatically, the recovery from the lesions under the tongue was 100% better. Lesions under buccal mucosa (L>R) and the inner side of the lower lip were as it is. Cracks at an angle of the mouth by using Vaseline lip care cream were 100% better. Burning only after having mild spicy food along with the burning pain lasting for 20-30 mins was as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 22 months on 29th December 2017, the patient reported with no further recovery from the prevailing 70%-80% one. No new lesions and no spread had occurred. Symptomatically, the lesions under the tongue were 100% better. Lesions under buccal mucosa (L>R) and at the inner side of the lower lip were as it is. Cracks at an angle of the mouth by using Vaseline lip care cream were 100% better. Burning only after having a mild spicy food along with burning pain lasting for 20-30 mins were as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 24 months on 8th March 2018, the patient reported with no further recovery from the prevailing 70-80% one. No new lesions and no spread had occurred. Symptomatically, the relief from the lesions under the tongue was 100% better. 

Lesions under buccal mucosa (L>R) were as it is, and lesions at the inner side of the lower lip were better by 75%. Cracks at an angle of the mouth by using Vaseline lip care cream were better by 100%. Burning only after having mild spicy food along with burning pain lasting for 20-30 mins was as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 26.5 months on 16th May 2018, the patient reported with insignificant oral lesions with further recovery from 70%-80%. No new lesions and no spread had occurred. Symptomatically, the lesions under the tongue were better by 100%. Lesions under buccal mucosa (L>R) were the same and the lesions at the inner side of the lower lip were better by 75%. Cracks at an angle of the mouth by using Vaseline lip care cream were better by 100%. Burning only after having mild spicy food along with burning pain lasting for 20-30 mins was as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 28.5 months on 27th June 2018, the patient reported that his lesions were better by 75%, but the burning pain on eating spicy food was same The dryness had reduced. No new lesions and no spread had occurred. Symptomatically, the relief from the lesions under the tongue was better by 100%. Lesions under buccal mucosa (L>R) were as it is and the lesions at the inner side of the lower lip were better by 75%. Cracks at an angle of the mouth by using Vaseline lip care cream was 100% better. Burning only after having mild spicy food was as it is. For the burning pain lasting for 15-20 mins, he avoided eating spicy. The relief from the problem after eating hot/cold food was also 100% better.

After 30.5 months on 27th August 2018, the patient reported that lesions were as it is and the burning pain on eating spicy food was also as it is, including the dryness for 2 months. No new lesions and no spread had occurred. Symptomatically, the lesions under the tongue were better by 100%. Lesions under buccal mucosa (L>R) were the same, and the lesions at the inner side of the lower lip were better by 75%. Cracks at an angle of the mouth by using Vaseline lip care cream were better by 100%. For the burning only after having mild spicy food along with the burning pain lasting for 15-20 mins, he avoided eating spicy, and these issues were as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 32.5 months on 21st November 2018, the patient reported that his recovery from the lesions had improved and burning sensation only on contact spicy food. On examination, currently, lesions were not visible. No new lesions and no spread had occurred. Symptomatically, the lesions under the tongue were better by 100%. Lesions under buccal mucosa (L>R) and the lesions at the inner side of the lower lip were better by 75%. Cracks at an angle of the mouth by using Vaseline lip care cream was better 100%. Burning only after having mild spicy food along with the burning pain lasts for 15-20 mins, for which he avoided eating spicy, were as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 34.5 months on 21st January 2019, the patient reported an increase in lesions from the last 4-5 days under the tongue. His old lesions were stable. Symptomatically, the lesions under the tongue were better by 100%. Lesions under buccal mucosa (L>R) and the inner side of the lower lip were stable. Cracks at an angle of the mouth by using Vaseline lip care cream were better by 100%. Burning only after having mild spicy food along with the burning pain lasting for 15-20 mins, for which he avoided eating spicy, were as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 36.5 months on 22nd March 2019, the patient reported that lesions were better by 50% and burning sensation occurred only after the contact of spicy food. Symptomatically, lesions under the tongue were better by 100%. Lesions under buccal mucosa (L>R) were better by 25% and the lesions at the inner side of the lower lip were better by 75%. Cracks at an angle of the mouth by using Vaseline lip care cream was better by 100%. Burning only after having mild spicy food along with burning pain lasting for 15-20 mins, for which he avoided eating spicy, were as it is. The relief from the problem after eating hot/cold food was also 100% better.

After 38.5 months on 22nd March 2019, the patient reported that lesions were much better up to 75% but burning pain inside the upper lip occurs after eating slightly spicy food. Symptomatically, the lesions under the tongue were better by 100%. The lesions under buccal mucosa (L>R) were better by 100%, and the lesions at the inner side of the lower lip were better by 75%. Cracks at an angle of the mouth by using Vaseline lip care cream was better by 100%. Burning only after having mild spicy food along with burning pain lasting for 15-20 mins was as it is. The relief from the problem after eating hot/cold food was also better by 100%.
He is still under our treatment.

Conclusion:
The above case illustrates how homeopathy, in a gentle way, helped the patient recover from 2 years of persistent lichen planus effectively and safely without any side-effects.
 
Written by Dr. Swapnil, Associate doctor to Dr. Rajesh Shah