Coexistence of severe peripheral ulcerative keratitis and lichen planus. Case Report

Ocular involvement in lichen planus is highly uncommon, primarily affecting the eyelids, conjunctiva, and less frequently, the cornea. Peripheral Ulcerative Keratitis (PUK), a rare subtype form of corneal lichen planus, has been reported only once in the literature. We report details of a 34-year-old man with confirmed cutaneous lichen planus who developed severe peripheral ulcerative keratitis (PUK), a rare ocular manifestation of lichen planus. Despite initial worsening with corticosteroids, successful resolution of PUK was achieved with topical Cyclosporin and azathioprine over two months but with a final visual acuity limited to light perception. To the best of our knowledge, very rare cases have been reported of the Coexistence of Severe Peripheral Ulcerative Keratitis and Lichen Planus. Lichen planus should be considered in any case of peripheral ulcerative keratitis associated with cutaneous-mucosal manifestations Cyclosporin and azathioprine are crucial for effective management and favorable outcomes in such cases. This case aims to show the importance of dermatological examination in the presence of any peripheral ulcerative keratitis. it also sheds light on the therapeutic difficulties and the prognosis of this rare form of ocular lichen planus.