{
  "abstract": "Background Oral Lichen Planus (OLP) is a T-cell-mediated inflammatory condition that may cause significant discomfort, particularly in its erosive and ulcerative forms (Lodi, Manfredi, Mercadante, et al. Cochrane Database Syst Rev. 2020 Feb 28;2(2):CD001168; Li, Tang, Zheng, et al. JAMA Dermatol. 2020;156(2):172-181). While the aetiology of OLP is often idiopathic, chemotherapy and immunomodulatory agents used in palliative oncology can trigger or exacerbate the condition (Marques, Lopes, Montovani, et al. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2022;134(3): e96).Aim To increase awareness of OLP among palliative care professionals, outline initial management strategies, and highlight the importance of timely referral to Oral Medicine services.Method This case series describes two palliative oncology patients with biopsy-confirmed OLP, seen in the Oral Medicine department at Glasgow Dental Hospital. One patient had metastatic breast cancer; the other had non-small cell lung cancer.Results Patient A, on immunotherapy for metastatic breast cancer since 2008, presented in 2019 with severe oral and cutaneous ulceration. Biopsies in 2019 and 2023 confirmed OLP. Treatment included topical corticosteroids (mouthwash and inhaler), benzydamine (Difflam), and sodium lauryl sulphate (SLS)-free toothpaste. Symptom relief was further aided by the adjustment of a sharp molar cusp. The patient was discharged in 2023 with good oral symptom control.Patient B was on immunotherapy for non-small cell lung cancer, with a history of chemotherapy and Zoledronic acid for bone metastases (stopped due to medication-related osteonecrosis of the jaw affecting the right maxillary antrum). On presentation in 2022, the patient reported painful ulceration in the left buccal mucosa near a mobile molar. A paraneoplastic process was initially suspected. However, biopsy and serology confirmed bullous/erosive OLP. Management involved systemic corticosteroids, antivirals and Difflam. Symptoms improved, steroids were tapered, and the patient was discharged in 2023.Conclusion OLP is a potentially debilitating oral condition in palliative care settings. Early identification and simple therapeutic interventions can significantly improve quality of life. However, persistent or severe presentations warrant multidisciplinary input, including referral to Oral Medicine services, to optimise patient outcomes.",
  "authors": [
    {
      "affiliations": [
        "Glasgow Dental Hospital, Glasgow, UK"
      ],
      "name": "Chris Grumley"
    },
    {
      "affiliations": [
        "Glasgow Dental Hospital, Glasgow, UK"
      ],
      "name": "Jennifer Taylor"
    },
    {
      "affiliations": [
        "Glasgow Dental Hospital, Glasgow, UK"
      ],
      "name": "Elizabeth Todd"
    }
  ],
  "title": "P-66 Oral lichen planus and oral lichenoid reactions in the context of palliative oncology care",
  "uid": "2380dd97-c550-5132-8933-6ac8d5851191"
}