A 36-year-old man presented with the new onset of stinging and burning on the tongue.
Key point: The lesions consist of well-defined whitish plaques, randomly scattered on the dorsum of the tongue. These plaques did not scrape off, as might be the case with thrush (oral moniliasis). A biopsy of a small specimen confirmed the diagnosis of lichen planus.
Treatment: Application of potent topical corticosteroids or administration of oral corticosteroids would be indicated. Unresponsive cases may require oral cyclosporine (2 to 4 mg/kg/d).
Note: Especially in a younger individual, hepatitis C virus infection should be sought; this viral infection is often associated with recent-onset lichen planus.