Abstract
Vulvo-vaginal-oral lichen planus (VVO-LP) is a chronic inflammatory condition affecting the mucous membranes of the oral cavity, skin, and genital areas. The exact etiology remains unclear, although immune-mediated mechanisms are considered likely contributors. It is a rare form of lichen planus, which typically presents in adults and is more common in middle-aged women. Key clinical features include painful ulcerative lesions in the oral, vaginal, and cutaneous regions, often resistant to conventional treatment. This condition can significantly impact the patient's quality of life due to persistent symptoms and complications such as scarring and infection. In this review, we present a case of a 43-year-old Saudi female who presented to our Oral Medicine Clinic with recurrent painful ulcerative lesions affecting the mouth, skin, and vaginal mucosa. Her medical history included type II diabetes mellitus and hypercholesterolemia. Oral biopsy results confirmed the diagnosis of lichen planus, with no signs of dysplasia. The patient was treated with a variety of topical and systemic therapies, including corticosteroids and immunosuppressants, but showed only temporary improvement. Despite short-term remission with all provided medications, the lesions recurred after discontinuation of treatment in a more severe form. This case report emphasizes the challenges associated with the diagnosis and management of VVO-LP, particularly its resistance to standard therapies. The patient's case underscores the need for further research into novel treatment strategies and long-term management plans for this rare and debilitating condition.