Chronic ulcerative stomatitis and lichen planus: just a coincidence or a direct link between the two diseases?

Chronic ulcerative dermatitis (CUS) is characterized by painful exacerbating and remitting oral erosions and ulcerations. A very characteristic direct immunofluorescence (DIF) pattern differentiates CUS from other immune-mediated oral vesiculo-erosive conditions. The clinical and histopathological features of CUS are very similar to erosive oral lichen planus. A middle-aged woman had CUS confirmed by DIF and chronic plantar ulceration. Histology of the lesion on the sole showed features of lichen planus (LP). DIF of the plantar lesion showed the same pattern as the oral lesion of CUS. The relationship between CUS and erosive (ulcerative) LP of the foot is discussed. Chloroquine improved the oral lesions while oral cyclosporine A ameliorated both oral and plantar lesions.