Isolated conjunctival lichen planus: A rare cause of cicatrizing conjunctivitis

A 58-year-old female diabetic patient with keratinization of the gray line, areas of linear scar traction, and forniceal shortening was evaluated. Cicatrizing conjunctivitis was diagnosed. Conjunctival biopsy was performed and the histopathological study revealed a prominent band-like lymphocytic infiltrate. Direct immunofluorescence (DIF) showed a heavy fibrinogen deposition which was irregular in the basement membrane consistent with lichen planus (LP). A full dermatological evaluation was unremarkable. The final clinicopathologic diagnosis was isolated conjunctival lichen planus. As cicatrizing conjunctivitis may have different etiologies with differing treatment strategies, it is important to diagnose this entity and start treatment with anti-inflammatory drugs to avoid vision loss.