Imiquimod 5% cream for isolated lichen planus of the lip

Lichen planus (LP) of the lips is a rare condition that is generally associated with other parts of the oral mucosa. Lip localization has an increased risk, since external trauma, smoking and ultraviolet light trigger malignant transformation. Only a few cases of isolated LP of the lips have been reported up to now, but results of larger series on oral LP suggest that it might be underestimated. Treatment of oral LP is usually difficult and lesions are generally resistant or recur, so that novel therapy alternatives are necessary. Here we report four cases of isolated LP of the lip successfully treated with imiquimod 5% cream. It was applied twice daily, 5 days a week, for 2 weeks. Two weeks after therapy, complete clinical and histopathological resolution was observed. No recurrence was observed during the 5, 10 and 18 months' follow-up period in cases 4, 3 and 1, respectively. Clinical and histopathological cure was also observed in case 2, but the patient showed clinical activation after 6 months. We suggest that imiquimod 5% cream is a safe and effective therapeutic treatment for oral LP.