Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease with periods of remission and exacerbation. A 23-year-old male came to Oral Medicine clinic, Cipto Mangunkusumo General Hospital (RSCM) with complaint of painful sore mouth in the oral cavity. Previously in 2019 the patient was diagnosed with erosive oral lichen planus and was absent for follow-up for almost 2 years. The patient also had a history of hematologic disorder with indefinite diagnosis. Intra oral examination showed sloughing, erosion, atrophic and hyperkeratosis at several locations in oral mucosa. The diagnosis was OLP with the differential diagnosis being discoid or systemic lupus erythematosus and other bullous diseases. He was then prescribed corticosteroid swish and spit and an antioxidant supplement. The patient was referred to hematology-oncologist for hematologic pathology and diagnosed as suspected polycythemia, but definitive diagnosis cannot be obtained due to patient’s refusal for bone marrow puncture. The change of OLP type within 2 years and the presence of suspected polycythemia is a matter of concern. The exacerbation of OLP should alarm clinicians for the possibility of systemic involvement. Thus, deep exploration and multidisciplinary collaboration are critically needed in the management of OLP.

• oral lichen planus,
• exacerbation,
• polycythemia

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