5 - 32 - LICHEN PLANUS Flashcards
effector cell of lichen planus
CD8-Tc cell
most specific marker for lichen planus
CXCL-9
- CXCR-3 ligand
three distinct follicular variants of lichen planus on the scalp
- lichen planopilaris
- frontal fibrosing alopecia,
- Gram-Little-Piccardi Lassueur syndrome (GLPLS)
end stage of follicular fibrosis caused by a primary inflammatory dermatosis such as lichen planus, lupus erythematosus, pustular scarring forms of folliculitis, fungal infections, scleroderma, and sarcoidosis
Pseudopelade of Brocq
most common type of oral or mucosal LP
Reticular form
most common site of involvement of oral LP
buccal mucosa
followed by the tongue and gingiva
most common cause of desquamative gingivitis, accounting for 75% of cases
oral lichen planus
Oral lichenoid reactions (OLRs) are usually seen on the buccal mucosa adjacent to amalgam dental fillings. Patch tests frequently show positive reactions to which substances?
mercury, gold, and other metals
A unique lichenoid eruption has been described on the tongues of individuals with HIV. This reaction is characterized by bilateral reticular keratotic or atrophic changes of the buccal mucosa and lichenoid atrophic patches over the dorsal tongue. The eruption usually follows intake of what medications?
zidovudine or ketoconazole intake
Male genitalia are involved in 25% of cases of lichen planus. What is the most commonly affected area with annular lesions?
glans penis
two major pathologic findings in lichen planus
- basal epidermal keratinocyte damage and
- a lichenoid interface lymphocytic reaction
optimal location for biopsy of cutaneous lichen planus
proximal trunk with avoidance of the distal extremities
where should biopsy be done if there is trachyonychia and pitting?
nail matrix
where should biopsy be done if there is presence of chromonychia, nail plate fragmentation, splinter hemorrhage, onycholysis, and subungual debris?
nail bed
first-line therapy for limited cutaneous lichen planus
high-potency topical corticosteroids
has the highest level of evidence of efficacy for lichen planus
Sulfasalazine
first-line nonimmunosuppressive systemic agent for LP
Metronidazole
highly effective for hypertrophic lichen planus
Acitretin
first-line agent in actinic lichen planus
hydroxychloroquine
often used as a second-line agent in cutaneous lichen planus
cornerstone of treatment in oral lichen planus
good oral hygiene with regular professional dental cleanings
first-line therapy in oral lichen planus
Topical steroids
