k Flashcards
lichen planus
1) cause
2) associated with
3) Affects?
1) unknown; immunologically mediated hypersensitivity
* NOT AUTOIMMUNE
2) Hep C
3) middle aged W and M (0.2-2%)
lichen planus has 4 forms?
reticular
plaque
erythematous
erosive
reticular lichen planus
most common
many white keratotic lines = Wickham’s striae
annular or lacy pattern
plaque lichen planus
slightly elevated to smooth and flat
erythematous lichen planus
red patches with very fine striae
erosive lichen planus
central area is ulcerated, keratotic striae adjacent to the site of erosion
bullous varient of lichen planus
short lived, rupture leaving a painful ulcer
histological characters of lichen planus
- hyperkeratosis
- degeneration of the basal cell layer by T-lymphocytes
- SAW toothed rete
- dense band-like inflam infiltrate of lymph at the immediate subepithelial region
direct immunoflourescnece of lichen planus
presence of fibrinogen at the basement membrane zone (90-100%)
treatment of lichen planus
CANNOT be cured
- notxt for reticular (no pain)
- topical and systenuc corticosterois
- immuno meds
- topical tacolimus 0.1%
controvery upon malignancy of lichen planus
- coincidental occurance
- confusion with dysplasia with LP featrues
- very LOW risk of SCC arising from erosive and atrophic forms
lupus erthematosus
1) cause
2) antibodies?
1) autoimmune disease; humoral AND cell mediated
2) yes, to nuclear antigens
lupus erthematosus systemic vs localized
systemic (acute)= SEL
localized (chronic)= discoid lupus erythematosus (DLE)
discoid lupus erythematosus (DLE) skin changes vs oral? affects who?
skin- red plaques with hypERpigmented margins and hyPOpigmented central zone
oral- erythematous or ulcerative lesions with white striae
*** affects middle aged women
histopathy of lupus erythematosus (LE)?
similar to LP how?
direct immunoflourescence shows what?
similar to lichen planus (LP) with hyperkeratosis, epithelial atrophy, and basal cell destruction
- sub-epithelial and perivascualar lymphocyticinfiltrate
- -direct flourescence with granular-linear deposits of IgG, IgM, IgA, C3 and fibrinogen along basement membrane
systemic lupus erythematosus (SEL) does what?
affects multiple organs
** anti-single stranded or double stranded DNA and anti Sm antibodies
systemic lupus erythematosus (SEL) of the oral cavity
- invovled vermillion, buccul, gingiae and palate
* erythematous or ulcerative lesions with white striae
txt of LE?
- topical and systemic corticosteroids
- immunosuppressive agents
- antimalarials
- various combinations
candidiasis acute vs chronic?
acute- pseudomembranous, atrophic, erythematous
chronic- hyperplastic, atrophic, angular cheilitis
Oral Submucous Fibrosis (OSF)
1) etiology
1) betel quid, areca nut, skeletal lime, tobacco
2)
Oral Submucous Fibrosis (OSF) clinical features?
- buccal, retromolar, soft palate
- pale mucosa, atrophy, immobility of tongue
- mucosal regidity, pain, trismus, fibrous bands and luekoplakia
Oral Submucous Fibrosis (OSF) histo?
likehood to become cancer?
hyperkeratosis, epithelial atrophy, dense collagen deposition, chronic inflammation
- dysplasia (10-15%)
- SCC (6%)
Oral Submucous Fibrosis (OSF) treatment?
steroids
surgical splitting of fibrous bands
close follow up
