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Question 1

lichen planus

1) cause
2) associated with
3) Affects?

Answer 1

1) unknown; immunologically mediated hypersensitivity
* NOT AUTOIMMUNE
2) Hep C
3) middle aged W and M (0.2-2%)

Question 2

lichen planus has 4 forms?

Answer 2

reticular
plaque
erythematous
erosive

Question 3

reticular lichen planus

Answer 3

most common
many white keratotic lines = Wickham’s striae
annular or lacy pattern

Question 4

plaque lichen planus

Answer 4

slightly elevated to smooth and flat

Question 5

erythematous lichen planus

Answer 5

red patches with very fine striae

Question 6

erosive lichen planus

Answer 6

central area is ulcerated, keratotic striae adjacent to the site of erosion

Question 7

bullous varient of lichen planus

Answer 7

short lived, rupture leaving a painful ulcer

Question 8

histological characters of lichen planus

Answer 8

• 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

Question 9

direct immunoflourescnece of lichen planus

Answer 9

presence of fibrinogen at the basement membrane zone (90-100%)

Question 10

treatment of lichen planus

Answer 10

CANNOT be cured

• notxt for reticular (no pain)
• topical and systenuc corticosterois
• immuno meds
• topical tacolimus 0.1%

Question 11

controvery upon malignancy of lichen planus

Answer 11

• coincidental occurance
• confusion with dysplasia with LP featrues
• very LOW risk of SCC arising from erosive and atrophic forms

Question 12

lupus erthematosus

1) cause
2) antibodies?

Answer 12

1) autoimmune disease; humoral AND cell mediated

2) yes, to nuclear antigens

Question 13

lupus erthematosus systemic vs localized

Answer 13

systemic (acute)= SEL

localized (chronic)= discoid lupus erythematosus (DLE)

Question 14

discoid lupus erythematosus (DLE) skin changes vs oral? affects who?

Answer 14

skin- red plaques with hypERpigmented margins and hyPOpigmented central zone

oral- erythematous or ulcerative lesions with white striae
*** affects middle aged women

Question 15

histopathy of lupus erythematosus (LE)?
similar to LP how?
direct immunoflourescence shows what?

Answer 15

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

Question 16

systemic lupus erythematosus (SEL) does what?

Answer 16

affects multiple organs

** anti-single stranded or double stranded DNA and anti Sm antibodies

Question 17

systemic lupus erythematosus (SEL) of the oral cavity

Answer 17

• invovled vermillion, buccul, gingiae and palate

* erythematous or ulcerative lesions with white striae

Question 18

txt of LE?

Answer 18

• topical and systemic corticosteroids
• immunosuppressive agents
• antimalarials
• various combinations

Question 19

candidiasis acute vs chronic?

Answer 19

acute- pseudomembranous, atrophic, erythematous

chronic- hyperplastic, atrophic, angular cheilitis

Question 20

Oral Submucous Fibrosis (OSF)

1) etiology

Answer 20

1) betel quid, areca nut, skeletal lime, tobacco

2)

Question 21

Oral Submucous Fibrosis (OSF) clinical features?

Answer 21

• buccal, retromolar, soft palate
• pale mucosa, atrophy, immobility of tongue
• mucosal regidity, pain, trismus, fibrous bands and luekoplakia

Question 22

Oral Submucous Fibrosis (OSF) histo?

likehood to become cancer?

Answer 22

hyperkeratosis, epithelial atrophy, dense collagen deposition, chronic inflammation

• dysplasia (10-15%)
• SCC (6%)

Question 23

Oral Submucous Fibrosis (OSF) treatment?

Answer 23

steroids
surgical splitting of fibrous bands
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