Lichen Disease

Question 1

What is Lichen Planus?

Answer 1

A chronic inflammatory skin condition of autoimmune aetiology

Question 2

What are clinical features of Lichen Planus?

Answer 2

Very itchy rash on palms/wrists, soles of feet and ankles, lower back of flexural surfaces
Often in a polygonal shape with Wickham’s striae (fine white lines) running across surface
Oral involvement with white lace pattern on tongue or buccal mucosa
Koebner phenomenon can be seen- new lesion at the site of trauma

Question 3

What can trigger eruptions of Lichen Planus?

Answer 3

Gold
Quinine
Thiazides

Question 4

What is the management of Lichen Planus?

Answer 4

Potent topical steroids=mainstay
Benzydamine mouth wash if oral

If extensive then may require oral steroids or immunosuppression

Question 5

What is Lichen Sclerosus?

Answer 5

Chronic inflammatory condition which affects the perianal and genital skin
More commonly seen in elderly females

Question 6

What are clinical features of Lichen sclerosus?

Answer 6

White cracked plaques on anal skin/vagina/penis (BXO)
Very itchy
May have associated dysuria, dyspareunia

Question 7

What is the management of Lichen sclerosus?

Answer 7

Very potent or potent topical steroids
If no response- biopsy required as could be vulval carcinoma (presence increases risk)