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dermatology > lichen planus > Flashcards

lichen planus Flashcards

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Dermatology Board Prep flashcards
1
Q

what is the etiology of lichen planus ?

A

t cell mediated autoimmune disorder
associated with stress
genetic predisposition
liver disease - hepatitis C
koebenrization
drugs associated :
gold
quinine
hydroxyquinine
captopril these cause a lichenoid rash

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2
Q

what is koebrnizatoin ?

A

the appearance of new skin lesions around previous lines of trauma that were previously unaffected

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3
Q

what diseases show the koeebner phenomenon

A

Vitiligo
Viral warts
psoriasis
lichen planus

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4
Q

what are the different types of Lichen planus ?

A

mucosal lichen planus
cutaneous lichen planus
lichen planpilaris
lichen planus of the nails
lichenoid drug eruption
lichen planus pigmentosus
bullous lichen planus

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5
Q

what is the presentation of cutaneous lichen planus ?

A

6Ps
purple
planar
polished
papular
pruritic
polygonal

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6
Q

what is the distribution of LP ?

A

mostly at the
wrists
ankles
lower back
in an annular or acitinic Arrangement ( sun exposed areas )
but may be scattered,
clustered, linear,

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7
Q

what is characteristic about LP plaques ?

A

have white striae called Wickham striae

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8
Q

where is mucosal lichen planus commonly seen ?

A

oral mucosa
vulva
glans of the penis

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9
Q

what is the presentation of mucosal lichen planus ?

A

painless white streaks in a lacy pattern
painful ulcers ( erosive lichen planus )

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10
Q

what is the most serious complication associated with erosive lichen planus ?

A

squamous ceell carcinoma

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11
Q

how does mucosal lichen planus present in the penis ?

A

classical papules in a ring around the glans

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12
Q

what is the presentation of lichen planpilaris ?

A

tiny red follicular papules which may eventually lead to scarring alopecia due to destruction of the hair follicles

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13
Q

what does lichen planus of the nails look like ?

A

onycholysis ( nail separates from the nail bed )
pterygium
grooves and ridges

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14
Q

what is pterygium ?

A

over growth of the proximal nail fold onto the nail bed

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15
Q

what is the presentation of lichen planus pigmentosus?

A

ill defined greyish brown spots
appear of the neck , face , limb and trunks
usually provoked by sun exposure but can present in areas like the armpit ( sun protected areas )
appear without an inflammatory phase

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16
Q

what is the presentation of lichenoid drug eruptions ?

A

Lichen planus-like rash caused by medications
may be asymptomatic , may be itchy
absent wickham striae

17
Q

what is bullous lichen planus ?

A

a rare subtype
where bullous lesions appear in the context of pre existing LP lesions

18
Q

how is a diagnosis of LP made ?

A

clinical features
biopsy
Direct immunofluorescent at the base of the epidermis
hepatitis markers

19
Q

what is the management of LP ?

A

Topical
. Potent topical. Steroids
. Topical calcineurine inhibitors - immunosupp
. Topical retinoids
. Intralesional steroid injections

Systemic
. Steroids
. Hydroxychloroquine ( oral LP )
. Acitretin
. Phototherapy

20
Q

what is Pityriasis Rosea ?

A

acute exanthematous eruption
Pityriasis - flaking or scaling of the skin
Rosea - pink in colour

21
Q

age group affected in Pityriasis Rosea ?

A

children and young adults

22
Q

what is the aetiology of pityriasis rosea ?

A

aetiology unclear
Triggered by upper respiratory viral infection (cough, cold, sore throat)

23
Q

what is the C/P of pityriasis Rosea ?

A

herald patch
then a secondary rash that appear a few days after the herald patch

24
Q

what is the distribution of the 2ry rash that comes with pityriasis rosea ?

A

scaly patches follows thee lines of the dermatomes
xmas tree appearance
chest and back , arms and neck ( T shirt )
may be veery itchy and may not itch at all

25
Q

what is the dddx of pityriasis rosea ?

A

fungal infection - tinea corporis
drug rash
secondary syphillus ( palms would be affected)
seborrheic dermatitis ( oily and scaly )
nummular eczema ( no herald patches )
viral exanthems

26
Q

what is the management of pityriasis rosea ?

A

Rash clears up in about six to twelve weeks
* shower with plain water and bath oil, aqueous cream,
* Apply moisturising creams to dry skin

Medical
-Topical steroid may reduce the itch
-Oral Acyclovir
- Phototherapy

27
Q

fate of lichen planus ?

A

Most lesions undergo spontaneous healing within 6m with post inflammatory hyperpigmentation.

dermatology (15 decks)

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