Lichen Planus Flashcards
What is T-lymphocyte infiltrate suggestive of?
Cell-mediated immunological damage to the epithelium
What are cell mediated immune responses?
Destruction of infected cells by cytotoxic Tcells
Or
Destruction of intracellular pathogens by macrophages
What is lichen planus?
Common chronic inflammatory disease of the skin and mucous membrane
What are the clinical features of lichen planus?
Striae
Atrophic
Erosions
Plaques
What age group + gender does lichen planus most commonly affect?
40-60 years old female
What is the Aetiology of lichen planus?
Idiopathic
Appears to be T-lymphocyte mediated disorder
May be immunological abnormality
What are the potential triggers of lichen planus?
Hepatitis, herpes and varicella zoster virus
Stress and anxiety
Allergy to mercury/polymer
Immune disorders
What is the management of lichen planus?
Monitor size + position at each appointment
Refer if lesion changes appearance
OHI - soft toothbrush and SLS free toothpaste
Diet advice - avoid spicy/peppermint
Removal of amalgam/polymer fillings
What is the consistency of striae in lichen planus ?
Firmer than surrounding mucosa
May not be palpable (a smooth surface instead)
What are striae and how do they appear?
It is the most clinical feature
Usually asymptomatic
Sharply defined, snowy white boarders
Lacy/annular pattern
May occasionally be interspersed with minute, white papules
What is T-lymphocyte infiltrate?
Tumor-lymphocyte infiltrate
A abnormal mass of tissue that forms when cells grow and divide more than they should/do not die when they should
What are erosions
A rarer form of lichen planus (erosive lichen planus)
Irregular areas of epithelial destruction
Can be persistent
Higher risk of becoming malignant
What are plaques?
White lesions within the oral cavity
Occasionally seen in the early stages, particularly on the dorsum of the tongue
Can result from persistent disease + mainly affect buccal mucosa
Lesions are often symmetrical
What are atrophic lesions?
Red asymptomatic mucosal thinning
Often combined with striae
What is the appearance of erosive lichen planus?
The margins may be slightly depressed
Can be covered by a smooth, slightly raised, yellowish layer of fibrin
Striae can radiate from margins of erosions
Gradual healing at the periphery will begin at this stage
What symptoms can erosive lichen planus cause?
Burning sensation and pain
Difficulty eating
