Lichen Planus Flashcards
Age ranged affected by LP
30-50s
List the types of LP (6)
RAPBPE
Reticular
Atrophic
Papular
Bullous
Plaque
Erosive
Describe the histology of LP
Lymphocytic band hugging the BM
T cell infiltrate into BM
Describe the histology of a lichenoid reaction (6)
T cell infiltrate
Saw tooth rete ridges
Basal cell damage
Patchy acanthosis
Parakeratosis
Civatte bodies
List the causes of LP
Stress
Genetics
Injury to skin
Localised skin disease - herpes zoster
Contact allergy w AMALGAM
Drugs - B blockers, Ace inhibitors, NSAIDs, diuretics
Symptoms of LP
Often none
May relate to thinning of epithelium
Sensitive to hot/spicy
Burning sensation in mucosa
Oral LP sites
Tongue
Lips
Palate
Gingivae
Buccal mucosa
Easiest biopsy site for LP
Buccal mucosa
Term for gingival LP
Desquamative gingivitis
Common surface affected by tongue LP
Dorsum
Loss of papillae + smooth tongue surface
Features of lichenoid drug reactions
More widespread
Often bilateral + mirrored
Poor response to steroid tx
Managing LP
Remove cause - if meds/amalgam restoration
Avoid AM removal during pregnancy
Biopsy
Bloods - haematinics, FBC, if lupus suspected autoantibody screen (ANA, Ro)
Topical OTC Mild intermittent lesion tx for lP
CHX MW
Benzydamine MW
SLS Free TP
Primary care persisting symptomatic lesions tx
Topical steroids
Beclomethasone inhaler
Betamethasone MW
Hospital care persisting symptomatic lesions tx
Higher strength topical steroids
Skin steroid cream - Clobetasol
Topical tacrolimus
Hydroxychloroquine
Systemic immunomodulators - Azathioprine
