Lichen Planus 2 Flashcards
what are the common medications associated with lichen planus
ACE inhibitors
beta blockers
NSAIDs
DMARDs
how do you term a lichenoid reaction when you know the cause
a lichenoid reaction to … CAUSE
how should you manage drug associated lichenoid reactions
have to consider benefit vs risk of stopping medicine
discuss with patient’s GP
what is the management of lichen planus
remove any causes -medicines or dental restorations
what tests should you do when lichen planus is present
haematinics
FBC
autoantibody screen if suspected lupus
what is treatment for mild intermittent lichen planus lesions
topical OTC remedies
chlorhexidine and benzdamine mouthwash
avoid SLS containing toothpaste
what is treatment for persisting symptomatic lichen planus lesions in the primary care setting
topical steroids (beclamethasone and betamethasone mouthwash)
what is treatment for persisting symptomatic lichen planus in the hospital setting
skin steroid cream
hydroxychloroquine
systemic immunomodulators
give two examples of systemic immunomodulators
azathioprine, mycophenolate
what is the drug regime for beclamethasone metre dose inhaler
0.5mg per puff
2 puffs
2/3 times daily
what is the drug regime for betamethasone mouthwash
1mg in 10 ml water for 2 mins twice daily
what is graft versus host disease
looks like lichen planus
but pt has had bone marrow transplant and the bone marrow now recognises the host as foreign and causes immunological damage
under the microscope, how can graft versus host disease appear
lymphocytic band around the basement membrane
what is different histologically between lichen planus and lupus
in lupus the lymphocyte infiltrate is deep in the connective tissue and away from the basement membrane
what is discoid lupus
when lesions are only found in the mouth and there are no autoantibodys present
