Lichen Planus Flashcards
Name clinical variants of LP (total 9)
- Annular, blacks, penis and scrotum
- Linear, secondary to trauma
- Hypertrophic, shins and interphalangeal joints, most pruritic, heals with scar and dyspigmentation
- Atrophic, rare, white/bluish papules/plaques with central atrophy, lower exits and trunk, resembles lichen sclerosis et atrophicus
- Vesiculobullous, rare, within lesions of LP
- Erosive Ulcerative, SCC risk, desquamative gingivitis
- Follicular (lichen planopilaris), trunk and medial aspects of proximal exits, scalp with cicatricial alopecia
- Lichen Planus Pigmentosus, dark brown macules in sun-exposed areas and flexural folds, similar to erythema dyschromicum perstans
- Actinic, affects sun-exposed areas, over exits
Erosive mucous membrane disease (LP)
- Hepatitis C infection
Graham-Little-Piccardi-Lassueur syndrome
- Follicular LP of skin and/or scalp
- Multifocal cicatricial alopecia of scalp
- Nonscarring alopecia of axillary and pubic areas
Sites of involvement
- Palmoplantar
- Yellow, compact keratotic papules and papulonodules on lateral margins of fingers and hand surfaces
Sites of involvement
- Inverse
- Rare, flexural such as axilla, under breast, and groin, reddish-brown and discrete papules
Sites of involvement
- Nails, classic findings
- 20 nail dystrophy (trachyonychia)
- Classically, dorsal pterygium
- Pits common
Sites of involvement
- Mucosal
- Mouth, vagina, esophagus, conjunctiva, urethra, anus, nose, larynx
- Glans penis most common (annular lesion)
- Leukoplakia/erythroplakia, erosive, or generalized desquamative vaginitis
- Conjunctival LP, cicatricial conjunctivitis
Sites of involvement
- Scalp
- End-stage: scarring alopecia
Pseudopelade of Brocq
- Scarring alopecia and fibrosis, end-stage follicular fibrosis, caused by primary inflammatory dermatosis such as LP, LE, pustular scarring forms of folliculitis, favus, scleroderma, and sarcoidosis
Drug-induced LP, described distribution and name the offending drugs
- Symmetric eruption on trunk and exts, photodistribution
- 5-FU, carbamazepine, chlorpromazine, diazoxide, ethambutol, quinine/quinidine, tetracyclines, thiazides, and furosemide
Name special forms of LP/lichenoid eruption (total 6)
- Drug-induced LP
- LP-lupus overlap
- Lichen planus pemphigoides
- Keratosis lichenoides chronica (Nekam Disease)
- LP and malignant transformation
- Lichenoid keratosis
Lichenoid keratosis (LP-like keratosis)
- Sun-exposed skin of exts
- Histological features of LP with parakeratosis
- Co-occurs with solar lentigo, SK, and AK
LP and malignant transformation, common sites
- Risk low to none at all
- Risk increases with longstanding disease, erosive, or atrophic type, tobacco use
- Common sites includes tongue, gingiva, buccal mucosa, with hx of either arsenic or X-ray exposure
Lichen planus pemphigoides (differentiate from bullous LP)
- Either on top of LP lesion or de novo on uninvolved skin
- Bullous LP results from intense lichenoid inflammation and extensive liquefaction degeneration of basal keratinocytes
- Histologically LP with linear deposition of IgG and C3 at DE junction
Name the offending drugs for lichenoid drug eruption (7 total)
- Beta-blockers, antimalarials, captopril, gold, penicillamine, HCTZ, NSAIDs
Name the causative agents for lichenoid dermatitis (6 total)
- Color film developers, dental restorative materials, musk ambrette, nickel, aminoglycosides, gold
Name medical conditions associated with LP
- Autoimmune chronic active hepatitis
- Primary biliary cirrhosis
- Postviral chronic active hepatitis
- HCV in some populations