Lichen planus

Question 1

Incidence

Answer 1

Less 1%

Question 2

Lesions

Answer 2

flat-topped (Latin planus,“ at”), pink to violaceous, shiny, and pruritic polygonal
papules

Violaceous,with white lines(Wickhamstriae)

Question 3

4Ps in the lesion.

Answer 3

papule
Purple
pruritic
Polygonal

Question 4

Prediliction

Answer 4

Flexural arms and legs wc can be generalized

Wrists(flexor),lumbar region, shins (thicker, hyperkeratotic lesions), scalp, glans penis (see Section 34), and mouth

Question 5

Main symptom

Answer 5

Pruritus, Pain in mouth

Question 6

Gender

Answer 6

Female

Question 7

How to dx.

Answer 7

Clinical but confirmed w histopath.

Question 8

Dermatopathology.

Answer 8

Inflammation with hyper- keratosis, increased granular layer, irregular
acanthosis, liqueaction degeneration of the basal cell layer, and band-like mononuclear
infiltrate that hugs the epidermis. Keratinocyte apoptosis (colloid, Civatte bodies) found at the dermal–epidermal junction. Direct immuno-
uorescence reveals heavy deposits of brin at the junction and IgM and, less requently, IgA, IgG, and C3 in the colloid bodies.

Question 9

Treatment

Answer 9

Topical glucocorticoids with occlusion for cutaneous lesions. Intralesional triamcinolone (3mg/ml)

Cyclosporine and triamcinolone “mouthwash” - severely symptomatic oral LP.

systemic steroid, cyclosporine,
systemic retinoids.

Question 10

Tx for generalized LP or resistant to topical tx.

Answer 10

PUVA photochemotx.