Lichenoid Dermatoses

Question 1

Name this dermatologic diagnosis

Answer 1

Lichen planus

(upper dermis is eating away the lower dermis)

Question 2

Name that dermatologic diagnosis

What are common features of this disorder?

What is an associated infection?

Answer 2

Lichen planus

• +++pruritus
• silver, grey, purple colour
• Increased prominence to arms+lips (distal predominance)

Hepatitis C

Question 3

Name this dermatologic diagnosis

What are characteristics of this disorder?

Answer 3

Nail lichen planus

• Spoon shaped
• Pterygium (arching of the nail)

Question 4

Name that dermatologic diagnosis

Answer 4

Lichen planopilaris

• Scarring alopecia

Question 5

Name that dermatologic diagnosis

What are associated features with this diagnosis?

What is the recommended treatment

Answer 5

Oral Lichen Planus or VVG (vulvo-vaginal gingival)

• Frequent candidal infections
• Weight changes
• Dysphagia

Treatment

• high-dose steroids
• MMF
• Immunosuppressants

Question 6

Name that dermatologic disorder

Where is it most commonly located?

What can it be mistaken for?

Answer 6

Hypertrophic lichen planus

Legs

Squamous cell carcinoma

Question 7

Name that dermatologic diagnosis

Answer 7

Bullous lichen planus

Question 8

What is the recommended treatment for lichen planus?

Answer 8

• Directed towards the type of lichen planus
  
  • Cutanaeous = topical steroids
  • Acute = PO steroids
  • Mucosal = 12mo steroids + rituximab
• If extensive but not super symptomatic = PUVA
• If treatment resistant = MTX

Question 9

What are common causes of lichenoid drug eruptions?

Answer 9

• Penicillamine
• Antimalarials (chloroquine, HCQ, quinacrine)
• Cardiac medications (methyldopa, labetalol, captopril, enalapril)
• Thiazides (HCTZ, chlorothiazide [can be photoinduced])
• Gold salts
• Quinidine
• NSAIDs

Question 10

Name that dermatologic disorder

What population is this commonly seen in?

How long does it typically occur?

Answer 10

Lichen striatus

5-15yo

Persists for months (self-resolving; potent TCS can speed resolution)

Question 11

Name that dermatologic disorder

What type of histology is seen with this diagnosis?

When should this be expected to spontaneously resolve?

How can symptoms be managed?

Answer 11

Lichen Nitidis

Ball and claw histology

1-8 years

TCS

Question 12

Name the 2 presentations and this dermatologic disorder

What is unique about this management?

What other management strategies can be used?

Answer 12

Pityriasis lichenoides

• Acute = PLEVA
• Chronic = PLC

Erythromycin x 4-6 months

UVB phototherapy, MTX

Question 13

Name the 2 dermatologic conditions with this appearance

Answer 13

• Lichen planus pigmentosus
  
  • geographic, macular grey dyspigmentation
  • face, upper limbs
• Erythema dyschromium perstans
  
  • ovoid with clear borders
  • truncal, extensive