13. Lichen planus

Question 1

Lichen planus definition

Answer 1

• Common chronic inflammatory disease
• Affects oral mucosa, skin, genital mucosa, nails and hair

Question 2

Lichen planus Etiology

Answer 2

• Not well known
• T-cell mediated immune reaction against epithelial basal cells possible

Question 3

Clinical features of Lichen planus

Answer 3

• Small White papules that coalesce-> forms symmetrical pattern
• 6 forms-> Reticular
  Erosive
  Ulcerative
  Atrophic
  Hypertrophic
  Bullous pigmented
• Remissions and exacerbations
• Located on buccal mucosa, tongue, gingiva and lips
• Middle aged individuals w/ 2:1 female to male ratio

Question 4

Diagnosis of Lichen planus

Answer 4

• Clinically
• Good prognosis

Question 5

Laboratory tests of Lichen planus

Answer 5

• Biopsy and histologic examination
• Direct immunofluorescence

Question 6

Differential diagnosis of Lichen planus

Answer 6

• Fordyce spots
• Chemical burn
• Candidiasis
• Leukoplakia
• Erythroplakia

Question 7

Treatment of Lichen planus

Answer 7

• Mild asymptomatic forms dont need treatment
• Severe symptomatic cases-> systemic corticosteroids(prednisolone 20-40mg per day)
• Topical corticosteroids for less severe cases
• Topical antiseptic mouthwashes avoided