Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FINALS - Oral Medicine > Lichen Planus > Flashcards

Lichen Planus Flashcards

1
Q

What is lichen planus?

A

A chronic disease, affecting 1% of the population.

Typically those aged 30-50

Can be idiopathic, drug related, or rarely related to systemic disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What types of lichen planus are there?

A

Reticular
Atrophic/erosive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How would you determine if a lichen planus was atrophic?

A

If there is an accompanied erythemous change (redness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How would you determine if a lichen planus was erosive?

A

If there is yellowish fiberous covering over the base of the connective tissue, where there is very little epithelium left.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Histologically how would you identify lichen planus?

A

Chronic inflammatory cell infiltration

Saw tooth rete ridges

Basal cell damage

Partchy acanthosis

Parakeratosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the mechanism by which the epithelium changes during a lichenoid reaction?

A
  • Lymphocyte activation
  • Overeaction to normal triggers
  • Can be triggered by hep C, herpes, amalgam, medicines.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which drugs can trigger a lichenoid reaction?

A

ACE inhibitors
Beta-adrenergic blockers
Diuretics – Bendroflumethiazide, frusemide
NSAIDs
DMARDs
Gold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can trigger lichenoid reactions?

A

Genetic factors
Physcial/emotional stress
Injury to skin
Localised skin disease
Systemic viral infection
Contact allergy (metals/amalgam)
Medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the symptoms of lichen planus?

A

Often none
Thinning of epithelium may lead to sensitivty to hot/spicy food
Burning sensation in the mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List two other conditions which gingival lichen planus may be confused with?

A

Gingival pemhigoid and plasma cell gingivitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why might it be challenging to biopsy suspected gingival lesions?

A

Could damage junctional tissues attached to the bone/tooth. Risk loss of attachment for a biopsy that MAY be nothing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How would you differentiate between plaque induced gingivitis and gingival lichen planus?

A

No clear band around the tooth
No enlarged tissue onto the tooth
Colour is consistant with that of tissue further down the tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should be considered when taking a biopsy of the tongue?

A

Easy to take the sample but may be painful when healing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the cause of lichen planus on the tongue?

A

Its usually idopathic, but lateral lesions may be caused by nearby amalgam.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which metal in an amalgam filling is the cause of lichenoid reactions?

A

There has not been any one agent identified.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should you consider removal of an amalgam to manage a lichenoid reaction?

A

If it is potentially malignant
If it symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the main management principles for lichen planus?

A

Removal of causative agent
Biopsy
Blood tests
Local topical agents
Topical steroids

18
Q

What topical steroids should be given in a primary care setting?

A

Beclomethasone MDI 0.5mg/puff, 2 puffs 2-3/day

Betamethasone rinse, 1mg/10ml, 2mins/twice daily

19
Q

When should topical steroids be prescribed for oral lesions?

A

If they are persisting beyond typical remedies.

If they are symptomatic.

20
Q

What treatments for lichen planus can be given in a hospital setting?

A

Higher stregnth steroids (clobetasol)

Topical tacrolimus
Hydroxychloroquine
Systemic immunomodulators

21
Q

What is graft versus host disease?

A

A disease where the host immune cells reject grafted tissue, resulting in systemic issues including possible lichenoid reactions.

22
Q

In lichen planus Skin cases what is the percentage you are also likely to have oral lesions?

A
  • 50%
23
Q

In Lichen Planus oral cases what is the percentage with skin lesions?

A
  • 10-30%
24
Q

What type of Lichen Planus is this?

A
  • Reticular
25
Q

What type of Lichen Planus is this?

A

Atrophic / erosive

26
Q

What type of Lichen planus is this?

A
  • Ulcerative
27
Q

What are the Oral lichen planus sites?

A
  • Buccal mucosa
  • Gingivae (Desquamative Gingivitis)
  • Tongue (lateral aspect, dorsum)
  • Lips
  • Palate
28
Q

What is the most common oral site for Lichen planus?

A
  • Anywhere on Buccal mucosa but more likely on
  • Anterior at commisure
  • Mid
  • Posterior around 3 rd molar tooth
  • An easy biopsy site
29
Q

When found in Isolation what is Gingival Lichen planus also called?

A
  • Desquamative gingivitis
  • Has very erythematous appearance
30
Q

What is very important in settling gingival lichen planus?

A
  • OHI
  • Esp interdental
  • Seems plaque driven in many pts
31
Q

What lichen planus is this?

A
  • Gingival lichen planus
32
Q

When Lichen planus is found on the Dorsum of the tongue what is its trigger?

A
  • Usually idiopathic
  • Loss of papillae and smooth tongue surface
33
Q

When Lichen planus is found on the lateral aspect of tongue what is the trigger usually?

A
  • Drug or amalgam trigger
  • Amalgam most likely if there is isolated lateral tongue lesion
  • Drug if multiple lesion
34
Q

What is this an example of?

A
  • Tongue lichen planus
35
Q

What is this a type of ?

A
  • Lip lichen planus
36
Q

During a lichenoid reaction what occurs histologically?

A
  • Chronic inflammatory cell infiltrate
  • Saw tooth rete ridges
  • Basal cell damage
  • Parakeratosis
37
Q

Describe what is going on histologically in this picture

A
38
Q

What other sites of the body can be affected by Lichen Planus?

A
  • Skin
  • Scalp
  • Genital
  • Hair
  • Nails
39
Q

Histologically what disease is this picture showing?

A
  • Lichen planus
  • Clear T cell infiltrate into the basal membrane area of connective tissues
  • The dark purple lymphocytic band hugging the basement membrane is key diagnostic feature of LP
40
Q

Describe this Lichenoid reaction

A
  • Chronic inflmmatory cell infiltrate (T cell)
    -Saw tooth rete ridges
  • Basal cell damage
  • Patchy acanthosis of epithelial layer
  • Parakeratosis of superficial epithelium
41
Q

Using what occurs histologically what info does this give us in regard to Lichen Planus as a disease?

A
  • Shows lymphocyte activation which means the body is attempting to remove a perceived threat
  • Most likley the langerhans cells in epithelium are presenting an antigen which triggers an immune response (T lymphocytes) to remove chronic irritation - causing change in epithelium
  • Lichen Planus does not have singular cause
42
Q

What are some other thoughts to cause of LP?

A
  • Genetic predisposition
  • Physical and emotional stress
  • Injury to skin called koebnerisation

FINALS - Oral Medicine (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions