Brainscape's Knowledge GenomeTM

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


See full index

Lichen > Learn to Like the Lichens > Flashcards

Learn to Like the Lichens Flashcards

1
Q

Common chronic vulvar disease with bimodal distribution

A

lichen sclerosus

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

Most common location of lichen sclerosus on vulva

A 
100% labia
70% clitoris
67% perineum
32% buttocks
32% perianus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Can lichen sclerosus be asymptomatic?

A

Yes

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

Most common symptom of lichen sclerosus

A 
pruritus
severe
intolerable
pruritus ani
can interfere with sleep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Other less common symptoms of lichen sclerosus

A 
burning
soreness
dysuria
dyspareunia
apareunia
pain with defecation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how might lichen sclerosus present in children?

A

pruritis
constipation
prepubertal bleeding from trauma
dysuria

*still classic exam findings in children, no need to biopsy
may regress with puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

On exam, signs of lichen sclerosus include…

A 
hypopigmentation
ivory white papules or plaques
cigarette paper appearance
cellophane-like sheen
hour glass/figure of eight appearance
typically **limited to labia majora
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs of secondary changes of lichen sclerosus

A 
fusion of labia minora
scratching yields open areas 
erosions
urinary retention
tearing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

vulvar whitening that is completely symmetric and no loss of labia majora is most likely…

A

vitiligo

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

lichen sclerosus histopathology

A

thinned layer of epidermis, sometimes hyperkeratosis of surface, loss of rete pegs, lymphocytic infiltrate underneath (inflammation)

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

extragenital involvement

A

neck, shoulder, flexor aspects and wrists, o

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

lichen sclerosus treatments, “general care measures”

A 
bland emollients
100% cotton underwear
avoid tight, occlusive clothing or trauma
no soaps to the vulva
sitz baths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

lichen sclerosus treatment, medication first line

A

superpotent steroid ointment

clobetasol propionate 0.05% thin, invisible film layer BID for 1 month, then QD for 2 months

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

lichen sclerosus treatment, medication for maintenance

A 
clobetasol BID (class I) 
OR
triamcinolone 0.1% QD to BID (class IV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

lichen sclerosus, other medical treatment

A

intralesional triamcinolone with bupivacaine Qmonth (for itching)
-
oral steroids (prednisone, prednisolone, methyl prednisolone), rare
-
retinoids
-
Potoba (potasium para-aminobenzoate) inhibits glycosaminoglycan secretion by skin fibroblasts
- chloroquine, antimalarial

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

lichen sclerosus, surgical treatment

A

LIMITED due to high rate of recurrence.

Division of mucosal adhesions helpful in clitoral phimosis, introital narrowing

17
Q

pediatric lichen sclerosus treatment

A
  • superpotent to midpotency steroids with maintenance
  • long-term follow up
  • do not need to biopsy
18
Q

classic lichen simplex chronicus phrase and exam finding

A

severe itch-scratch cycle

lichenification: palpably thickened skin, exaggerated skin markings, scale, cracks

19
Q

Treatment for severe itch-scratch cycle

A
  • oral steroids (short term)
  • cefadroxil 500 mg PO BID x 7 days
  • amitriptyline 25-50 mg for 7 days or Atarax 25-50 mg QD to QID PRN
  • Triamcinolone IM inj Q1month x3 doses
  • White cotton gloves
20
Q

lichen planus etiology

A

likely autoimmune

may be related to ACE-i use, beta-blockers, spontaneously

21
Q

lichen planus histology

A

hyperkeratosis
degeneration of basal layers
lymphocytic infiltrate of the dermis
epidermal acanthosis

22
Q

lichen planus characteristic signs

A
  • pruritic papule
  • may look like LS
  • erosion with white lacy edge
  • on keratinized skin
  • erosive on vulva, vagina, mouth
  • non-erosive on extremities
23
Q

lichen planus symptoms

A
  • pruritus
  • irritation
  • rawness
  • burning
  • dyspareunia
  • apareunia
24
Q

lichen planus types

A
  1. erosive (85% cases) - erosions
  2. classical - small purple, polygonal papules, reticulate lace pattern
  3. hypertrophic - single or multiple white-hyperkeratotic papules and papules
25
Q

lichen planus treatment, first line

A
  • intravaginal dilator
  • topical steroids (clobetasol or hydrocortisone acetate suppositories QHS)
  • topical estrogen
  • tacrolimus
26
Q

lichen planus, other treatments

A
  • anti-inflammatory abx
  • misoprostol
  • hydroxychloroquine
  • retinoids
  • cyclosporine
  • cyclophosphamide
  • azathioprine
  • etanercept
  • mycophenolate
  • MTX
27
Q

how to treat lichen sclerosus or lichen planus vulvar pain

A
  • TCA
  • anticonvulsants
  • PT
  • sexual counseling
28
Q

lichen planus, surgical treatment

A

lysis of adhesions

  • improve urine flow, decrease UTI
  • allow intercourse
29
Q

If the diagnosis is unclear, or refractory to treatment, then _____

A

biopsy

30
Q

true or false, ointments preferred over creams

A

true

ointments cause less irritation
petroleum jelly base stays longers

Lichen (1 decks)

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