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BDS4 Oral Medicine > Lichen Planus > Flashcards

Lichen Planus Flashcards

1
Q

What is Lichen Planus?

A
  • Chronic inflammatory disease
  • Affects approx 1% of pop
  • Mainly 30-50 age
  • Can be idiopathic or drug related
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2
Q

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

A
  • 50%
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3
Q

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

A
  • 10-30%
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4
Q

What type of Lichen Planus is this?

A
  • Reticular
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5
Q

What type of Lichen Planus is this?

A

Atrophic / erosive

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6
Q

What type of Lichen planus is this?

A
  • Ulcerative
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7
Q

What are the Oral lichen planus sites?

A
  • Buccal mucosa
  • Gingivae (Desquamative Gingivitis)
  • Tongue (lateral aspect, dorsum)
  • Lips
  • Palate
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8
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
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9
Q

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

A
  • Desquamative gingivitis
  • Has very erythematous appearance
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10
Q

What other diagnosis does desquamative gingivitis have a similar clinical appearance to?

A
  • Gingival pemphigoid
  • And plasma cell gingivitis
    (Histology important to tell the difference)
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11
Q

Why is a biopsy for gingival lichen planus difficult?

A
  • Risk of damaging attachment area of gingiva/tooth
  • Adherent attached mucosa damaged lifting from bone
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12
Q

What is very important in settling gingival lichen planus?

A
  • OHI
  • Esp interdental
  • Seems plaque driven in many pts
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13
Q

What is the presentation of gingival lichen planus?

A
  • Can be patchy
  • Some forms more ‘typical’ reticular pattern
  • Varies
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14
Q

What lichen planus is this?

A
  • Gingival lichen planus
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15
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
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16
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
17
Q

What do you need to caution the pt when receiving a tongue biopsy?

A
  • Easy procedure
  • Painful when healing
18
Q

What is this an example of?

A
  • Tongue lichen planus
19
Q

What is this a type of ?

A
  • Lip lichen planus
20
Q

During a lichenoid reaction what occurs histologically?

A
  • Chronic inflammatory cell infiltrate
  • Saw tooth rete ridges
  • Basal cell damage
  • Parakeratosis
21
Q

Describe what is going on histologically in this picture

A
22
Q

What are the symptoms of lichen planus?

A
  • Often none
  • May relate to thinning of epithelium so will be sensitive to hot/spicy food or have a burning sensation in the mucosa
23
Q

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

A
  • Skin
  • Scalp
  • Genital
  • Hair
  • Nails
24
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
25
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
26
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
27
Q

What are some other thoughts to cause of LP?

A
  • Genetic predisposition
  • Physical and emotional stress
  • Injury to skin called koebnerisation
28
Q
A

BDS4 Oral Medicine (22 decks)

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