Lichen Planus

Question 1

Clinical patterns of LP

Answer 1

reticular, atrophic, ulcerative

Question 2

sites LP affects

Answer 2

buccal mucosa
gingival-> desquamative gingivitis
tongue, lips, palate

Question 3

Histology

Answer 3

hyper/parakeratosis
degeneration of basal cell layer
hugging band of T lymphocyte
thickened basement membrane
emigration of lymphocytes into basal cells
CD4 and CD8 lymphocytes

Question 4

pt info

Answer 4

<1% malignant transformation rate (inc if inc risk factors)
common condition
monitor clinical photos
OHI
limit risk factors
if symptomatic referral

Question 5

OLLs

Answer 5

more often widespread
bilateral/ mirrored
poorly responsive to steroid tx

Question 6

restorative materials causing OLLs

Answer 6

gold amalgam

Question 7

drugs that cause OLLs

Answer 7

NSAIDs, anti-malarials, b blockers, anti-hypertensives

Question 8

Primary care tx

Answer 8

chlorhexidine
topical steroids
- beclomethasone MDI
0.5mg/ puff 2puffs 2-4x daily, vent over ulcer
- betamethasone rinse
2 tabs/2tsp water refrain from eating or drinking for 30 mins, don’t swallow

Question 9

secondary care tx

Answer 9

systemic steroids
prednisilone
high dose short duration 30mg/5 days.
can be used once a month
adrenal suppresion>steroid dependency>taper

systemic immunomodulators
hydroxychloroquine