Lichen planus

Question 1

Lichen planus with cicatricial alopecia of the scalp is called ?

Answer 1

Graham little syndrome.

Question 2

Graham-little syndrome triad ?

Answer 2

1. Cicatricial alopecia of the scalp.
2. Perifollicular keratotic papules of the skin.
3. Nonscarring alopecia of the axillae and pubic area.

Question 3

histopathology of LP?

Answer 3

• band like lymphohistiocytic infiltrate.
• Necrotic keratinocytes.
• irregular acanthosis “ Saw-toothed appearance”
• Hyperorthokeratosis and granulosis.

Question 4

Vulvovaginal lichen planus Forms ?

Answer 4

• Erosive (85%-90%).
• Papular.
• Hypertrophic.

Question 5

Hypertrophic LP typical location ?

Answer 5

Ant. lower legs

Question 6

lichen planus most commonly affects the ?

Answer 6

Extremities, particularly the flexural surface of the WRISTS and ankles, forearms, lower legs and thighs, palms and soles.

Question 7

just flip the card!! some important info. about LP ?

Answer 7

• Bullous LP is rare.
• Pterygium is the most specific nail abnormality.
• Buccal mucosa involvement is the most common in oral LP.
• Acitretin is the 1st line TTT.
• Can cause cicatrical alopecia.
• Long lasting erosive LP can result in SCC.
• could be associated with viral infections (ex. HCV)

Question 8

Lichen planopilaris types ?

Answer 8

• Classic type.
• Frontal fibrosing alopecia.
• Graham-little syndrome.

Question 9

Which special signs that we can see in LP ?

Answer 9

• kobner phenomenon.

- Wickham’s striae.

Question 10

Clinical variants of LP ?

Answer 10

• Hypertrophic LP. (typically ant. lower legs)
• Hyperpigmented LP. (sun-exposed areas or flexural areas)
• Annular LP. (violaceous plaques with central clearing and atrophy)
• Actinic LP. (sun-exposed areas, triggered by UV)
• bullous LP and LP pemphigoides.
• Lichen planopilaris.

Question 11

The most specific nail abnormality in LP is the formation?

Answer 11

Dorsal pterygium.

Question 12

LP in direct immunoflurescence shows ?

Answer 12

Deposition of several immunoglobulins at cytoid bodies.

Question 13

Oral lichen planus. Clinical forms?

Answer 13

• Reticular.
• Atrophic.
• Erosive. (ass. with risk to SCC)

Question 14

describe the scalp involvement in Lichen planus?

Answer 14

• LP involves hair follicles in a condition known as lichen planopilaris (LPP) cicatricial alopecia (frontal fibrosing alopecia) may result.
• women are affected much more commonly than men

Question 15

TTT of LP ?

Answer 15

• 1st line: Acitretin.
• Topical: CS and calcineurin inhibitors.
• Systemic: CS, oral retinoids, cyclosporine, MTX and phototherapy.

Question 16

Type of lichen planus which may be complicated by SCC is ?

Answer 16

Ulcerative mucosal type.