Lichenoid Reaction Flashcards
(12 cards)
What are lichenoid reactions (LR)?
A group of lesions similar to lichen planus clinically and histologically, involving skin or oral mucosa
Lichenoid reactions include lichenoid mucositis, lichenoid drug reactions, and lichenoid lesions.
What distinguishes lichenoid reactions from lichen planus?
The underlying cause is identifiable and withdrawal of the same leads to remission of these lesions.
What are some known triggering factors for lichenoid reactions?
Triggers include:
* Dental restorative materials
* Graft-versus-host disease
* A broad range of drugs
* Flavoring agents
* Tobacco chewing
Examples of drugs associated include antimalarials, NSAIDs, antihypertensives, oral hypoglycemics, and beta blockers.
True or False: Contact hypersensitivity to dental restorative materials is primarily mediated by galvanism.
False
Recent studies suggest a cell-mediated contact hypersensitivity, mostly involving type IV delayed hypersensitivity reaction.
What are the clinical features of lichenoid reactions?
They present as:
* Reticular lesions
* Erythematous lesions
* Erosive lesions
* Ulcerations
* Whitish streaks similar to Wickham’s striae
Clinical manifestations are very similar to lichen planus.
What is the widely accepted diagnostic criterion for lichenoid reactions?
Disappearance of lesions after withdrawal of the triggering agent and recurrence upon reintroduction.
How does the inflammatory infiltrate in lichenoid reactions differ from that in lichen planus?
In lichenoid reactions, the infiltrate is diffuse and extends deeper into the lamina propria, unlike the sharp band seen in lichen planus.
What types of cells are typically found in the inflammatory infiltrate of lichenoid reactions?
The infiltrate consists of:
* Plasma cells
* Eosinophils
* Lymphocytes
* Increased colloid or Civatte bodies may be present.
What is lichenoid dysplasia?
Epithelial dysplasia associated with a band-like inflammatory infiltrate that can mimic lichen planus.
It may be seen in proliferative verrucous leukoplakia (PVL), which is common in older females and not associated with tobacco usage.
What role does identification and elimination of triggering factors play in the management of lichenoid reactions?
It plays a major role in the management and can lead to resolution of lichenoid lesions.
How long can lichenoid lesions take to resolve?
They can take many months or longer to resolve.
What is the reported malignant transformation rate in oral lichenoid lesions?
The malignant transformation rate is reportedly higher in oral lichenoid lesions that do not have all typical clinical and histologic features of oral lichen planus.
