Lichen Planus -...
Transcript of Lichen Planus -...
Lichen Planus
• Common inflammatory disease of the skin, mucous membranes, and hair follicles
• The four ‘P’s– Pruritic – Polygonal – Planar– Papules
Etiology
• Exactly not known
• Infections: HCV, HSV, HPV, H. pylori
• Stress, Alcohol, Tobacco, Dental amalgams
• Autoimmune: A/W Vitiligo, AA, DM
• Drug induced
Clinical features
• Flat-topped polygonal, violaceous, pruritic papules
• Flexors, Trunk
• Wickham’s striae
• Koebner’s phenomenon
Classification
• Morphology
• Configuration
• Distribution
Morphology
• Classical
• Hypertrophic
• Atrophic
Configuration
• Linear
• Annular
• Reticulate (Net-like)
Distribution (Site)
• Trunk and flexors (Classical LP)
• Shins (Hypertrophic LP)
• Scalp (Lichen planopilaris)
• Oral cavity (OLP)
• Nails (Pterygium)
Drug induced LP
• Gold salts
• Beta blockers
• Antimalarials (OLP)
• Thiazide diuretics
• Furosemide
• Spironolactone
• Penicillamine
Clinical features
• Extensor involvement
• Bilaterally symmetrical
• Photosensitivity
• Photoaggravation
Treatment
• Corticosteroids
– Topical: Clobetasol, halobetasol (0.05% cream/ointment)
– Intralesional: Triamcinolone acetonide (10-40 mg/ml every 3 weeks)
– Systemic: Prednisolone, Methylprednisolone, Deflazacort (0.5-1 mg/kg)
• Immunosupressives: MTX, Cys, etc.
• Antihistamines: Sedative/Non-sedative
• Withdrawal of drug in case of DILP
• Removal of dentures for OLP