LICHEN PLANUS

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LICHEN PLANUS

• BY
• DR.MAHESH MATHUR,MD,DVD,DCP(UK)

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LICHEN PLANUS

• DIFINETION
• CHRINIC INFLAMMATORY DISEASE OF UNKNOW ETIOLOGY
  CHARECTRISED BY ------
• SHINY VIOLACEOUS ITCHY FLAT TOPPED PAPULAR
  LESIONS MORPHOLOGICALLY
• HISTOLOGICALLY CHARECTERISED BY --------
• LIQUIFIED DEGENRATION OF BASAL CELL LAYER AND
  BAND LIKE LINEAR CELLULAR
• INFILTRATION IN DERMIS

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INCIDENCE

• WORLD WIDE MUCH MORE IN ASIAN COUNTRIES
• 1 TO 2 OF ALL NEW CASES IN
• DERMATOLOGY CLINIC
• SKIN LESION SUBSIDES IN 50 OF CASES
• IN 9 MONTHS AND 100 BY 18 MONTHS
• MUCOUS MEMBREANS INVOLVE IN 30 OT 70 CASES
• NAIL INVOLMENT IN 10 OF CASES

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PATHOGENESIS

• AUTOIMMUNE
• INFILTRATION OF CD 4 / CD 8CELLS
• INCREAS IN LangerhanS CELLS NUMBER IN SKIN
  LESIONS
• FAMILIAL- HLA B7 -

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CLINICAL TYPES

• HYPERTROPHICUS
• FOLLICULAR
• ACTINICUS
• PIGMENTOSUS
• ANULAR
• LINEAR
• GUTTATE
• NAIL- 15
• MUCOSAL- 40 TO 60
• ORAL
• PERIANAL
• ESOPHAGIAL
• GENITAL

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TYPICAL LICHEN PLANUS
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TYPICAL LICHEN PLANUS

• SHINY,
• VIOLACEOUS
• PAPULAR
• LESIONS

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KOBNERS PHENOMENON
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WICHAMS STRAIE
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LICHEN PLANUS HYPERTROPHICUS
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LICHEN PLANUS HYPERTROPHICUS
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LICHEN PLANUS - BULLOSUS
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BULLOUS LICHEN PLANUS
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LICHEN PLANUS
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ANNULAR LESION AT SHAFT OF PENIS
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LICHEN PLANUS ACTINICUS
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LICHEN PLANUS TROPICUS
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LICHEN PLANOPILARIS
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CICATRICAL ALOPECIA
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LICHEN PLANS AT PALM
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LICHEN PLANUS AT FOOT
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LICHEN PLANUS-ORAL LESION
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ORAL LICHEN PLANUS
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LICHEN PLANUS AT TONGUE
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LICHEN PLANUS -TONGUE
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EROSIVE LICHEN PLANUS
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PERI ANAL LICHEN PLANUS
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LICHEN PLANUS PERIANAL REGION
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NAIL CHANGES IN LICHEN PLANUS
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LICHEN PLANUS- NAILS
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HISTOPATHOLOGY

• HYPERKERATOSIS
• HYPERGRANULOSIS
• ACANTHOSIS
• LIQUFYING DEGENERATION
• OF BASAL CELL LAYER
• EOSINOPHILIC CYTOID BODIES

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HISTOPATHOLOGY HIGH MAGNIFICAITON
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LICHEN PLANOPILARIS
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IMMUNOFLOURACENCE

• IgG C3
• DEPOSITION
• AT DERMOEPIDERMAL
• JUNCTION

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IMMUNOFLOURACENCE

• CYTOID BODIES
• IGM STAINING

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DRUGS CASUUSING LICHENOID REACTION

• ANTIMALARIALS
• THIAZID DIURATICS
• ISONIAZID
• CHLORPROPAMID
• B-BLOCKERS
• KETOCONAZOLE
• NSADS
• ACE INHIBITORS
• TETRACYCLINE
• COLOURING AGENTS

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LICHENOID DRUG RASH
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TREATMENT PROGNOSIS

• STEROIDS-TOPICAL SYSTAMIC
• PUVA
• CYCLOSPOIN
• AZOTHIOPRIN