It is characterized by polygonal, flattopped, violaceous papules and plaques with overlying, reticulated, fine white scale wickhams striae, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. This line has considerable relevance if we consider the above example. Media in category lichen planus the following 20 files are in this category, out of 20 total. Lichen planus is an uncommon disorder of unknown cause that most commonly affects middleaged adults. Lichen planus is a mucocutaneous disease characterized by nonspecific inflammation. Lichen planus is a chronic inflammatory skin condition affecting the skin and mucosal surfaces. Lichen planus is a common skin rash that is not contagious. Actinic lichen nitidus eruption was the best descriptor of their patient with clinical and histologic features of both photoinduced lichen planus and lichen nitidus. Lichen planus is chronic mucocutaneous disease of autoimmune origin, affecting around 0.
It is characterized by oval or irregularlyshaped brown to graybrown macules and patches on the skin. Lichen planuslike cutaneous lesions dr sampurna roy md. Majority of the patients of lichen planus, lichen planus pigmentosus and lichen planopilaris were in the age group of 2040 years. Areas that are exposed to sun such as the forehead, temples and neck are most commonly affe. Although oral lichen planus predominantly occurs in adults older than 40 years, younger adults and children can also be affected. Feb 24, 2020 lichen planus is a cellmediated immune response of unknown origin. Lichen planus is a chronic, inflammatory, autoimmune disease that affects the skin, oral mucosa, genital mucosa, scalp, and nails. Most people with lichen planus experience no to few symptoms, others may have painful sores or ulcers in the mouth. Oral lichenplanus clinical features, histopathology. A 23yearold italian woman presented with asymptomatic, symmetric, hyperpigmented patches on her face. Oral lichen planus is a relatively common manifestation, found in approximately 1% to 2% of individuals older than 15 years. Oral lichen planus olp is the mucosal counterpart of cutaneous lp. Signs and symptoms include patches of fine white lines and dots most commonly in the inside of the cheeks, gums, andor tongue.
Of 303 patients diagnosed with oral lichen planus, 58 19. Treatment, commonly with a steroid cream or ointment, often eases the itch and may reduce the rash until the condition clears. Lichen planus actinicus definition of lichen planus. Summertime actinic lichenoid eruption, a distinct entity. If this is the case, treatment may not be necessary. Oral lichen planus is a chronic inflammatory, a noninfectious disease that causes lesions on the buccal mucosa, tongue andor gums. Summertime actinic lichenoid eruption sale was first described by bedi1 in 1978. Jul 15, 2015 actinic lichen planus lp is a rare form of lichen planus, which is a condition that affects the skin andor mouth. In cases of oral lichen planus, the mucous membranes inside the mouth are the only area affected. Lichen nitidus is a rare benign chronic papular lesion of unknown etiology. With lichen planus, lichen means tree moss and planus refers to flat, and the reason its called that, is that lichen planus is a flattopped skin rash that looks a bit like tree moss.
The clinicohistopathological features of 75 patients of lichen planus were studied. It affects approximately 12% of the general adult population. Common symptoms may include lacywhite lesions in the mouth, which may cause a burning sensation. Lichen planus actinicus gene h kim md, radha mikkilineni md dermatology online journal 1. No permanent cure exists for the condition, but certain.
Lichenoid dermatitis project gutenberg selfpublishing. Lichen planus has been found to be associated with hepatitis c virus infection, chronic active hepatitis, and primary biliary cirrhosis. Oral lichen planus is a noninfectious, inflammatory condition that affects the membranes inside the mouth, and its a variation of the skin condition, lichen planus. Lichen planus pemphigoides is a rare condition characterized by blisters arising on normal or erythematous skin in a patient with concurrent lichen planus. Apr 04, 2018 lichen planus is a common skin rash that is not contagious. Actinic lichen planus is a variant form of lichen planus located on lightexposed areas, occurring in children or young adults dark skinned individuals living in tropical countries. Oral lichen planus is a inflammatory condition that affects the inside of the mouth. For some patients, the symptoms are mild, but for others, painful sores and red, inflamed tissues cause discomfort. The erythematous scaly form is the most common clinical presentation. The age range of the patients was from 5 to 60 years in males and 7 to 76 years in females. It is one of the most common dermatological conditions involving the oral cavity.
Lichen planus is a chronic inflammatory disease that affects skin and mucosa. Nouira k ey words actinic lichen planus, tunisia, sun exposure actinic lichen planus alp is a distinct variant of lichen planus mainly involving teenagers with an asian racial profile. Sunlight seems to be a triggering factor in most cases. It must be distinguished from bullous lichen planus, in which, as a consequence of severe basal cell hydropic degeneration, blisters arise within lichenoid papules or plaques. Oral lichen planusolp could either accompany the cutaneousskin lesions or. In actinic lp, specifically, affected people develop mildly itchy, coinshaped patches on sun exposed areas such as the face, the neck and the backs of the hands. Oral lichen planus is a chronic disease that causes painful patches inside the mouth. Lichen planus free download as powerpoint presentation.
In contrast to lichen planus and lichen planopilaris, linear lichen planopilaris of the face is more common in middleaged men. A clinicopathological study of cutaneous lichen planus. The oral manifestations of lichen planus have been described. People who have lichen planus develop flattopped, purple, or reddish bumps on their skin. Lichen planusa clinicohistopathological indian j dermatol.
Hence, there was a clinicopathological discrepancy. A 53yearold woman presented for evaluation and treatment of discrete, violaceous, annular plaques on the forehead and cheeks. It is derived from the greek word leichen0 means tree moss and latin word planus means flat. Women diagnosed with oral lichen planus must schedule a vaginal examination as 50 percent of women also have the rash near their genitals as well, increasing the risk for vulvar cancer. Lichen planopilaris, a subtype of lichen planus, is an inflammatory condition characterized by patchy or diffuse hair loss with erythematous papules and keratotic follicular lesions that evolve to cicatricial alopecia 2 history. There is irregular epidermal hyperplasia forming a characteristic sawtooth appearance with wedge. Clinicopathological study to evaluate oral lichen planus. An introduction to dermatology 1905 lichen planus 1. Oral lichen planus genetic and rare diseases information.
Lichen planus may affect the skin cutaneous lichen planus, oral cavity oral lichen planus, genitalia penile or vulvar lichen planus, scalp lichen planopilaris, nails, or esophagus. Oral lichen planus a study of associated factors with special reference to thyroid disease jairo robledosierra department of oral medicine and pathology, institute of odontology, sahlgrenska academy at university of gothenburg oral lichen planus olp is one of the most common and debilitating oral mucosal lesions in the adult population. A universal diagnostic criteria for oral lichen planus. Lichen planusa clinicohistopathological request pdf. Lichen planus causes, symptoms and treatment patient. Rare in children in west, but more common in children in asia and middle east indian j dermatol venereol leprol 2010. Lichen planus pigmentosus genetic and rare diseases. It leads to the severe destruction of the epithelial basal layer. The mean age of males was a decade lower than that of females in lp and lichen planus pigmentosus figure 1, figure 2. Scanning power view of lichen planus shows a lichenoid reaction pattern figure 1 characterised by the combination of degeneration of the basal layer of the epidermis and a band like lymphocytic infiltrate obscuring the dermoepidermal junction.
Other diagnoses like lichen planus actinicus lpa, lichen planopilaris lpp and oral lp were also confirmed histopathologically. Homeopathic treatment for oral lichen planus by dr. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Treatment strategies for lichen planus actinicus are based primarily on anecdotal reports but should include the use of sunscreens and sun avoidance 4. Lichen planus lp is a chronic inflammatory and immune mediated disease that affects the skin, nails, hair, and mucous membranes. Controversy about the use of terms actinic lichen planus alp and sale is also discussed. If you continue browsing the site, you agree to the use of cookies on this website.
It may be found with other diseases of altered immunity, such as ulcerative colitis, alopecia areata, vitiligo, dermatomyositis, morphea, lichen sclerosis, and myasthenia gravis. Actinic lichen planus genetic and rare diseases information. Several clinical morphologic patterns have been described, and multiple therapies with variable results have been used. What are the histopathologic features of lichen planus. A rare type of lichen planus, familial bullous lichen planus, could be generelated.
It was originally regarded as a variant of lichen planus but it is now considered a distinct entity. When lichen planus develops in the mouth, it often does not cause pain or other symptoms. Linear lichen planopilaris of the face is a rare variant of lichen planopilaris. Oral lichen planus with malignant transformation to invasive. Classic lp typically presents as pruritic, polygonal, violaceous flattopped papules and plaques. Lichen planus see a picture of lichen planus and other skin eruptions see images comment from. The clinical and histopathologic features of actinic lichen planus in 16 patients were studied. The histopathologic features distinguish lichen planus based on the presence of irregular acanthosis and colloid bodies in the epidermis with destruction of the basal layer. Lichen planus actinicus is a photodistributed variant of lichen planus that most often occurs in individuals with dark complexions. Lichen planus actinicus is a distinct clinical variant of lichen planus in which lesions are limited to sunexposed areas of the body. Lichen planopilaris, also called follicular lichen or follicular lichen planus, was initially described by pringle in 1895. Lichen planus lp is a distinctive entity with prototypic lichenoid papules that show distinctive color and morphology, develop in typical locations, and manifest characteristic patterns of evolution.
Lichen planus lesions are described using the six ps. Lichen planus lp is an inflammatory skin condition with characteristic clinical and histopathological findings. Selflimiting, lasting 1 2 years, although longer for oral lesions. Lichen planus is a skin rash caused by an immune response. Jul 06, 2008 histopathology skin lichen sclerosus et atrophicus. In all clinically diagnosed cases of lph, histopathology was confirmatory. The majority of the patients were young, and men and women were almost equally affected. This is also known as lichen planus actinicus, actinic lichen niditus, lichen planus atrophicus annularis, lichen planus subtropicus, lichen planus tropicus, lichenoid melanodermatitis, and summertime actinic lichenoid eruption 9. Hydroxychloroquine, intralesional glucocorticoids, and acitretin with topical glucocorticoids have been used successfully in patients with lichen planus actinicus. There are several clinical types of lichen planus that share similar features on histopathology. Lichen planus is a cellmediated immune response of unknown origin.
Lichen planus lp is a chronic mucocutaneous disorder of the stratified squamous epithelium that affects oral and genital mucous membranes, skin, nails, and scalp. Universal diagnostic criteria for oral lichen planus patil, et al. However 7 cases were diagnosed as lichen planus hypertrophicus lph on histopathology. It may be found with other diseases of altered immunity, such as ulcerative colitis, lichen sclerosis, myasthenia gravis etc. Microscopic features, similar to the gross morphology, are distinctive although the. A reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science 1900 14586857880. Characteristic features include distinctive purplish, flattopped papules discrete or coalescent into plaques on the trunk and flexor surfaces.
The biopsy specimen and the clinical presentation were consistent with lichen planus actinicus. The lesions are multiple more than 10 lesions, bilateral, and often symmetrical with prominent associated pruritus. Lichen nitidus mainly affects children and young adults. The lesions in some patients may remit spontaneously with sun avoidance. Its prevalence in the general population is around 1% to 2%, and there are a large number of cases in females. Histopathology skinlichen sclerosus et atrophicus youtube. Allergic reactions to amalgam metal alloys dental restorations fillings may contribute to the oral lesions identical to oral lichen planus lesions both clinically as well as histologically. Nouira k ey words actinic lichen planus, tunisia, sun exposure actinic lichen planus alp is a distinct variant of lichen planus mainly. Lichen planus causes, symptoms, diagnosis, treatment. Lichen planus complications include oral cancer, vulvar cancer, squamous cell carcinoma and penile cancer. July 23 as of now the lichen planus rash pretty much covers 95 percent of my body, and some places i have scratched to the point that there are extremely dark marks, its kind of embarrassing. The presentation of the entity can be diverse and hereby, we report an interesting presentation.
Nine similar cases with new findings and new conclusions are reported herein. Pathology of lichen planopilaris top 8 facts dr sampurna. Webmd explains other symptoms, causes, and treatment. When lichen planus causes pain, burning, redness, blisters, sores, or ulcers, it can be treated.
Usually flexor arms and legs, glans penis and mucous membranes. Lichen planus affects primarily middleaged adults, and the prevalence is greater among women. Nov 08, 2016 lichen planus pigmentosus lpp is a rare form of lichen planus. Hyperkeratotic palmoplantar lichen planus in a child. Lichen planus actinicus lp actinicus is a variant of lichen planus often confined to individuals in tropical and subtropical regions. Clinicopathological study to evaluate oral lichen planus for. Lichen planus vulgaris common type was seen in 329 74% patients, lichen planus hypertrophicus in 56 %, lichen planus actinicus in 33 7.
The lesions involve sunexposed areas and are characterized by welldefined nummular patches which have a deeply hyperpigmented centre surrounded by a hypopigmented zone. Nov 20, 2019 lichen nitidus is a relatively rare, chronic skin eruption that is characterized clinically by asymptomatic, flattopped, skincolored micropapules see image below. Jan 30, 2014 lichen planus subtypes based on the site of involvement. Lichen planus, an inflammatory disease, tends to affect the skin and oral mucosa but may involve the nails, scalp, esophagus, and anogenital regions. Lichen planus lp is an inflammatory, pruritic disease of the skin and mucous membranes and can be generalized or localized. Hon aprof amanda oakley, dermatologist, hamilton, new zealand, 1997.
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