Lichen planus and its management 2019

1. by fazeela jamal 1

2. Lichen Planus
and its
management
Presented by : Fazeela Jamal
by fazeela jamal 2

3. Content
• Definition.
• Incidence, Age group, Gender predisposition
to lichen planus
• Diagnosis and Clinical features.
• Management and treatment.
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4. Introduction
• Lichen Planus is an inflammatory
autoimmune type of chronic
mucocutaneous disease
• That affects – the skin and oral
mucosa.
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5. • Its mucocutaneous disease
• And pre malignant condition
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6. by fazeela jamal 6

7.  Lichen planus can be triggered by:
 Hepatitis C infection
 Flu vaccine
 Certain pigments, chemicals and metals
 Pain relievers, such as ibuprofen (Advil, Motrin IB, others) and naproxen
(Aleve, others)
 Certain medications for heart disease, high blood pressure or arthritis
The cause of lichen planus is usually not known, although
possible causes include: Hepatitis C, a virus that attacks your liver. Certain
medicines, including some drugs used to treat high blood pressure, diabetes,
heart disease, and malaria. Reactions to metal fillings in your teeth.
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Causes

8. Lichen planus is common; has a
prevalence of 1-2% in the population
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• Incidence

9. • Slight female
predisposition for
oral lichen planus
but Lichen planus
is more common
in men.
• Age group
between 30-65 is
at higher risk.
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Gender Age

10. Symptoms
• On the skin, lichen planus is characterised by the presence of small,
polygonal, flat-topped, Pruritic (itchy) papules on the flexor surface
of the wrist, lower back, ankles and shins.
• Purplish, flat bumps, most often on the inner forearm, wrist or
ankle, and sometimes the genitals
• Itching
• Blisters that break to form scabs or crusts
• Lacy white patches in the mouth or on the lips or tongue
• Painful sores in the mouth
• Hair loss
• Change in scalp color
• Nail damage or loss
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11. Diagnosis
• Biopsy. Your doctor removes a small piece of affected tissue for
examination under a microscope. The tissue is analyzed to
determine whether it has the cell patterns characteristic of lichen
planus.
• Hepatitis C test. You may have your blood drawn to test for
hepatitis C, which is a possible trigger for lichen planus.
• Allergy tests. Your doctor may refer you to an allergy specialist
(allergist) or dermatologist to find out if you're allergic to
something that can trigger lichen planus.
• Other tests may be needed if the doctor suspects you have any
of the several variations of lichen planus, such as the type that
affects the esophagus, genitals, ears or mouth.
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12. Clinical Presentation
• 5 types of lichen planus within oral cavity have
been described such as ;
• Plaque form; resembles leukoplakia clinically but has
multifocal distribution. Plaque generally ranged from
slightly elevated to smooth and flat. Affects the
dorsum of the tongue and buccal mucosa.
• Erythematous or atrophic form; appears as red
patches with fine white striae. Attached gingiva is the
common site involved in this form of lichen planus.
Patient may complain of burning, sensitivity, and
generalised discomfort.
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13. • Erosive form; the central area of the lesion is ulcerated. A
fibroins plaque covers the ulcers. Shows a red, glazed
appearance. Affected site is the buccal mucosa and tongue.
• Reticular form ; most common character by numerous
interlacing white keratotic lines called Wickham's striae that
produce a lacy pattern on the buccal mucosa.
• Bullous form; this form is rarely encountered. Bullae
ranges from few millimetres to centimetres in diameter.
These bullae are short lived and upon rupture, leaves a
painful ulcer. Affected site is buccal mucosa, especially in
the posterior and inferior regions adjacent to 2nd and 3rd
molars.
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17. Management
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18. Thank you !!!!
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