Lichen planus

1. LICHEN PLANUSLICHEN PLANUS
BY
DR.MAHESHDR.MAHESH
MATHURMATHUR,,MD,DVD,DCP(UK)MD,DVD,DCP(UK)

2. 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

3. 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

4. PATHOGENESIS
 AUTOIMMUNE –
INFILTRATION OF CD 4+ / CD 8+CELLS &
INCREAS IN Langerhan’S CELLS NUMBER IN
SKIN LESIONS
 FAMILIAL- HLA B7 -

5. CLINICAL TYPES
 HYPERTROPHICUS
 FOLLICULAR
 ACTINICUS
 PIGMENTOSUS
 ANULAR
 LINEAR
 GUTTATE
 NAIL- 15%
 MUCOSAL- 40 TO 60%
ORAL
PERIANAL
ESOPHAGIAL
GENITAL

6. TYPICAL LICHEN PLANUS

7. TYPICAL LICHEN PLANUS
 SHINY,
 VIOLACEOUS
 PAPULAR
 LESIONS

8. KOBNER’S PHENOMENON

9. WICHAM’S STRAIE

10. LICHEN PLANUS
HYPERTROPHICUS

11. LICHEN PLANUS
HYPERTROPHICUS

12. LICHEN PLANUS -
BULLOSUS

13. BULLOUS LICHEN PLANUS

14. LICHEN PLANUS

15. ANNULAR LESION AT SHAFT OF
PENIS

16. LICHEN PLANUS
ACTINICUS

17. LICHEN PLANUS TROPICUS

18. LICHEN PLANOPILARIS

19. CICATRICAL ALOPECIA

20. LICHEN PLANS AT PALM

21. LICHEN PLANUS AT FOOT

22. LICHEN PLANUS-ORAL LESION

23. ORAL LICHEN PLANUS

24. LICHEN PLANUS AT
TONGUE

25. LICHEN PLANUS -TONGUE

26. EROSIVE LICHEN PLANUS

27. PERI ANAL LICHEN PLANUS

28. LICHEN PLANUS – PERIANAL
REGION

29. NAIL CHANGES IN LICHEN
PLANUS

30. LICHEN PLANUS- NAILS

31. HISTOPATHOLOGY
 HYPERKERATOSIS
 HYPERGRANULOSIS
 ACANTHOSIS
 LIQUFYING DEGENERATION
OF BASAL CELL LAYER
 EOSINOPHILIC CYTOID BODIES

32. HISTOPATHOLOGY HIGH
MAGNIFICAITON

33. LICHEN PLANOPILARIS

34. IMMUNOFLOURACENCE
 IgG & C3
 DEPOSITION
AT DERMOEPIDERMAL
JUNCTION

35. IMMUNOFLOURACENCE
 CYTOID BODIES
 IGM STAINING

36. DRUGS CASUUSING
LICHENOID REACTION
 ANTIMALARIALS
 THIAZID DIURATICS
 ISONIAZID
 CHLORPROPAMID
 B-BLOCKERS
 KETOCONAZOLE
 NSADS
 ACE INHIBITORS
 TETRACYCLINE
 COLOURING AGENTS

37. LICHENOID DRUG RASH

38. TREATMENT & PROGNOSIS
 STEROIDS-TOPICAL & SYSTAMIC
 PUVA
 CYCLOSPOIN
 AZOTHIOPRIN