LICHEN PLANUSLICHEN PLANUS

BY

DR.MAHESH DR.MAHESH MATHURMATHUR,,MD,DVD,DCP(UK)MD,DVD,DCP(UK)

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 CELLULARINFILTRATION IN DERMIS

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

PATHOGENESIS

AUTOIMMUNE – INFILTRATION OF CD 4+ / CD 8+CELLS &

INCREAS IN Langerhan’S CELLS NUMBER IN SKIN LESIONS

FAMILIAL- HLA B7 -

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

TYPICAL LICHEN PLANUS

TYPICAL LICHEN PLANUS SHINY, VIOLACEOUS PAPULAR LESIONS

KOBNER’S PHENOMENON

WICHAM’S STRAIE

LICHEN PLANUS HYPERTROPHICUS

LICHEN PLANUS HYPERTROPHICUS

LICHEN PLANUS - BULLOSUS

BULLOUS LICHEN PLANUS

LICHEN PLANUS

ANNULAR LESION AT SHAFT OF PENIS

LICHEN PLANUS ACTINICUS

LICHEN PLANUS TROPICUS

LICHEN PLANOPILARIS

CICATRICAL ALOPECIA

LICHEN PLANS AT PALM

LICHEN PLANUS AT FOOT

LICHEN PLANUS-ORAL LESION

ORAL LICHEN PLANUS

LICHEN PLANUS AT TONGUE

LICHEN PLANUS -TONGUE

EROSIVE LICHEN PLANUS

PERI ANAL LICHEN PLANUS

LICHEN PLANUS – PERIANAL REGION

NAIL CHANGES IN LICHEN PLANUS

LICHEN PLANUS- NAILS

HISTOPATHOLOGY

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

HISTOPATHOLOGY HIGH MAGNIFICAITON

LICHEN PLANOPILARIS

IMMUNOFLOURACENCE

IgG & C3 DEPOSITION AT DERMOEPIDERMAL JUNCTION

IMMUNOFLOURACENCE

CYTOID BODIES IGM STAINING

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

LICHENOID DRUG RASH

TREATMENT & PROGNOSIS

STEROIDS-TOPICAL & SYSTAMIC PUVA CYCLOSPOIN AZOTHIOPRIN