Also known as wickham striae, an inflammatory autoimmune disorder involving keratinized and mucosal surfaces symptoms. Lichen planus is an inflammatory skin condition, characterized by an itchy, noninfectious rash on the arms and legs. Lichen planus lp is a chronic inflammatory and immunemediated disease that affects the skin, nails, hair, and mucous membranes. Oral lichen planus cant be passed from one person to another. Of 303 patients diagnosed with oral lichen planus, 58 19.
Jun 06, 2014 histopathology, a diagnosis of lichen planus with well differentiated scc was made. Lichen planus lichen planus lp is a disease of the skin andor mucous membranes that resembles lichens. In contrast to lichen planus and lichen planopilaris, linear lichen planopilaris of the face is more common in middleaged men. Patient was followed for 6 months and was almost free of lesions. Most of the nonulcerative type of olp improved with topical and systemic medications and recurrence is common. We found that the bilateral buccal mucosa was the most commonly affected site, followed by the tongue and the gingiva.
Oral lichen planus is a relatively common manifestation, found in approximately 1% to 2% of individuals older than 15 years. Lichen planus is a subacute to chronic inflammatory disease affecting the skin, mucous membranes, nails, and hair. Lp greek leichen tree moss, latin planus flat, even was first explained in 1869 by dr. These authors evaluated 719 oral lichen planus cases diagnosed at the oral clinical and pathology unit ii, dentistry school, buenos aires university, argentina, between 1991 and 1997, and found that all the 32 cases of malignant transformation 6,51% occurred in atypical forms of lichen planus, such as presentation in the plaque, the erosive. Histopathological features of oral lichen planus and its res. Histopathology confirmed the diagnosis of lichen planus and bullous lichen planus. Oral lichen planus olp is a relatively common disorder with unknown etiology. Management of pain in erosive lichenplanus using low level. Pdf to highlight the most characteristic histopathological findings of oral lichen planus and their correlation with the clinical manifestations and.
Lichen planus is a disease of the skin andor mucous membrane that resembles lichens. The lesions of cutaneous lichen planus typically resolve within12 years, whereas the lesions of oral lichen planus are long lasting and persist for 20 years resolution of the white striations, plaques, or papules is rare. Key points uncommon condition typically affecting the skin andor mucous membranes exact cause is unknown, but is thought to be an acquired abnormal immune system reaction symptoms are predicated on the form the condition takes. Clinical and histopathological spectrum of lichen planus. Prevalence of oral lichen planus in indian population is 2. A case report of erosive lichen planus of the oral. Oral lichen planus olp exhibits variations in severity and response to corticosteroid therapy. Nov 04, 2019 a biopsy is indicated with erosive oral lichen planus for several reasons.
There is irregular epidermal hyperplasia forming a characteristic sawtooth appearance with wedgeshaped hypergranulosis. However, many patients respond poorly to or will develop. Identify and treat lichen sclerosus, lichen simplex chronicus, and lichen planus 3. It is derived from the greek word leichen0 means tree moss and latin word planus means flat. Jul 01, 2011 lichen planus is a chronic, inflammatory, autoimmune disease1 occurring in 0.
Oral lichen planus olp and oral lichenoid lesions oll are clinically and histologically similar lesions but their treatment planning and prognosis are different. Malignant potential of erosive lichen planus is more when compared to other types of lichen planus. Lichen planus a clinicopathological correlation from a. The role of granzyme bexpressing cd8positive t cells in apoptosis of keratinocytes in lichen planus. Diagnosis and treatment of lichen planus american family. Oral lichen planus with malignant transformation to invasive. Pdf erosive lichen planus diagnosis and management. Oral lichen planus liekun playnus is an ongoing chronic inflammatory condition that affects mucous membranes inside your mouth. Lichen planus is a mucocutaneous disorder of unknown aetiology with mucosal involvement seen in 3070% of cases. Oral lichen planus with malignant transformation to. Among the six clinical variants of olp described by andreasen, reticular, erosiveulcerative, papular, plaquelike, atrophic, and bullous, reticular is the most common variant. Oral lichen planus olp is the mucosal counterpart of cutaneous lp.
Histopathological findings in oral lichen planus and their correlation. Is vulvovaginal lichen planus associated with squamous. In some cases, longterm erosive lichen planus can increase the chance of. It is thought to be the result of an autoimmune process with an unknown initial trigger. Wilson probably referred to the condition that was originally described by herba as lichen ruber 3, 4. Physical and histopathological examinations were carried out to confirm the diagnosis of oral lichen planus. Understand melanosis to melanoma diagnosis at the end of this presentation the participant will.
Lichen planus is a chronic inflammatory disease that affects the skin and mucosa. Erosive oral lichen planus involving the buccal mucosa. Wilson as an inflammatory disorder of the stratified squamous epithelia with an unknown etiology. Where the trigger is known a lesion as a lichenoid lesion. Clinically, it has specific and clearly identifiable features. 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. Lichen planus lp is a tcellmediated autoimmune disease that affects the skin and often the mucosa, nails, and scalp. Thus, the aim of this study was to determine the correlation of histopathology and clinical olp. Pdf histopathological findings in oral lichen planus and their. Differentiated vulvar intraepithelial neoplasia had standard, basaloid, and hypertrophic morphology, superficially resembling erosive lp in 9 24% of 38 and hypertrophic lp in 6 16% of 38. This article aims to report of two cases of erosive lichen planus of oral cavity in a 68 year old female and in 28 year old male with emphasis on histopathology. Zachariah, absorption of a topical steroid and evaluation of adrenal suppression in patients with erosive lichen planus, oral surgery, oral medicine, oral pathology, 69, 6, 688, 1990.
Telmisartaninduced lichen planus eruption manifested on. Erosive vulvovaginal lichen planus erosive vlp is the most common variant. Oral lichen planus olp is a chronic mucosal condition commonly. Erosive lichen planus is a rare form of lichen planus that can last a long time. Lichen planus classically presents on the wrists and ankles. In 1978 a clinical and histopathological definition of lichen planus was formulated by who as. Clinicopathologic correlation of oral lichen planus and oral. Oral lichen planusolp could either accompany the cutaneousskin lesions or. Lichen planus is an uncommon disorder of unknown cause that most commonly affects middleaged adults. Oral lichen planus is a chronic inflammatory mucocutaneous disease which frequently involves the oral. Role of histopathology alpna thakur 1, sunil kumar gupta 1, aarti bhattacharya 2, 1 department of dermatology, hind institute of medical sciences, safedabad, barabanki, up, india. It consists of small, manysided, flattopped, pink or purple bumps. Commonly seen variant of oral lichen planus is reticular type whereas erosive type of lichen planus is the second most common. Aug 17, 20 oral lichen planus is a chronic inflammatory disease.
Here, a 52yearold male presented with a 10year history of. It leads to the severe destruction of the epithelial basal layer. Lp can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. Histopathology is a reliable tool to diagnose lichen planus and differentiate it from other lichenoid eruptions. 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. Oral lichen planus symptoms and causes mayo clinic. Rees, effectiveness of a low dose of cyclosporine in the management of patients with oral erosive lichen planus, oral surgery, oral medicine, oral pathology, oral radiology, and endodontology, 80, 2, 161, 1995.
The average age of individuals with this complication is 50 to 55 years. Professor emeritus, emory university school of medicine. Oral lichen planus olp is a chronic inflammatory dermatosis of unknown etiology that often involves the mucous membranes. Negative direct immunofluorscence test excluded lichen planus pemphigoides. These lesions may cause burning, pain or other discomfort.
Topical corticosteroids are considered firstline therapy. Lichen planus has been found to be associated with hepatitis c virus infection, chronic active hepatitis, and primary biliary cirrhosis. It can be induced by a variety of medications and may spread through the isomorphic phenomenon. Treatment of chronic erosive oral lichen planus with low. The condition is characterized by erythematous areas and interspersed pseudomembranous areas. Histopathological characterization of the oral lichenoid disease. Chronic erosive oral lichen planus eolp is a severe and painful form of lichen of the buccal mucosa and is often resistant to systemic or topical therapies.
Lichen planus lp is a chronic inflammatory and immune mediated disease that affects the skin, nails, hair, and mucous membranes. Plaquetype variant of reticular oral lichen planus with erosive areas involving the dorsum of the tongue. Involvement of the oral cavity may present with white wickhams striae or as erosive painful lesions figure 68. Oral lichen planus is one of the most common dermatological diseases presenting in the oral cavity. Pdf a case of kikuchifujimoto disease associated with. The literature suggests that certain presentations of the disease such as. The boy was treated with prednisone 1 mgkg day the dose was gradually tapered and discontinued over the next 1. Vulva lichen planus accessed 3 october 2017 itching causes hyperkeratosis. May 17, 2014 lichen planus is a mucocutaneous disease characterized by nonspecific inflammation. Lichen planus is a common dermatologic disorder involving the glabrous skin, hairbearing skin and scalp, nails, and mucous membranes of the oral cavity, penis, and vulva. The reliability of immunofluorescence and histopathology.
It may be found with other diseases of altered immunity, such as ulcerative colitis, lichen sclerosis, myasthenia gravis etc. Lichen planus lp is a chronic mucocutaneous disorder of the stratified squamous epithelium that affects oral and genital mucous membranes, skin, nails, and scalp. Oral lichen planus is a chronic inflammatory mucocutaneous disorder that is tcell mediated. Clinically, oral lichen planus has specific and clearly identifiable features, 18 usually presenting in one of two main forms the reticular and the erosive forms although other forms are not rare.
Oral lichenoid disease, histopathology, subtypes, characterization, oral lichen planus, oral lichenoid lesion, epithelial dysplasia. Fortyfour percent to 60% of patients have the erosive form of the disease, 28% to. Individuals with oral lichen planus often require some form. Fortyfour percent to 60% of patients have the erosive form of the disease, 28% to 34% plaque type, and 16% to 28% reticular. Feb 17, 2017 lichen planus is chronic mucocutaneous disease of autoimmune origin, affecting around 0. It was originally named lichen ruber planus and lichen. Linear lichen planopilaris of the face is a rare variant of lichen planopilaris. Treatment of olp depends on symptoms, the extent of clinical involvement, medical history and other factors. 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 is a chronic disease that can be controlled but not eliminated. Oral lichenplanus clinical features, histopathology.
Lichen planus is a mucocutaneous disease characterized by nonspecific inflammation. Lichen planus, developed, clinical picture 793 lichen planus, developed, clinical picture 1066. Develop a plan for caring for patients with the itch scratch cycle 4. Individuals with oral lichen planus often require some form of maintenance therapy to keep their disease under control.
Jan 30, 2014 lichen planus lp is a chronic inflammatory disorder that most often affects middleaged adults. The prevalence of erosive lichen planus in patients with kfd, as of this date, is unknown with no previously reported cases describing an association between the two conditions. Lichen planus is a cellmediated immune response of unknown origin. Oral lichen planus is a chronic disease that causes painful patches inside the mouth. Webmd explains other symptoms, causes, and treatment. Pathogenesis thought to be an auto immune process with unknown trigger if the trigger is known then it is called lichenoid reaction exposure to medicines, dyes, other chemicals as gold, antimalarials, antibiotics. Lichen planus lp is a chronic inflammatory disorder that most often affects middleaged adults.
In some cases, longterm erosive lichen planus can increase the chance of some types of cancer developing. The diagnosis of olp can be made from the clinical features if they are sufficiently characteristic, particularly if typical skin or other lesions are present, but biopsy is recommended to confirm the diagnosis and to. If the ulcerated tissue is limited to the gingiva, desquamative gingivitis can be ruled out with biopsy, as well as cicatricial pemphigoid and pemphigus vulgaris, which have similar characteristics. It causes painful ulcers to develop in the mouth and in the genital areas of both males and females. Current immunosuppressiv etherapies usually control oral mucosal. Oral lichen planus olp is one of the most common diseases of the oral mucosa. Lichen planus lp is a chronic, but benign and selflimited disease of the skin andor oral mucosa with an unknown etiology. Pathology of lichen planopilaris top 8 facts dr sampurna. Lichen planus, developed, clinical picture 792 lichen planus, developed, clinical picture 1065 lichen planus, kobners phenomenon. A goal of therapy is to convert bothersome erosive or ulcerative oral lichen planus to the asymptomatic reticular form. Oral lichen planus may appear as white, lacy patches. It seems to affect most ethnic groups and has a prevalence of 0. Patients with atrophic and erosive forms of olp typically experience significant discomfort.
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