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42 Cards in this Set

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LP
males vs females? ages?
race?
familial?
location?
males constant rate 20-60 yrs old
females increase w age peak 60 yrs
1-2% familial
flexor wrists, dorsal hands, medial thighs, shins, genitalia, glans penis, palms/soles RARE FACE
LP
cutaneous vs mm?
mm more chronic
LP kids?
4% of all LP cases
LINEAR or SEGMENTAL, FOLLICULAR
NAILS (kids more isolated nails)
LONG COURSE

INDIAN SUBCONTINENT
20 NAIL DYSTROPHY
LP Nails
5-10%
lunula red
PTERYGIUM
LP mm
% will develop skin?
males or females? ages?
types?
15% w mm develop skin
75% female
mm female 57 male 47

Types
1. Reiculate (all pts w erosive, 23%)
2. erythematous/atrophic(37% pts w erosive)
3. ulcerative/erosive (mc) 0%
LP mm Reticular
23% sx
tongue
LP lower or upper lip?
Lower lip 15%
Upper lip RARE 2% (bx)
mm LP locations
buccal 90%
gingiva > 50%
lower lip 15%
upper lip RARE 2%
dental fillings?
LP
MERCURY, GOLD PALLADIUM
% of females with oral LP that have vulvovaginal
25% oral LP have vulvovaginal LP
LP conjunctiva
RARE
oral and gingivival
CICARIATION, SUBEPI SCARRING< KERATITIS
LP hepatitis?
Hep C 4 - 60%
Hep B vaccine one month after 2nd dose
Hep C LP
Erosive
No Hep C in lesions
not assoc with clinical pattern/LFTs
tx interferon alpha begin LP/wosen LP
+/- impove w treatment for Hep C
Xanthomas in LP
primary billiary cirrhosis
D-penicillamine

lichenoid may contain xanthomatous cells
Primary Sclerosing Cholangitis
Oral LP
assoc with?
oral LP
LP types
1. Classic LP
2. LP pemphigoides
LP pemphigoides
triggered by MEDS and PUVA
DIF LINEAR IgG and C3 BMZ
Basal hemidesmosome
180 kd (different region than BP?)
Rare ABs to Desmoplakin I and II (ulcerative mm)
EPITOPE SPREADING
squamatized
loss of basal cells
Colloid Bodies
in epi
Civatte Bodies
in dermis
Linear LP
Koebner's
< 1% LP 10% Japan
Lines of Blaschko
mc KIDS
sip areas between lesions
Annular LP
glans penis, axillae, groin
90% males
< 10 lesions
asymptomaic
cenral hyperpig
polycyclin figures
central hyperpigmented macules
Hypertrophic LP
Lichen Planus Verrucous
SHINS
VARIABLE SCALE
Ulcerative LP
mm
RARE SKIN
RARE loss toenails
+/- ciatricial alopecia
+/- buccal mucosa
Oral LP
chronic
Buccal 90%
gingiva > 50% (desquamative gingivitus)
tongue 40%
vulvovaginal-gingival syndrome
erosion erythema leukokeratosis
vag 2/3 pts
labia minoraatrophy
1/3 pts RETICULATE BUCCAL
10% pts cutaneous
LP increase SCC?
ORAL AND VULVOVAGINAL only
0.4 - 5% avg 1 %
only w erythematous/atrophic or ulcerative
bx fixed eroseive or leukokeratotic lesions
LP BMZ?
dense shaggy staining fibrinogen
Tropical Dyschromic Lichenoid Disorder
dyschromia hyperpig
< 40yrs
macular increwase pig
upper 1/2 body
bx lichenoid
mm rare
LP actinicus
actinic LP
lichenoid melanodermatitis
summertime actinic lichenoid eruption
Africa, Middle East, Indian Subcontinent
genetic predisposition
Spring/Summer no winter
20s
sunexposed face
+/- mild pruritus
LP pigmenosus
Central America, Indian Subcontinent, Japan
Males = females
face, neck, < 10 % body
+/- pruritus
+/- periph classic LP lesions
US blacks?
Erythema dychronicum perstans
Ashy Dermatitis
Dermatosis Cinecienta
< 40 yrs
Chronic
all ages
SYMMETRICAL/generalized
ASHY GRAY MACULAR
+/- very fine mm erhythemaous papular non scaling boder periph lesions SMALL CORD
no LP papules
no pruritus
no nails
no mm
histo:
periph = LP
cenral = postinflammatory pig
cytoid bodies
idiopathic eruptive macular pigmentation
11 years
rown to gray macules
NECK TRUNK PROX EXREMITIES
NOT CONFLUENT
spon resolve
Keratosis Lichenoides Chornica
very RARE
chilhood/birth
violaceous papulonodular hyperkeratotic covered w gray scales
EXTREMITIES BUTTOCKS
keratotic plugs
telangiectasias
diffuse thick palms/soles or discree hyperkeratottic papules
sharply marginaed erythema, scaling , telangiectasias face (similar to seb derm/rosacea)
nail changes
oral aphthae lesions
hoarseness vocal cord edema
1/3 eyelids
histo irregular acanthosis
tx: CALCIPOTRIOL, RETINOIDS, PUVA
NO TOPICAL OR ORAL STEROIDS
Lichen Nitidus
chronic
linear arrays Koebner's
penis lower abdomen
palmoplantar lichen nitidus
keatotic plug
nail chages
op gray yellow papules or petechiae hard palate
Lichen Striatus
KIDS < 6 yrs
LINES OF BLASCHKO
EXTERMITY > TRUNK < 10% face
asymptomatic
1 yr spon resovle w scarring
Lichen Striatus
Kids < 6 yrs
Lines of blaschko
hypopig
extremity > trunk < 10% face
asymptomatic
skin then nails or sme time
nail plae thinning, splitting, hyperkeratosis
1 YR SPON RESOLVE WITHOUT SCARRING
histo depends on stage
+/- spongiotic dermatitis
Lichenoid
band-like necrotic k@ at DEG +/- grandulomas
dense L@ around ECCRINE GLANDS/DUCTS (in contrast to LP)
siblings, summer/spring
Lichen Sclerosis
Lichen Sclerosis t arophicus
kids to old, prepub and postmen (biomodal age)
female
1/3 female auoimmune
follicular balck plugs
ertyehmatous to violaceous halo
bullae hemorrhagic penis?
vulvar/perianna FIGURE EIGHT or HOURGLASS
NO VAG/CERVICAL MUCOSA (like LP)
Infantile Perineal Protusion Pyramidal soft tissue swelling
covered y red/rose skin along median perineal raphe (skin between posterior forchette and anus) prepub ecchymosis
% of females with Lichen sclerosis no sx?
9%5
Lichen Sclerosis Men penis
male hypopig?
glans penis hemoorhagic
no erosions
PHIMOSIS, PARAPHIMOSIS
(10% adult men wih phimosis and 60% boys with phimosis)
uncircumcised no tx 50% with sx after cricumcised
urethral meatal stenosis
less commmon perianal
extragenital: upper back, chest, reast no sx
+/- op
assoc with morphea
Borrelia atzelii?