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LICHEN PLANUS

LICHEN PLANUS

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LICHEN PLANUS

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  1. LICHEN PLANUS BY DR.MAHESH MATHUR,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