Lichen Planus

00:03 Our topic here is lichen planus.

00:06 Be very careful.

00:08 I have described to you a condition called lichen simplex chronicus.

00:16 Do not confuse one with the other.

00:18 In lichen planus, thought to be an autoimmune phenomenon.

00:23 Associated with hepatitis C in areas of high prevalence.

00:27 Memorize that.

00:29 With lichen planus, you automatically pay attention to letter P.

00:36 And with that P, it will give you the clinical pearls of your particular morphology of lichen planus; purple pruritic polygonal that will coalesce and form plaques.

00:49 The five Ps with lichen planus.

00:55 Not to be confused with lichen simplex chronicus.

01:01 Common in the wrists and hands.

01:04 So, you would have this purple polygonal, and then you have your papules that are going to coalesce and form plaque, and can also occur in the oral.

01:13 This can be oral or genital mucosa If you take a look at this morphology here, you’ll notice that we have not only a purplish papule on the perimeter or periphery, but then as you come closer, polygonal and it coalesced to form a? Plaque.

01:36 Autoimmune in nature, PPPPP.

01:41 Pathology: band-like inflammation, destruction of the keratinocytes, and at the dermoepidermal junction, okay? Lichen planus.

01:54 Management: Limited disease treated with potent topical steroids.

01:59 You have antihistamines may show to help with the pruritus, that's it.

02:04 Extensive skin/mucosal disease may require oral steroids.

02:08 And mucosal involvement is a sign of more of a recalcitrant and a longer lasting disease, which is not a good sign.

02:16 Remember the one that I described in the mouth, Wickham's striae Consultation with a dermatologist or dentist is often recommended so that you know as to what to do with your patient cosmetically.