Podcast
Questions and Answers
What is the MOST likely cause of the variations seen in the clinical presentation of different lichen planus subtypes?
What is the MOST likely cause of the variations seen in the clinical presentation of different lichen planus subtypes?
- Exposure to different types of allergens in the environment
- The patient's age at the onset of the disease
- Genetic polymorphisms interacting with environmental stimuli (correct)
- Variations in hygiene practices among affected individuals
When annular lichen planus lesions appear, where are they MOST commonly found?
When annular lichen planus lesions appear, where are they MOST commonly found?
- The face and neck
- The elbows and knees
- The penis and scrotum (correct)
- The scalp and forehead
What is a key characteristic that distinguishes annular lichen planus lesions from typical lichen planus papules?
What is a key characteristic that distinguishes annular lichen planus lesions from typical lichen planus papules?
- They are more likely to be itchy.
- They are more common in older patients.
- They only appear on sun-exposed areas.
- They form a ring shape or expand outwards with central clearing. (correct)
Actinic lichen planus is MOST often observed in which demographic?
Actinic lichen planus is MOST often observed in which demographic?
What is the MOST probable underlying cause of lichen planus appearing in a linear pattern, following the lines of Blaschko?
What is the MOST probable underlying cause of lichen planus appearing in a linear pattern, following the lines of Blaschko?
What recent finding differentiates zosteriform lichen planus from linear lichen planus that does NOT follow dermatomal lines?
What recent finding differentiates zosteriform lichen planus from linear lichen planus that does NOT follow dermatomal lines?
Why is it important to distinguish linear and zosteriform lichen planus from other segmental skin diseases?
Why is it important to distinguish linear and zosteriform lichen planus from other segmental skin diseases?
A patient presents with a linear eruption that does NOT follow dermatomal lines. Which term is MOST accurate to describe this condition?
A patient presents with a linear eruption that does NOT follow dermatomal lines. Which term is MOST accurate to describe this condition?
In fewer than 0.2% of lichen planus cases, the eruption may follow lines of Blaschko. What are lines of Blaschko?
In fewer than 0.2% of lichen planus cases, the eruption may follow lines of Blaschko. What are lines of Blaschko?
Which of the following conditions should be considered in the differential diagnosis of linear or zosteriform lichen planus?
Which of the following conditions should be considered in the differential diagnosis of linear or zosteriform lichen planus?
Flashcards
Clinical Variants of Lichen Planus
Clinical Variants of Lichen Planus
Variations in lichen planus presentation based on lesion configuration, morphology, and location.
Annular Lichen Planus
Annular Lichen Planus
Ring-shaped lesions formed by coalescing papules or centrifugal expansion with central clearing, common on genitals.
Actinic Lichen Planus
Actinic Lichen Planus
Occurs in subtropical zones on sun-exposed skin of young adults/children, often annular.
Linear Lichen Planus
Linear Lichen Planus
Lichen planus papules developing in a line, often due to trauma.
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Blaschkoid Lichen Planus
Blaschkoid Lichen Planus
Lichen planus eruption following Blaschko lines, rare.
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Zosteriform Lichen Planus
Zosteriform Lichen Planus
Lichen planus mimicking a zoster (shingles) pattern.
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When to use 'Linear' term
When to use 'Linear' term
Term to use when dermatomal lines are NOT followed.
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Zosteriform Lichen Planus cause
Zosteriform Lichen Planus cause
Study found varicella zoster antigens suggesting a viral trigger of disease.
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Differential Diagnosis Required
Differential Diagnosis Required
Important to differentiate linear and zosteriform lichen planus from other diseases.
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Mimickers of Linear Lichen Planus
Mimickers of Linear Lichen Planus
Lichen striatus, linear epidermal nevus, inflammatory linear and verrucal epidermal nevus, linear psoriasis, and linear Darier disease.
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- Clinical variants of lichen planus are categorized by lesion configuration, morphologic appearance, and site of involvement
- Despite variations, lichen planus subtypes often have morphological clues of a Lichen Tretinoin Receptor (LTR)
- The causes of these variants are unknown but likely involve genetic and environmental factors
Configuration
Annular Lichen Planus
- Occurs in about 10% of lichen planus cases
- Develops as a ring of merged papules or expands outward with central clearing
- More common on the penis and scrotum
- Large lesions can appear annular due to central resolution and hyperpigmentation with a raised rim
- Actinic lichen planus occurs in sun-exposed areas of dark-skinned young adults and children, and is frequently annular
Linear, Blaschkoid, and Zosteriform Lichen Planus
- Linear patterns may develop due to trauma
- In fewer than 0.2% of cases, eruptions may follow lines of Blaschko
- This is thought to be caused by postzygotic, somatic mutations
- Zosteriform lichen planus may be triggered by a virus or an isotopic response involving resident memory cells
- Linear lichen planus should be used only when dermatomal lines are not followed
- Linear and zosteriform lichen planus must be differentiated from several other segmental diseases
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