Lichen planus

Introduction to Lichen Planus

Welcome to the Lichen Planus subsection of the Dermatology for the MSRA course.

This section is designed to provide comprehensive and structured learning materials to help you understand and master the topic of Lichen Planus for the MSRA.

Resources for Lichen Planus:

1. Lichen Planus Revision Notes for MSRA: Detailed and concise notes covering causes, symptoms, diagnosis, and treatment based on UK NICE guidelines. Use these notes to get a thorough understanding of the condition.
2. Lichen Planus Flashcards for MSRA: Interactive flashcards to help you retain key facts and concepts related to lichen planus. Perfect for quick revision sessions and reinforcing knowledge.
3. Lichen Planus Accordion Q&A Notes for the MSRA: A question-and-answer style resource designed to enhance active learning and test your understanding. Ideal for quick coverage of weak areas.
4. Lichen Planus Rapid Fire Quiz for MSRA: A fast-paced quiz to evaluate your recall and understanding of lichen planus. Use it to assess your progress and readiness for more advanced material.

We encourage you to use these resources as part of your revision plan, and explore related topics within the Dermatology for the MSRA course.

Key Points about Lichen Planus:

• Definition: Lichen planus is an inflammatory condition that affects the skin, mucous membranes, hair, and nails, presenting with pruritic, polygonal, purple papules or plaques.
• Causes:
  • The exact cause is unknown, but it is believed to involve an autoimmune response.
  • Potential triggers include viral infections (e.g., hepatitis C), certain medications (e.g., NSAIDs, beta-blockers), and genetic predisposition.
• Symptoms:
  • Itchy, purple-colored flat-topped papules and plaques, often on the wrists, lower back, and ankles.
  • Mucosal involvement can cause white lacy patches in the mouth (Wickham’s striae).
  • Nail changes such as thinning, ridging, or nail loss.
  • Scalp involvement can lead to patchy hair loss (lichen planopilaris).
• Diagnosis:
  • Clinical examination of characteristic lesions.
  • Skin biopsy to confirm histopathological features.
  • Tests for underlying causes such as hepatitis C in some cases.
• Management:
  • Topical corticosteroids are first-line for managing skin lesions.
  • Oral corticosteroids or immunosuppressants (e.g., methotrexate) for severe or widespread disease.
  • Antihistamines to manage itching.
  • Regular follow-up for oral or mucosal lichen planus, which carries a small risk of developing squamous cell carcinoma.
• Complications:
  • Persistent itching and discomfort can affect quality of life.
  • Mucosal involvement, particularly oral lichen planus, has a risk of malignant transformation.
  • Scarring in severe cases, particularly in the scalp and nails.

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Free MSRA Podcast: Lichen Planus