Lichen Planus Causes, Symptoms, and Histopathology

Lichen Planus Causes, Symptoms, and Histopathology

Write short note on lichen planus.
Answer:

“Role of immune dysfunction in causing lichen planus”

Lichen planus is a precancerous condition.

It is a common mucocutaneous disease that arises due to an abnormal immunological reaction and the disease has some tendency to undergo malignant transformation.

Lichen planus

Etiopathogenesis of Lichen Planus

• Oral lichen planus is a T cell-mediated autoimmune disease in which cytotoxic CD8 + T cells trigger the apoptosis of oral epithelial cells. The CD8 + lesional T cells may recognize the antigen associated with major histocompatibility complex (MHC) class 1 on keratinocytes. After antigen recognition and activation, CD8 + cytotoxic T cells may trigger keratinocyte apoptosis. Activated CD8 + T cells may release cytokines that attract additional lymphocytes.
• As per the recent studies in psychoneuroimmunology psychosomatic stress results in autoimmunity reactions and this leads to lichen planus.

“Common causes of lichen planus explained”

Lichen planus Clinical Features

• It occurs among middle-aged and elderly people.
• There is a slight predilection for the females.
• Lichen planus can involve several areas of the oral cavity. Oral lesion: Mucosal surface of buccal mucosa, vestibule, tongue, lips, floor of mouth, palate, and gingiva.
• The patient may report a burning sensation in the oral mucosa.
• The oral lesion is characterized by radiating white and gray velvety thread-like papules in linear, angular, or retiform arrangement; tiny white elevated dots are present at the intersection of white lines known as “Wickham’s striae”.

Lichen planus symptoms

“Importance of early diagnosis of lichen planus”

Lichen planus Histopathology

• Overlying surface epithelium exhibits hyper orthokerati nation or hyper para keratinization or both.
• Acanthosis of the spinal cell layer is present.
• Shortened and pointed rete pegs of epithelium produce a “Sawtooth” appearance.
• Intercellular edema in the spinous cell layer is present.

“Techniques for managing oral lichen planus pain”

• There is the presence of necrosis or liquefaction degeneration of the basal cell layer of epithelium.
• Few rounded or ovoid, amorphous eosinophilic bodies are present which are known as “Civatt bodies”.
• These Civatt bodies represent dead keratinocytes or other necrotic epithelial components which are transported to connective tissue for phagocytosis.
• Chronic inflammatory cell infiltration is present in the juxta epithelial lesion.

Lichen planus histopathology

“Impact of stress on triggering lichen planus outbreaks”