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Pathology - Lichen planus
Definition • An inflammatory dermatosis characterized by pruritic purple papules clinically and a lichenoid response pattern histologically.
Epidemiology • Affects around 1% of the population. • Typically occurs in middle-aged people, with a slight prevalence in females. Aetiology: Unknown. Pathogenesis • Believed to signify a delayed-type hypersensitivity response to an unidentified epidermal antigen.
Presentation • The cutaneous lesions are diminutive, flat-topped, violaceous papules that are typically associated with acute pruritus. • Delicate white lines (Wickham’s striae) typically traverse the surface. • The lesions predominantly manifest on the flexor surfaces of the wrists, the extensor surfaces of the hands, and the forearms. • Oral involvement is prevalent (see p. 86), as are genital lesionsespecially in males.
Histopathology • A substantial band-like inflammatory infiltrate comprising lymphocytes and macrophages is observed beneath the epidermis. • The basal layer of the epidermis exhibits vacuolar damage accompanied by cytoid body formation and melanin leakage. • The epidermis demonstrates irregular acanthosis, hyperkeratosis, and wedge-shaped hypergranulosis.
Prognosis: In the majority of instances, the condition resolves autonomously over a variable duration ranging from weeks to one year.
Definition • An inflammatory dermatosis characterized by pruritic purple papules clinically and a lichenoid response pattern histologically.
Epidemiology • Affects around 1% of the population. • Typically occurs in middle-aged people, with a slight prevalence in females. Aetiology: Unknown. Pathogenesis • Believed to signify a delayed-type hypersensitivity response to an unidentified epidermal antigen.
Presentation • The cutaneous lesions are diminutive, flat-topped, violaceous papules that are typically associated with acute pruritus. • Delicate white lines (Wickham’s striae) typically traverse the surface. • The lesions predominantly manifest on the flexor surfaces of the wrists, the extensor surfaces of the hands, and the forearms. • Oral involvement is prevalent (see p. 86), as are genital lesionsespecially in males.
Histopathology • A substantial band-like inflammatory infiltrate comprising lymphocytes and macrophages is observed beneath the epidermis. • The basal layer of the epidermis exhibits vacuolar damage accompanied by cytoid body formation and melanin leakage. • The epidermis demonstrates irregular acanthosis, hyperkeratosis, and wedge-shaped hypergranulosis.
Prognosis: In the majority of instances, the condition resolves autonomously over a variable duration ranging from weeks to one year.
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