Disease where t-cells attack epidermis.

- drug induced, ; dyes, antihypertensive, beta blockers, ACEis, diuretics

-pathogen: hep c 

- immunisation

Recurring, chronic, non-contagious, episodes mths-yrs

Are shiny, flat topped polygonal firm papules from pin point to >1cm size. 

Pruritic,  may appear oily/rough.

When healed, hyperpigmentation may result.

Front of wrists, lower back, ankles (usually very thick and itchy here) and palms + soles (palmoplantar LP, yellow and firm).

Can affect mouth + genitals (mucosal LP), scalp (Lichen planopilaris), nails, shins (also thick here), esophagus

Painless white lacy streaks on cheeks, sides of gum and lips. Can have painful, persistant ulcers (erosive LP). Diffuse redness and peeling of gums 

May begin as burning sensation while eating

- Manage symptoms and good oral hygiene

- Change amalgam fillings as can be allergy

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what is this condition?

- asymptomatic papules, lacy pattern, erosive and ulcerative

-pruritus, discharge or hemorrhage

- dorsal pterygium (raised wedged shaped deformity)

- can be notching, pitting, grooving, anonychia, dystrophy

-linear melanonychia (brown bands)

[image]

Dorsal pterygium is specific to which skin condition?

1. Lichen planopilaris

2. Lichen planus Actinic

Hx, clinical features

Biopsy 

Oral up to 5yrs

Others 50% cleared by 6mths

85% by 18 mths

PLENTIFUL

PRURITIC

PLANE

POLYGONAL

PSG

PURPLE

POLISHED

PAPULES

PART OF BODY - FLEXURES

Topical corticosteroids for all besides nails

extensive or severe pruritus may need oral corticosteroids 

avoid stress

use simple emollients

minimise trauma

for itching try antihistamines, soothing baths like aveeno, cold wet dressings, menthol/phenol

immunosuppressives

retinoids

monitor oral LP for squamous cell carcinoma, avoid tobacco/alcohol

[image]

What condition is this?

Follicular keratotic papules/plaques that coalesce to form salmon coloured plaques with well defined borders which then develop scales. Can be islands of sparing with no involvement.

Affects any body part, eg elbows, knees, palms, soles

Triggers may be genetic, infection, rash, burn

- emolients for dry skin (salicyclic acid, lactic acid, urea)

- screen for malignancy or HIV

- counselling and support groups

[image]

"Orange sandal" is seen in which condition and may also develop fissures?

- Inherited genetically

- Acquired through environmental factors or changes health status (skin conditions, circulation issues, internal disease, infection, meds, toxins)

1. FOCAL (mainly pressure areas)

2. DIFFUSE (majority of skin)

3. PUNCTATE (small bumps)

- assess mechanical factors

-emollients

-keratolytics (salicyclic acid, lactic acid)

-Topical vit D (calcipotriol)

-Topical retinoids (isoretinoin, tretinoin, adalpelene, tazarotene)

-Regular debridement

-Genetic therapy

-Treat hyperhidrosis with potassium permanganate or Acl hexahydrate lotion or botox

-Systemic retinoids (acitretin)

Punctate : tiny hard bumps on palms/soles

Filiform: tiny spikes mainly on skin of palms/soles

Marginal : tiny bumps along border of fingers/soles/palms/toes

- Streak HK running length of each finger

-cardiomyopathy

-woolly hair

2-4 yrs old

focal HK palms/soles

can affect mental development in half. Excess tears, sensitive to light, eye pain and redness

- focal PPK, hyperhidrosis, blistering of feet

- thick nails that can be discoloured, affects fingernails more

- white patches on tongue and inside of cheeks

- tooth abnormalities

- cork screw hair- bumps

- sebaceous cysts

-diffuse transgradient PPK soon after birth

-increased sweating, malodor

-secondary infections

-mostly on Mljet in Croatia

Scleroatrophy of distal extremities, PPK and hypoplastic nail changes

there is also increased risk for squamous cell carcinomas

-transgradiens diffuse PPK in honeycomb shape

-pseudoainhum

-starfish keratosis on backs of hands/feet

-rare hearing loss

-destruction of periodontium resulting in loss of primary teeth by 4 and most permanent teeth by 14

PPK in first few years of life

-wooly hair

-cardiomyopathy

-PPK

-AR

8-10 yrs

diffuse PPK from sole to achilles tendon, excessive sweating

symptoms improve into middle age

emollient, retinoids intermittently or continuously

sunlight exposure will either improve or make worse

care of hair, nails, teeth if affected

Punctate

[image]these are symptoms of what type of focal PPK