Sandbox:Inflammatory dermatosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]
Synonyms and keywords:
Overview
Historical Perspective
Classification
Pathophysiology
The etiology of lichen planus is not known. An immune-mediated mechanism involving activated T cells, particularly CD8+ T cells, directed against basal keratinocytes has been proposed [4]. Upregulation of intercellular adhesion molecule-1 (ICAM-1) and cytokines associated with a Th1 immune response, such as interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 alpha, IL-6, and IL-8, may also play a role in the pathogenesis of lichen planus [4-7].
Causes
| Clinical features | Diagnosis | Management | ||||
|---|---|---|---|---|---|---|
| Recommended regimen | Alternative regimens | Follow-up | Other recommendations | |||
| Lichen sclerosus | ||||||
| Lichen planus | purplish lesions, or supporting evidence of lichen planus lesions elsewhere on the body. This particularly includes the mouth in cases of erosive (penogingival) disease | irregular saw-toothed acanthosis, increased granular layer and basal cell liquefaction. Band-like dermal infiltrate (mainly lymphocytic). The condition may be associated with pre-cancerous change | ||||
| Zoon’s (plasma cell) balanitis | ||||||
| Psoriasis | ||||||
| Circinate balanitis | ||||||
| Eczema | symptoms ranges from mild non-specific erythema to widespread oedema of the penis. | |||||
| Seborrhoeic dermatitis | ||||||
| Fixed drug eruption | Well demarcated and erythematous, but can be bullous with subsequent ulceration | |||||
| Non-specific balanoposthitis | ||||||
Epidemiology and Demographics
Based upon limited data, cutaneous lichen planus is estimated to occur in less than 1 percent of the population [1].
Cutaneous lichen planus most frequently develops between the ages of 30 and 60 years [1,2]. Childhood cutaneous lichen planus occurs, but is uncommon [3]. There does not appear to be a strong sex or racial predilection for cutaneous lichen planus [1,2].
Screening
Natural History, Complications, and Prognosis
Natural history
Complications
Prognosis
Diagnosis
History and symptoms
Physical examination
Laboratory findings
Treatment
General measures
Good hygiene which include retracting the foreskin regularly and gentle cleansing of entire glans, preputial sac, and foreskin were found effective in treating the diseases.