Skin Lichen Planus, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Skin Lichen Planus, Diagnosis and Treatment and Related Diseases

Lichen Planus is a chronic inflammatory disease of the skin
It consists of red small papules which can cause itch and scratching
It is often associated with lesions of the mucosal membranes
Lichen Planus occurs more in women than in men

The cause of lichen planus may be related to an allergic or immune reaction
It is also associated with chronic hepatitis C virus infection
The typical rash of Pruritic, Planar, Purple, Polygonal, Papular
Microscopic appearance is hyperparakeratosis of the granular cell layer

The goal of treatment is to reduce symptoms and speed healing.
Dressings placed over skin medicines to protect from scratching
Topical Medicines include topical corticosteroids and Vitamin A cream.
More severe cases need oral corticosteroids, retinoids and Cyclosporine.

-An original poem by Kenneth Kee

Skin Lichen Planus is a chronic inflammatory disease of the skin which typically consists of red small papules that joined together to from rough scaly patches.
Lichen planus is a disorder that forms an itchy rash on the skin or in the mouth
Lichen planus is a poorly understood skin condition.
Its name describes that it resembles a simple plant, a lichen, which grows on rocks and tree bark, while planus is Latin for flat.
It is often linked with lesions of the mucosal membranes.
There are 2 main types:
1. Skin Lichen Planus is the most frequent type of Lichen Planus.
About 80% of people have red small papules that combined together to from rough scaly patches.
The skin normally grows very more quickly and is thicker than normal.
2. Mucosal Lichen Planus (small, red papular lesion of the mouth and mucous membranes)
Cause
The precise cause of lichen planus is not known even though it is immunologically mediated.
The initiating antigen is not clear;
Langerhans cells process the antigen to T lymphocytes, leading to an epidermotropic infiltrate.
Histologically, the inflammation is depicted as a lichenoid infiltrated effacing the dermo-epidermal junction.
Some patients with lichen planus have a positive family history.
It has been noticed that affected families have a higher frequency of human leukocyte antigen B7 (HLA-B7).
Others have determined a link between idiopathic lichen planus and human leukocyte antigen DR1 (HLA-DR1) and human leukocyte antigen DR10 (HLA-DR10);
It may be linked to an allergic or immune reaction
1. Allergic reactions to medicines for high blood pressure (methyl dopa), dyes, and other chemicals (including gold, antibiotics, arsenic, iodides, chloroquine, quinacrine, quinide, phenothiazines and diuretics.)
2. Chronic hepatitis C virus infection
3. Stress exacerbate the disorder
4. Allergic reactions to amalgam and gold filling can produce oral lesions
Symptoms
The start is sudden or gradual.
They may persist weeks or months and be repeat occurring.
Often they become chronic.
Skin rash
The typical skin rash of lichen planus is well-defined:
1. Pruritic,
2. Planar,
3. Purple,
4. Polygonal
5. Papular.
When seen under the microscope the papules have typical network of white lines (Wickham's striae)
Diagnosis
The doctor may make the diagnosis based on the appearance of the skin lesions.
A skin lesion biopsy can verify the diagnosis.
Direct immunofluorescence study shows globular deposits of immunoglobulin M (IgM) and complement mixed with apoptotic keratinocytes
Treatment
Lichen planus is a self-limiting disease that normally recovers within 8-12 months.
Medicinal therapies are:
Topical steroids
Systemic steroids
Oral metronidazole
Oral acitretin
Narrow-band or broadband UV-B therapy
PUVA
Immunosuppressants
Tacrolimus
TABLE OF CONTENT
Introduction
Chapter 1

• Language: English
• Publisher: Kenneth Kee
• Release date: Jul 22, 2019
• ISBN: 9780463275382

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Skin Lichen Planus,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2019 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Skin Lichen Planus, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Skin Lichen Planus)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Skin Lichen Planus

Lichen Planus is a chronic inflammatory disease of the skin

It consists of red small papules which can cause itch and scratching

It is often associated with lesions of the mucosal membranes

Lichen Planus occurs more in women than in men

The cause of lichen planus may be related to an allergic or immune reaction

It is also associated with chronic hepatitis C virus infection

The typical rash of Pruritic, Planar, Purple, Polygonal, Papular

Microscopic appearance is hyperparakeratosis of the granular cell layer

The goal of treatment is to reduce symptoms and speed healing.

Dressings placed over skin medicines to protect from scratching

Topical Medicines include topical corticosteroids and Vitamin A cream.

More severe cases need oral corticosteroids, retinoids and Cyclosporine.

-An original poem by Kenneth Kee

What is Skin Lichen Planus?

Skin Lichen Planus is a chronic inflammatory disease of the skin which typically consists of red small papules that joined together to from rough scaly patches.

Lichen planus is a disorder that forms an itchy rash on the skin or in the mouth

Lichen planus is a poorly understood skin condition.

Its name describes that it resembles a simple plant, a lichen, which grows on rocks and tree bark, while planus is Latin for flat.

It is often linked with lesions of the mucosal membranes.

What are the types of Skin Lichen Planus?

There are 2 main types:

1. Skin Lichen Planus is the most frequent type of Lichen Planus.

About 80% of people have red small papules that combined together to from rough scaly patches.

The skin normally grows very more quickly and is thicker than normal.

2. Mucosal Lichen Planus (small, red papular lesion of the mouth and mucous membranes)

Lichen Planus happens more in females than in males.

It is also more frequent in the middle aged.

It is infrequent in children

What are the causes of Skin Lichen Planus?

Causes

The precise cause of lichen planus is not known even though it is immunologically mediated.

The initiating antigen is not clear;

Langerhans cells process the antigen to T lymphocytes, leading to an epidermotropic infiltrate.

Histologically, the inflammation is depicted as a lichenoid infiltrated effacing the dermo-epidermal junction.

Some patients with lichen planus have a positive family history.

It has been noticed that affected families have a higher frequency of human leukocyte antigen B7 (HLA-B7).

Others have determined a link between idiopathic lichen planus