Lichen Planus

Lichen Planus

Q. 1

Which of the following drugs is used in generalised lichen planus?

 A

Systemic steroids

 B

Dapsone

 C

Both Dapsone & Systemic steroids

 D

Methotrexate

Q. 1

Which of the following drugs is used in generalised lichen planus?

 A

Systemic steroids

 B

Dapsone

 C

Both Dapsone & Systemic steroids

 D

Methotrexate

Ans. C

Explanation:

A combination therapy with steroids and Dapsone gives a better result than 1 drug used alone.


Q. 2

Scenario: Maliya was diagnosed with Lichen Planus after suffering with flat topped polygonal papules which retains the skin lines.

Assertion: Wickham’s striae are white lines which traverse the surface of the papules.

Reason: A focal decrease in thickness of the granular layer and infiltrate corresponds to the presence of Wickham’s striae.

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Q. 2

Scenario: Maliya was diagnosed with Lichen Planus after suffering with flat topped polygonal papules which retains the skin lines.

Assertion: Wickham’s striae are white lines which traverse the surface of the papules.

Reason: A focal decrease in thickness of the granular layer and infiltrate corresponds to the presence of Wickham’s striae.

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Ans. C

Explanation:

LP is characterized by shiny, violaceous, flat-topped polygonal papules which retain the skin lines.

Wickham’s striae are white lines which traverse the surface of the papules.

A focal increase in thickness of the granular layer and infiltrate corresponds to the presence of Wickham’s striae.


Reference:
Rook’s Textbook of Dermatology, 8th Edition


Q. 3

Mouth Lesion are seen in:

 A

Psoriasis

 B

Lichen Planus

 C

Basal Cell CA

 D

Icthyosis Vulgaris

Q. 3

Mouth Lesion are seen in:

 A

Psoriasis

 B

Lichen Planus

 C

Basal Cell CA

 D

Icthyosis Vulgaris

Ans. B

Explanation:

B i.e. Lichen planus


Q. 4

Mucosa is involved in:

 A

Psoriasis

 B

Lichen planus

 C

Alopecia

 D

Scabies

Q. 4

Mucosa is involved in:

 A

Psoriasis

 B

Lichen planus

 C

Alopecia

 D

Scabies

Ans. B

Explanation:

B i.e., Lichen planus


Q. 5

Features of lichen planus are

 A

Pruritis

 B

Purple color

 C

Papule

 D

All

Q. 5

Features of lichen planus are

 A

Pruritis

 B

Purple color

 C

Papule

 D

All

Ans. D

Explanation:

A i.e. Pruritus, B i.e. Purple, C i.e. Papule


Q. 6

Max. Joseph’s space is a histopatho-logical feature of:

 A

Psoriasis vulgaris

 B

Lichen planus

 C

Pityriasis rosea

 D

Parapsoriasis

Q. 6

Max. Joseph’s space is a histopatho-logical feature of:

 A

Psoriasis vulgaris

 B

Lichen planus

 C

Pityriasis rosea

 D

Parapsoriasis

Ans. B

Explanation:

B i.e. Lichen planus


Q. 7

Civatte bodies are found in :

 A

Lichen Planus

 B

Psoriasis

 C

Dermatophytosis

 D

Vitiligo

Q. 7

Civatte bodies are found in :

 A

Lichen Planus

 B

Psoriasis

 C

Dermatophytosis

 D

Vitiligo

Ans. A

Explanation:

A. i.e. Lichen planus


Q. 8

True about lichen planus-

 A

Basal cell degeneration

 B

Colloid bodies seen

 C

Epidermal hyperplasia in chronic cases

 D

All of the above

Q. 8

True about lichen planus-

 A

Basal cell degeneration

 B

Colloid bodies seen

 C

Epidermal hyperplasia in chronic cases

 D

All of the above

Ans. D

Explanation:

A i.e. Basal cell degeneration; B i.e. Colloid bodies seen; C i.e. Epidermal hyperplasia in chronic cases


Q. 9

Basal cell degeneration characteristically seen in:

 A

Lichen planus

 B

Psoriasis

 C

Pemphigus

 D

DLE

Q. 9

Basal cell degeneration characteristically seen in:

 A

Lichen planus

 B

Psoriasis

 C

Pemphigus

 D

DLE

Ans. A

Explanation:

A i.e. Lichen planus


Q. 10

A young lady presents with lacy lesions in oral cavity and genitals, and her proximal nail fold has extended onto the nail bed. What is the likely diagnosis 

 A

Lichen planus

 B

Candidiasis

 C

Both

 D

None

Q. 10

A young lady presents with lacy lesions in oral cavity and genitals, and her proximal nail fold has extended onto the nail bed. What is the likely diagnosis 

 A

Lichen planus

 B

Candidiasis

 C

Both

 D

None

Ans. A

Explanation:

A i.e. Lichen planus


Q. 11

A 30 year old male present with pruritic flat-topped polygonal, shiny violaceous papules with flexural distribution. the most likely diagnosis is‑

 A

Psoriasis

 B

Pityriasis

 C

Lichen planus

 D

Lichenoid dermatitis

Q. 11

A 30 year old male present with pruritic flat-topped polygonal, shiny violaceous papules with flexural distribution. the most likely diagnosis is‑

 A

Psoriasis

 B

Pityriasis

 C

Lichen planus

 D

Lichenoid dermatitis

Ans. C

Explanation:

C. i.e. Lichen planus


Q. 12

Which of the following is pruritic:

 A

Lichen planus

 B

Psoriasis

 C

Icthyosis

 D

Secondary syphilis

Q. 12

Which of the following is pruritic:

 A

Lichen planus

 B

Psoriasis

 C

Icthyosis

 D

Secondary syphilis

Ans. A

Explanation:

A. i.e. Lichen planus


Q. 13

Lacy white lesion in mouth with pterygium is seen in :

 A

Psoriasis

 B

Ptirysis alba

 C

Lichen planus

 D

Leprosy

Q. 13

Lacy white lesion in mouth with pterygium is seen in :

 A

Psoriasis

 B

Ptirysis alba

 C

Lichen planus

 D

Leprosy

Ans. C

Explanation:

C. Lichen planus


Q. 14

Regarding Lichen Planus all are true, except :

 A

Hypopigmentation in most residual disease

 B

Lymphatic infiltration in supradermal layer

 C

Itchy polygonal, purple papule

 D

Skin, hair and oral mucosa commonly involved

Q. 14

Regarding Lichen Planus all are true, except :

 A

Hypopigmentation in most residual disease

 B

Lymphatic infiltration in supradermal layer

 C

Itchy polygonal, purple papule

 D

Skin, hair and oral mucosa commonly involved

Ans. A

Explanation:

A. i.e. Hypopigmentation in residual disease


Q. 15

All of the following regarding Lichen planus are true except:

 A

Does not involve mucous membrane

 B

Associated with Hepatitis ‘C

 C

Topical steroid are the mainstay of therapy

 D

Spontaneous remissions 6mo to 2 years

Q. 15

All of the following regarding Lichen planus are true except:

 A

Does not involve mucous membrane

 B

Associated with Hepatitis ‘C

 C

Topical steroid are the mainstay of therapy

 D

Spontaneous remissions 6mo to 2 years

Ans. A

Explanation:

A. i.e. Does not involve mucous membrane


Q. 16

Characterstic nail finding in lichen planus

 A

Pitting

 B

Pterygium

 C

Beau’s Lines

 D

Hyperpigmentation of nails

Q. 16

Characterstic nail finding in lichen planus

 A

Pitting

 B

Pterygium

 C

Beau’s Lines

 D

Hyperpigmentation of nails

Ans. B

Explanation:

B i.e. Pterygium


Q. 17

10 year old chid has violaceous papule and pterygium of nails. The diagnosis is

 A

Psoriasis

 B

Pemphigus

 C

Pemphigoid

 D

Lichen Planus

Q. 17

10 year old chid has violaceous papule and pterygium of nails. The diagnosis is

 A

Psoriasis

 B

Pemphigus

 C

Pemphigoid

 D

Lichen Planus

Ans. D

Explanation:

D i.e. Lichen planus


Q. 18

Itchy polygonal violaceous (itchy/prusitic) palpules seen rn

 A

Psoriasis

 B

Pemphigus

 C

Lichen planus

 D

Pitriasios rosea

Q. 18

Itchy polygonal violaceous (itchy/prusitic) palpules seen rn

 A

Psoriasis

 B

Pemphigus

 C

Lichen planus

 D

Pitriasios rosea

Ans. C

Explanation:

C. i.e. Lichen planus


Q. 19

Most characteristic Feature of lichen planus is: 

 A

Thinning of nail plate is most common

 B

Non scarring alopecia

 C

Violaceous lesions on skin and mucous membrane 

 D

Wickham striae

Q. 19

Most characteristic Feature of lichen planus is: 

 A

Thinning of nail plate is most common

 B

Non scarring alopecia

 C

Violaceous lesions on skin and mucous membrane 

 D

Wickham striae

Ans. D

Explanation:

D i.e. Wickham Striae


Q. 20

The most characteristic finding In lichen planus is:

 A

Civatte bodies

 B

Basal cell degeneration

 C

Thinning of nail plate

 D

Violaceous lesions

Q. 20

The most characteristic finding In lichen planus is:

 A

Civatte bodies

 B

Basal cell degeneration

 C

Thinning of nail plate

 D

Violaceous lesions

Ans. B

Explanation:

B i.e. Basal cell degeneration


Q. 21

In Lichen planus TOC is:

 A

Topical Salicylic acid

 B

UV ray

 C

Systemic steroids

 D

Erythromycin

Q. 21

In Lichen planus TOC is:

 A

Topical Salicylic acid

 B

UV ray

 C

Systemic steroids

 D

Erythromycin

Ans. C

Explanation:

C i.e. Systemic Steroids


Q. 22

Which of the following are pruritic lesions

 A

Lichen planus

 B

Sun burns

 C

Pemphigoid

 D

All of the above

Q. 22

Which of the following are pruritic lesions

 A

Lichen planus

 B

Sun burns

 C

Pemphigoid

 D

All of the above

Ans. D

Explanation:

A i.e. Lichen planus; B i.e. Sun burns; C i.e. Pemphigoid

In SLE skin lesions are neither itchy nor painfulQ 

Lesion

Itching

SLE

Not itchyQ

Psoriasis

Very uncommonQ

Pemphigus

Mild

Pemphigoid

Common

Sun burn

Common

DLE

Very common

Lichen planus

Voilaceous (extremely itchy)Q


Q. 23

All of the following are Eradicable diseases EXCEPT-

 A

Tuberculosis

 B

Guinea worm

 C

Polio

 D

Measles

Q. 23

All of the following are Eradicable diseases EXCEPT-

 A

Tuberculosis

 B

Guinea worm

 C

Polio

 D

Measles

Ans. A

Explanation:

Ans. is ‘a’ i.e., Tuberculosis 

o Smallpox is the only disease that has been eradicated.

o Other diseases which are candidates for global eradication Polio, measles, dracunculiasis, diphtheria.


Q. 24

All predisposes to oral cancer except –

 A

Erythroplakia

 B

Leukoplakia

 C

Submucosal fibrosis

 D

Lichen planus

Q. 24

All predisposes to oral cancer except –

 A

Erythroplakia

 B

Leukoplakia

 C

Submucosal fibrosis

 D

Lichen planus

Ans. D

Explanation:

Answer is ‘d’ i.e. Lichen planus 


Q. 25

Nail deformity commonly seen in lichen planus are all of the following except:  

March 2009

 A

Pterygium

 B

Longitudnal grooves

 C

Oncholysis

 D

Beau’s lines

Q. 25

Nail deformity commonly seen in lichen planus are all of the following except:  

March 2009

 A

Pterygium

 B

Longitudnal grooves

 C

Oncholysis

 D

Beau’s lines

Ans. D

Explanation:

Ans. D: Beau’s lines

Lichen planus affects one or more nails in 10% of cases, sometimes without involving the skin surface – if all nails are abnormal and nowhere else is affected it is called twenty nail dystrophy.

  • The nail plate tends to thin and may become longitudinally grooved and ridged.
  • The nail may darken, thicken up or lift off the nail bed (onycholysis).
  • Sometimes the cuticle is destroyed and forms a scar (pterygium)-diagnostic.
  • The nails may shed, stop growing altogether and rarely, completely disappear. Beau’s lines are transverse grooves that appear simultaneously on all nails

Q. 26

Wood’s lamp is not used for diagnosing:

September 2010, March 2013

 A

Vitiligo

 B

Porphyria

 C

Pityriasis

 D

Lichen planus

Q. 26

Wood’s lamp is not used for diagnosing:

September 2010, March 2013

 A

Vitiligo

 B

Porphyria

 C

Pityriasis

 D

Lichen planus

Ans. D

Explanation:

Ans. D: Lichen planus

Wood’s lamp has many uses, both in distinguishing fluorescent conditions from other conditions and in locating the precise boundaries of the condition. It is also helpful in diagnosing:

  • Fungal infections (Microsporum audouini). Some forms of tinea, such as Trichophyton tonsurans, do not fluoresce.
  • Bacterial infections (Corynebacteriium minutissimum, Pseudomonas)
  • Propionibacterium acnes, the bacteria responsible for acne, exhibits an orange glow under a Wood’s lamp

Q. 27

Which of the following is not a type of lichen planus?

 A

Lichen scrofulosorum

 B

Lichen planopilaris

 C

Lichen hypertrophica

 D

Lichen pigmentosa

Q. 27

Which of the following is not a type of lichen planus?

 A

Lichen scrofulosorum

 B

Lichen planopilaris

 C

Lichen hypertrophica

 D

Lichen pigmentosa

Ans. A

Explanation:

Ans. a. Lichen scrofulosorum

Lichen scrofulosorum is a type of cutaneous TB, not the lichen planus.

`Lichen scrofulosarum is a type of cutaneous TB. It is the most common type of tuberculide (hypersensitivity TB) seen around hair follicles.’

`Lichen scrofulosorum (also known as ‘Tuberculosis cutis lichenoides) is a rare tuberculid that presents as a lichenoid eruption of minute papules in children and adolescents with tuberculosis. The lesions are usually asymptomatic, closely grouped, skin-colored to reddish-brown papules, often perifollicular and are mainly found on the abdomen, chest, back, and proximal parts of the limbs. The eruption is usually associated with a strongly positive tuberculin reaction.’

Clinical variants of Lichen Planus

Annular Lichen planus pemphigoides Follicular (LichenplanopilarisQ)
Hypertrophie Lichen planuspigmentosusQ Lichen   planus follicularis decalvans
Atrophic Erythrodermic Actinic
Ulcerative Linear  
Bullous    
Inverse    

Q. 28

Koebner phenomenon seen in ‑

 A

Psoriasis

 B

Lichen planus

 C

Warts

 D

All the above

Q. 28

Koebner phenomenon seen in ‑

 A

Psoriasis

 B

Lichen planus

 C

Warts

 D

All the above

Ans. D

Explanation:

Ans. is ‘d’ i.e., All the above


Q. 29

True about the lesions of lichen planus ‑

 A

Polygonal violaceous paple

 B

Affect skin and mucous membranes

 C

Are pruritic

 D

All the above

Q. 29

True about the lesions of lichen planus ‑

 A

Polygonal violaceous paple

 B

Affect skin and mucous membranes

 C

Are pruritic

 D

All the above

Ans. D

Explanation:

Ans. is ‘d’ i.e., All the above 


Q. 30

Lichen planus all are true except ‑

 A

Pruritic lesion

 B

Involves nails

 C

Involves mucus membranes

 D

Steroid is not used in treatment

Q. 30

Lichen planus all are true except ‑

 A

Pruritic lesion

 B

Involves nails

 C

Involves mucus membranes

 D

Steroid is not used in treatment

Ans. D

Explanation:

Ans. is ‘d’ i.e., Steroid is not used in treatment


Q. 31

Pterygium of nail is seen in ‑

 A

Lichen planus

 B

Psoriasis

 C

tinea ungium

 D

Alopecia areta

Q. 31

Pterygium of nail is seen in ‑

 A

Lichen planus

 B

Psoriasis

 C

tinea ungium

 D

Alopecia areta

Ans. A

Explanation:

Ans. is ‘a’ i.e., Lichen planus

Dorsal pterygium

  • Winged appearance of nail due to a central fibrotic band divides a nail proximally in two.
  • Fibrotic band obstructs normal nail growth. eg :- lichen planus

Ventral pterygium or pterygium inversum unguis

  • Occurs on the distal undersurface of the nail, with forward extension of the nail bed epithelium dislocating the hyponychium and obscuring the distal groove.eg:- trauma, systemic sclerosis, Raynaud’s phenomenon, lupus erythematosus, familial and infective.

Q. 32

Histological feature of lichen planus is ‑

 A

Acantosis

 B

Interphase dermatitis

 C

Non specific

 D

Basal cell degeneration

Q. 32

Histological feature of lichen planus is ‑

 A

Acantosis

 B

Interphase dermatitis

 C

Non specific

 D

Basal cell degeneration

Ans. D

Explanation:

Ans. is `d>a’ i.e., Basal cell degeneration > Acantosis

  • The basic pathology in lichen planus is the damage to the basal cell layer of epidermis leading to hydropic degeneration of basal cells”.                                                                                                       —Venkataram Pie 59

Histopathologv in Lichen planus

  1. The basic pathology in lichen planus is the damage to the basal cell layer of epidermis leading to hydropic degeneration of basal cells.
  2. Epidermal thickening especially of granular cell layer —> Hypergranulosis.
  3. Hyperkeratosis (Thickening of stratum cornuem)
  4. Acanthosis (Thickening of Stratum) malpighi.
  5. Subepidermal – lichenoid band due to deposition of lymphocytes & histiocytes in upper dermis.
  6. Dropping of melanin pigment from damaged keratinocytes of epidermis into dermis –> pigment incontinence.
  7. This melanin is engulfed by macrophages which results information of cytoid bodies (civatte or colloid bodies).
  8. Mox Joseph Histological cleft -3 Separation of epidermis in small clefts.

Q. 33

Treatment of choice for lichen planus ‑

 A

Topical corticosteroids

 B

Systemic corticosteroids

 C

Antihistaminics

 D

Acitretin

Q. 33

Treatment of choice for lichen planus ‑

 A

Topical corticosteroids

 B

Systemic corticosteroids

 C

Antihistaminics

 D

Acitretin

Ans. A

Explanation:

Ans. is ‘a’ i.e., Topical corticosteroids

Treatment of Lichen planus

  • The first line treatment of lichen planus are topical corticosteroids.
  • Second choice would be systemic corticosteroids for symptom control and possibly more rapid resolution.
  • Oral antihistaminics are given for pruritic.
  • PUVA can be used for extensive lesions.
  • Acitretin can be used for mucosal lesions.


Leave a Reply

%d bloggers like this:
Malcare WordPress Security