Bullous Lichen Planus Developing After Two Decades of Classical Mucocutaneous Lichen Planus
Naima Luqman
Keywords: Lichen planus, Bullous lichen planus, Vesiculobullous, Subepidermal blister, Histopathology
ABSTRACT
INTRODUCTION:
An autoimmune chronic inflammatory disease, lichen planus involves not only the skin of the whole body but also involves the nails, hair/scalp and oral mucosa.1,2 The lesions are pain topped, pink, itchy and pink. They are common in women, 3,4 The inner sides of forearms, back sides of hands, knees and feet are usually commonly involved. However, the oral mucosal involvement is also not uncommon. The disease rarely progresses to malignancy. Seasonal changes, hormonal change, and anxiety may trigger the onset of formation of new crops of the disease. The relapses and remissions vary from person to person and there is not a specific time period that has been established to date. Similarly, the time period for which the lesions stay on the body also varies in different patients5
DISCUSSION:
In bullous lichen planus, blistering is a consequence of severe liquefactive degeneration of basal keratinocytes.2 It is very important to distinguish between the bullous eruption of lichen planus which do not arise on normal skin but only arise on the previously affected skin by lichen planus. The condition may also be associated with the presence of autoantibodies in the blood as the disease is an autoimmune disorder.3 The autoantibodies may also be formed against the basement membrane. That is why it is important to make a confirmatory diagnosis on the basis of clinical, histopathological and immunological basis.5