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:

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.					Avoidance of precipitants – especially soaps.5 . Emollients – applied as required and used as a soap substitute.
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].

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.