Now@nejm new england journal of medicine home about insights physicians-in-training what's new nejm archive 200 years lichen planus posted by sara fazio • february 23rd, 2012 the various clinical presentations and treatment options of lichen planus are reviewed in the latest article in our clinical practice series, including available data to guide management. Lichen planus is a mucocutaneous inflammatory disease of unknownâ origin. buy viagra online The skin and oral mucosa are the most frequently involvedâ areas. Other mucous membranes (including the genitalia, esophagus,â and conjunctiva) and skin appendages (e. viagra online G. do gay men use viagra , scalp hair and nails) canâ also be affected. One or several areas can be involved, eitherâ concomitantly or sequentially. The clinical presentation of lichenâ planus varies depending on the area involved. where can you buy viagra over the counter in uk Clinical pearls • what is the typical presentation of lichen planus? buy viagra Cutaneous lichen planus is characterized by flat-topped, violaceousâ papules, which in some cases can be intensely itchy (the so-calledâ “purple, polygonal, pruritic papules”). safe take viagra while drinking alcohol The lesions may result inâ long-standing residual hyperpigmentation, especially in dark-skinnedâ patients. Buy generic viagra online forum Oral lichen planus is characterized by symmetric reticularâ lesions that resemble a white, lacelike network, as well as byâ papules, plaques, erythematous lesions, and erosions; it is a chronicâ disease, and its erosive form is painful. order viagra online The clinicalâ characteristics of anogenital lichen planus are typically similar toâ those of both the cutaneous and the oral forms. buy viagra The erosive form ofâ mucosal lichen planus may result in fibrosis, with vulvar scarring,â vaginal stenosis, phimosis, esophageal stricture, blindness, orâ obstruction of the lachrymal canal. viagra for sale online Progressive scarring can alsoâ affect the nails and scalp. buy cheap viagra • what other conditions have been associated with lichen planus? viagra without a doctor prescription Oral lichen planus is generally considered a potentially premalignantâ condition; a 1% incidence of squamous-cell carcinoma has beenâ reported among patients with this condition in both retrospective andâ prospective cohort studies. buy cheap viagra The true risk remains controversial. boots.co.uk viagra Caseâ reports have also described squamous-cell carcinomas arising fromâ chronic anogenital, esophageal, or hypertrophic cutaneous lichenâ planus lesions. Several autoimmune disorders, particularly alopeciaâ areata and ulcerative colitis, have been reported to occur moreâ frequently in patients with lichen planus than in controlâ populations. viagra soft tabs how to take There is also a significant association between lichenâ planus and infection with hepatitis c virus (hcv). Safe drink alcohol viagra In twoâ meta-analyses, patients with lichen planus were reported to beâ approximately five times as likely as controls to be hcv-seropositive. safe take viagra while drinking alcohol Morning report questions q: what diagnostic evaluation is necessary when lichen planus isâ suspected? A: lichen planus is usually diagnosed clinically. viagra vs viagra and alcohol If a patient hasâ lichen planus at any site, the clinician should examine. viagra without a doctor prescription
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