[vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” oblique_section=”no” text_align=”left” css_animation=””][vc_column][ultimate_heading main_heading=”Candidate brief” main_heading_color=”#000000″ sub_heading_color=”#000000″ main_heading_style=”font-weight:bold;” main_heading_font_size=”desktop:36px;”]

“This gentleman has complained of mouth ulcers.  Please take a focused history and examination and discuss your findings with the examiners.”

[/ultimate_heading][vc_empty_space image_repeat=”no-repeat”][vc_video link=”https://vimeo.com/187711083″][vc_empty_space image_repeat=”no-repeat”][vc_row_inner row_type=”row” type=”full_width” use_row_as_full_screen_section_slide=”no” text_align=”left” css_animation=””][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Station time” counter_value=”20″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Time for this encounter” counter_value=”10″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Maximum time to examine your patient” counter_value=”8″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Minimum time for discussion and questions” counter_value=”2″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][/vc_row_inner][vc_empty_space image_repeat=”no-repeat”][/vc_column][/vc_row][vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” oblique_section=”no” text_align=”left” css_animation=””][vc_column][vc_accordion style=”accordion”][vc_accordion_tab title=”Common examiner questions”][vc_column_text]Common examiner questions include the following:

  1. What do you think this patient has?
  2. How would you like to investigate this patient next?
  3. What do you think the underlying cause of this patient’s signs is?

[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Diagnosis and clinical signs”][vc_column_text]This patient has oral lichen planus.

The clinical signs exhibited in this video include lesions on the hard palate and well defined lesions on the upper lip.

The diagnosis is lichen planus.

Lichen planus is a cell-mediated immunological disorder of unknown aetiology.  It is characterised by an indolent onset and spontaneous resolution after 6-12 months.  Most patients report some pruritis in the skin lesions, and mouth ulceration may be painful.

The diagnosis is lichen planus.

The lesions are clearly demarcated with raised plaques. These primarily occur on the flexor areas, and in particular, the ankles and wrists. They are shiny in nature and have a violaceous hue. They have white, streaks which are also known as Wickham’s striae. The lesions are pruritic.

They also can demonstrate Köebner’s phenomenon. The lesions, when resolved due to brown-ish macular scars.[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Discussion”][vc_column_text]Ensure when you see these lesions, to examine the oral mucosa as well as the nails. They may also be ulcerated. Sometimes, the nails can completely disappear.

Lichen planus is not generally associated with malignancy with the exception of vulval lesions in women.  Occasionally it is necessary to treat cutaneous lesions with topical steroids and (in severe cases) immunosuppression.  Some patients also respond to UV therapy.[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Specimen case presentation”][vc_column_text]”This patient has oral lichen planus.  I would like to confirm this diagnosis with a biopsy.”[/vc_column_text][/vc_accordion_tab][/vc_accordion][/vc_column][/vc_row]