What is lichen planus associated with?

Lichen planus is a condition that is primarily associated with T-cell autoimmunity directed against basal keratinocytes of the epidermis. The underlying mechanism involves a mediating immune response where activated CD8+ T-cells infiltrate the epidermis and attack these keratinocytes, leading to the characteristic inflammatory lesions of lichen planus. This immune-mediated reaction often manifests with white, lace-like lesions (Wickham's striae) and can affect not just the skin, but also mucosal sites including the oral cavity.

Understanding the autoimmune aspect of lichen planus is crucial in its diagnosis and management, as it highlights the relevance of immune system disorders in this skin condition. It can also relate to various triggers or associations, including stress, certain medications, and systemic diseases, but the root cause remains the autoimmunity targeting skin cells.

The other options present different medical conditions that are not directly linked to the mechanism of lichen planus, thus distinguishing the correct association pertaining to autoimmune processes affecting skin cells.