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Tekin B, Xie F, Lehman JS. Lichen Planus: What is New in Diagnosis and Treatment? Am J Clin Dermatol 2024; 25:735-764. [PMID: 38982032 DOI: 10.1007/s40257-024-00878-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/11/2024]
Abstract
Lichen planus (LP), an idiopathic, multifaceted chronic inflammatory disease with a heterogeneous clinical presentation, affects approximately 0.5-1% of the population. The various clinical manifestations of LP fall into three broad categories, namely cutaneous, appendageal, and mucosal, with further subclassification depending on the morphology and distribution patterns of individual lesions. There is mounting evidence that LP has systemic associations, including autoimmune conditions, glucose intolerance, dyslipidemia, and cardiovascular disorders. Cutaneous hypertrophic and mucosal forms of LP are at a heightened risk for malignant transformation. Familiarity with these potential associations in conjunction with long-term follow-up and regular screening could lead to a timely diagnosis and management of concomitant conditions. In addition, the frequent quality of life (QoL) impairment in LP underscores the need for a comprehensive approach including psychological evaluation and support. Several treatment strategies have been attempted, though most of them have not been adopted in clinical practice because of suboptimal benefit-to-risk ratios or lack of evidence. More recent studies toward pathogenesis-driven treatments have identified Janus kinase inhibitors such as tofacitinib, phosphodiesterase-4 inhibitors such as apremilast, and biologics targeting the interleukin-23/interleukin-17 pathway as novel therapeutic options, resulting in a dramatic change of the treatment landscape of LP. This contemporary review focuses on the diagnosis and management of LP, and places emphasis on more recently described targeted treatment options.
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Affiliation(s)
- Burak Tekin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Julia S Lehman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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2
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The Immunogenetics of Lichen Planus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1367:119-135. [DOI: 10.1007/978-3-030-92616-8_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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3
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Dermatologic Problems Commonly Seen by the Allergist/Immunologist. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:102-112. [PMID: 31351991 DOI: 10.1016/j.jaip.2019.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 11/23/2022]
Abstract
Allergists/immunologists see a variety of skin disorders, some of which have a known immunologic basis whereas others do not. We review the prevalence, etiology, clinical presentation, and effective and low-cost care of common dermatologic conditions seen in outpatient practices. Conditions discussed include pityriasis alba, seborrheic dermatitis, rosacea, acne, tinea infections, intertrigo, lichen planus, tinea versicolor, lichen simplex chronicus, scabies, pityriasis rosea, keratosis pilaris, and seborrheic keratosis. An understanding of frequently encountered cutaneous diseases and their therapies will help provide immediate access to treatment and improve the experience for both the affected patient and the clinician.
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Tziotzios C, Lee JYW, Brier T, Saito R, Hsu CK, Bhargava K, Stefanato CM, Fenton DA, McGrath JA. Lichen planus and lichenoid dermatoses: Clinical overview and molecular basis. J Am Acad Dermatol 2019; 79:789-804. [PMID: 30318136 DOI: 10.1016/j.jaad.2018.02.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Deriving from the Greek word λειχήν for "tree moss" and the Latin word planus for "planar," lichen planus is a relatively uncommon and heterogeneous cutaneous disorder that typically develops in middle-aged adults. Despite the significant clinical burden associated with the disorder, little well-conducted molecular research has been undertaken, possibly because of heterogeneity impeding consistent and confident phenotyping. The multiple variants of lichenoid disease bear overlapping clinical and pathologic features despite manifesting as distinct clinical disorders. The first article in this 2-part continuing medical education series provides a comprehensive overview of the clinical and pathologic characteristics of cutaneous lichenoid dermatoses and links these manifestations to recent advances in our understanding of the underlying pathobiology of such diseases.
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Affiliation(s)
- Christos Tziotzios
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom.
| | - John Y W Lee
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - Timothy Brier
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - Ryo Saito
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - Chao-Kai Hsu
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - Kapil Bhargava
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - Catherine M Stefanato
- Department of Dermatopathology, St. John's Institute of Dermatology, St. Thomas' Hospital, London, United Kingdom
| | - David A Fenton
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - John A McGrath
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
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5
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Namazi N, Niknezhad N, Niknejad N, Asadi-Kani Z. Familial facial lichen planopilaris and satisfactory response to isotretinoin. Dermatol Ther 2018; 31:e12633. [DOI: 10.1111/dth.12633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 03/25/2018] [Accepted: 06/02/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Nastaran Namazi
- Department of Dermatology; Shahid Beheshti University of Medical Sciences, Shohada-e-Tajrish Hospital; Tehran Iran
| | - Nasim Niknezhad
- Department of Dermatology; Shahid Beheshti University of Medical Sciences, Shohada-e-Tajrish Hospital; Tehran Iran
| | - Nakisa Niknejad
- Department of Pathology; Imam Khomeini Hospital Complex, Tehran University of Medical Sciences; Tehran Iran
| | - Zahra Asadi-Kani
- Department of Dermatology; Shahid Beheshti University of Medical Sciences, Shohada-e-Tajrish Hospital; Tehran Iran
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Huang C, Chen S, Liu Z, Tao J, Wang C, Zhou Y. Familial Bullous Lichen Planus (FBLP): Pedigree Analysis and Clinical Characteristics. J Cutan Med Surg 2016. [DOI: 10.1177/120347540500900503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Familial bullous lichen planus (FBLP) is a rare condition. The clinical features dearly have been described. Objective: We report the largest patient series of FBLP and describe its clinical characteristics and inheritance pattern. Methods: In this retrospective chart review, we analyzed nine consecutive familial pedigrees of FBLP with 36 affected individuals who presented to the Department of Dermatology at the Wuhan Union Hospital, a tertiary referral hospital in central China. Parameters analyzed include age of onset, gender predilection, lesional distribution, nail and mucosal involvement, clinical course, and inheritance pattern. Results: Thirty-six of 85 individuals in the nine families were affected (42.4%). Females were more likely to be affected than males (58.3% vs 35.7%, Ġ(χ2 = 3.99. P < 0.05). A bimodal disease onset was found, with one peak at 1–3 years and another at 13–17 years. The shin is the most commonly affected area (97%) followed by the upper limbs and the thighs. Involvement of the torso is relatively rare. Only a minority of cases involves the oral mucosa. The disease tends to follow a chronic and progressive course. The inheritance pattern is autosomal dominant with variable penetrance. Conclusion: Familial bullous lichen planus is a chronic, progressive bullous eruption of the lower and upper extremities. Compared with non familial bullous lichen planus, it has an earlier onset and wider disease distribution. It may be inherited as an autosomal dominant condition with variable penetrance.
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Affiliation(s)
- Changzheng Huang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Siyuan Chen
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zhixiang Liu
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Juan Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Chunsen Wang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Youwen Zhou
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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Wu D, Wang L, Sun M, Wang G, Fu S, Dong G, Wu Y. CIITArs4774 and rs6498122 polymorphisms are associated with oral lichen planus in Chinese people: a case-control study. Eur J Oral Sci 2013; 121:69-75. [DOI: 10.1111/eos.12029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
| | - Lifeng Wang
- Department of Biochemistry and Molecular Biology; Forth Military Medical University; Xi'an; China
| | | | | | - Shanmin Fu
- Department of Orthodontics; School of Stomatology; Forth Military Medical University; Xi'an; China
| | - Guangying Dong
- Department of Periodontics and Oral Medcine; School of Stomatology; Forth Military Medical University; Xi'an; China
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Wu D, Cheng S, Chen X, Sun M, Wang G, Fu S, Dong G, Wang L, Wu Y. Mitochondrial haplogroup B4 may be a protective factor to oral lichen planus susceptibility in Chinese. Oral Dis 2013; 20:62-8. [PMID: 23413987 DOI: 10.1111/odi.12074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 12/20/2012] [Accepted: 01/15/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is a common inflammatory disorder with a higher prevalence among women than men. The pathogenesis of OLP is still unclear, and its heredity is not well characterized. Maternal inheritance of mitochondrial DNA (mtDNA) indicates its importance in human ethnic group classification as well disease susceptibility. So, this study was conducted to find whether mtDNA haplogroup associates with OLP susceptibility in Chinese, and determine the influence of C-stretch structure of mtDNA on OLP susceptibility. SUBJECTS AND METHODS We sequenced three hypervariable regions of mtDNA from 242 patients with OLP and 237 healthy controls. The association between mtDNA haplogroups and OLP is tested by chi-square test. RESULTS Seventeen kinds of haplogroups were identified, and the frequency of haplogroup B4 was significantly higher in control group than that of the OLP group (P = 0.013, OR=0.429). In female samples, B4 declared even more significance (P = 0.003, OR=0.296). Meanwhile, the haplotypes of C-stretch in mtDNA did not have any significant difference between case-control groups. CONCLUSIONS Mitochondrial DNA haplogroup B4 might have a protective effect to OLP, and its protective effect resides predominantly in women. However, the association between C-stretch haplotype and OLP susceptibility still needs more patients for evaluation.
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Affiliation(s)
- D Wu
- Center for DNA Typing, Forth Military Medical University, Xi'an, China; Department of Biochemistry and Molecular Biology, Forth Military Medical University, Xi'an, China
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Clinical evaluation of oral lesions associated with dermatologic diseases. An Bras Dermatol 2010; 85:150-6. [PMID: 20520929 DOI: 10.1590/s0365-05962010000200004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Accepted: 01/20/2010] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dermatologic diseases are not only represented by lesions affecting the skin but also by manifestations that may involve the mucous membranes, including oral mucosa. OBJECTIVES To evaluate the frequency of oral manifestations associated with dermatologic diseases considering location and clinical characteristics of the lesions found and also gender, age and race of patients. METHOD It was an observational, cross-sectional study of patients who sought for treatment at the Dermatology Service of the University Hospital (Hospital Presidente Dutra-HUPD); UFMA, between October 2007 and October 2008 (n=88). RESULTS Age varied from 5 to 88 and there was predominance of female patients. 35% of the cases studied were diagnosed as lichen planus; 33% as lupus erythematosus; 24% as erythema multiforme; 7% as pemphigus vulgaris and 1% as pemphigoid group. Oral manifestations were more common among patients suffering from lichen pplanus (51%) and lupus erythematosus (20%). The most common clinical presentation found was reticular lichen planus located most predominantly in the buccal mucosa. CONCLUSIONS It is essential that dentists know these pathologies to be able to diagnose them in an early stage of the disease and to direct patients to adequate treatment. Furthermore, intraoral examination should be included as a routine practice in dermatological services.
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Abstract
Abstract: Allergists/immunologists see patients with a variety of skin disorders. Some, such as atopic and allergic contact dermatitis, are caused by abnormal immunologic reactions, whereas others, such as seborrheic dermatitis or rosacea, lack an immunologic basis. This review summarizes a select group of dermatologic problems commonly encountered by an allergist/immunologist.
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Kragelund C, Hansen C, Reibel J, Nauntofte B, Broesen K, Pedersen AML, Smidt D, Eiberg H, Torpet LA. Polymorphic drug metabolizing CYP-enzymes - a pathogenic factor in oral lichen planus? J Oral Pathol Med 2008; 38:63-71. [DOI: 10.1111/j.1600-0714.2008.00702.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Huang C, Yan X, Yang L, Zhang J, Tian J, Li J, Wang C, Tu Y. A retrospective and comparative study of familial and non-familial bullous lichen planus. ACTA ACUST UNITED AC 2008; 27:336-8. [PMID: 17641857 DOI: 10.1007/s11596-007-0331-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Indexed: 11/27/2022]
Abstract
In order to compare the clinical characteristics of familial and non-familial bullous lichen planus (BLP), the archival data of 36 BLP patients with positive family history and 21 BLP patients with negative family history diagnosed according to the clinical features and histopathology were collected in our department from 1956 to 2003. The clinical features were analyzed and compared. There were significant differences between familial and non-familial BLP in age of onset, duration of disease and extension of eruption (P<0.01). It was concluded that familial BLP appeared to differ from the non-familial form in its earlier age of onset, longer duration of the disease, more extensive eruption and more tendency to involve nails. Hereditary factors may play a role in the pathogenesis of familial BLP.
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Affiliation(s)
- Changzheng Huang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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13
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Ruiz-Maldonado R, Duran-McKinster C, Orozco-Covarrubias L, Saez-de-Ocariz M, Palacios-Lopez C. Keratosis lichenoides chronica in pediatric patients: A different disease? J Am Acad Dermatol 2007; 56:S1-5. [PMID: 17224382 DOI: 10.1016/j.jaad.2006.07.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2006] [Revised: 05/30/2006] [Accepted: 07/12/2006] [Indexed: 10/23/2022]
Abstract
Keratosis lichenoides chronica (KLC) is a rare acquired disease of adulthood, of unknown etiology, characterized by keratotic parallel linear lesions, retiform plaques, and keratotic, often follicular papules, chronicity and lichenoid histopathologic features. KLC of pediatric onset is considered extremely rare. Its features and relationship to adult onset KLC are unknown. We studied 8 cases of pediatric-onset KLC in the literature and 6 personal cases and compared them with 40 reported adult-onset KLC patients. The following features characterize pediatric-onset KLC: familial occurrence; probable autosomal recessive inheritance; early or congenital onset with facial erythemato-purpuric macules; forehead, eyebrow, and eyelash alopecia; pruritus; and a low frequency of other cutaneous and systemic abnormalities. Pediatric-onset KLC may represent a different disease or a subset of adult-onset KLC, with special genetic and clinical characteristics. Determining its precise nosology will have prognostic and therapeutic implications.
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14
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Huang C, Chen S, Liu Z, Tao J, Wang C, Zhou Y. Familial bullous lichen planus (FBLP): Pedigree analysis and clinical characteristics. J Cutan Med Surg 2006; 9:217-22. [PMID: 16502199 DOI: 10.1007/s10227-005-0146-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Familial bullous lichen planus (FBLP) is a rare condition. The clinical features dearly have been described. OBJECTIVE We report the largest patient series of FBLP and describe its clinical characteristics and inheritance pattern. METHODS In this retrospective chart review, we analyzed nine consecutive familial pedigrees of FBLP with 36 affected individuals who presented to the Department of Dermatology at the Wuhan Union Hospital, a tertiary referral hospital in central China. Parameters analyzed include age of onset, gender predilection, lesional distribution, nail and mucosal involvement, clinical course, and inheritance pattern. RESULTS Thirty-six of 85 individuals in the nine families were affected (42.4%). Females were more likely to be affected than males (58.3% vs 35.7%, G(chi 2 = 3.99. P < 0.05). A bimodal disease onset was found, with one peak at 1-3 years and another at 13-17 years. The shin is the most commonly affected area (97%) followed by the upper limbs and the thighs. Involvement of the torso is relatively rare. Only a minority of cases involves the oral mucosa. The disease tends to follow a chronic and progressive course. The inheritance pattern is autosomal dominant with variable penetrance. CONCLUSION Familial bullous lichen planus is a chronic, progressive bullous eruption of the lower and upper extremities. Compared with non familial bullous lichen planus, it has an earlier onset and wider disease distribution. It may be inherited as an autosomal dominant condition with variable penetrance.
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Affiliation(s)
- Changzheng Huang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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15
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Schwartz MP, Sigurdsson V, Vreuls W, Lubbert PHW, Smout AJPM. Two siblings with lichen planus and squamous cell carcinoma of the oesophagus. Eur J Gastroenterol Hepatol 2006; 18:1111-5. [PMID: 16957518 DOI: 10.1097/01.meg.0000221854.25039.83] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Lichen planus is a mucocutaneous disease which can also affect the oesophagus. Unlike in oral lichen planus an increased risk for the development of squamous cell carcinoma in the oesophagus has not been established. We describe two sisters with a history of long-standing cutaneous lichen planus who developed oesophageal squamous cell carcinoma, diagnosed at the ages of 68 and 70 years, respectively. In one of the cases, dysplastic areas were identified by high-magnification chromoendoscopy. In both cases, oesophageal resection was carried out with a curative intent. For the first time these sibling case reports suggest an increased precancerous potential of oesophageal lichen planus.
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Affiliation(s)
- Matthijs P Schwartz
- Department of Gastroenterology, University Medical Center, Utrecht, The Netherlands.
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Bermejo-Fenoll A, López-Jornet P. Familial oral lichen planus: presentation of six families. ACTA ACUST UNITED AC 2006; 102:e12-5. [PMID: 16876038 DOI: 10.1016/j.tripleo.2006.03.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2005] [Revised: 02/13/2006] [Accepted: 03/08/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To present a series of 13 different cases of oral lichen planus (OLP) in 6 different families. STUDY DESIGN From 249 lichen planus cases, we found 13 that could be considered to be family related. A study of these 13 cases of OLP was carried out across the various generations, and the means of presentation, placement, and injuries were studied, as well as signs and symptoms. RESULTS The predominant affectation was in the women; only 2 patients were male. The mothers showed predominance toward erythematous OLP with greater symptoms, and in their children, symptom-free white OLP was predominant. CONCLUSIONS It seems there may be some genetic predisposition toward OLP.
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Affiliation(s)
- Ambrosio Bermejo-Fenoll
- Department of Oral Medicine, Faculty of Medicine and Odontology, University of Murcia, Murcia, Spain
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19
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Abstract
Lichenoid eruptions are quite common in children and can result from many different origins. In most instances the precise mechanism of disease is not known, although it is usually believed to be immunologic in nature. Certain disorders are common in children, whereas others more often affect the adult population. Lichen striatus, lichen nitidus, Gianotti-Crosti syndrome, and lichen spinulosus are examples of lichenoid lesions that are more common in children than adults. Distinguishing these diseases is necessary for prediction of the course of the eruption and for optimal management. In most cases, certain clinical characteristics enable the clinician to reach a diagnosis, whereas in other cases biopsy is required for a definitive answer. Many of these lesions are self-limited and only require symptomatic treatment, although corticosteroids can hasten resolution in certain disorders. Discontinuation of the medication is often sufficient for resolution of lichenoid drug eruptions.
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Affiliation(s)
- Joline J Tilly
- New York University School of Medicine, Medical College of Wisconsin, Milwaukee, USA
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20
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de Moura Castro Jacques C, Cardozo Pereira AL, Cabral MG, Cardoso AS, Ramos-e-Silva M. Oral lichen planus part I: epidemiology, clinics, etiology, immunopathogeny, and diagnosis. Skinmed 2003; 2:342-7; quiz 348-9. [PMID: 14673245 DOI: 10.1111/j.1540-9740.2003.02038.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
This article presents a review of the literature on oral lichen planus, focusing on important aspects of its epidemiology, etiopathogeny, and clinical manifestations. The oral form is an important clinical presentation of lichen planus. It may precede or accompany the skin lesions, or it may be the only manifestation of the disease. Dermatologists, dentists, otorhinolaryngologists, and other specialists who deal with the oral cavity must be aware of this disease so they can diagnose, treat, and keep these patients under observation.
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Affiliation(s)
- Claudio de Moura Castro Jacques
- The Sector of Dermatology and Post-Graduation Course, Hospital Universitario Clementino Fraga and School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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23
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Abstract
The incidence of many skin diseases peak in adulthood, and these disorders may be difficult to recognize when they do present in childhood. Their clinical features may be distinct in pediatric patients, and they may be managed differently in children as compared to adults. Therefore, it is important that dermatologists are able to identify "adult" skin disease in the pediatric patient, and know how to appropriately manage these problems in young patients. The epidemiology, clinical features, differential diagnosis, and management of the following "adult" skin diseases in children are reviewed: psoriasis, lichen planus, rosacea, Sweet's syndrome, and mucosis fungoides. Distinctive features of lichen sclerosus and immunobullous diseases in childhood will also be briefly discussed.
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Affiliation(s)
- R Howard
- Division of Pediatric Dermatology, Children's Hospital Oakland, California, USA
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24
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Porter SR, Kirby A, Olsen I, Barrett W. Immunologic aspects of dermal and oral lichen planus: a review. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 83:358-66. [PMID: 9084200 DOI: 10.1016/s1079-2104(97)90244-4] [Citation(s) in RCA: 101] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
There have been many investigations, both experimental and epidemiologic, of the forms of LP affecting the skin and oral mucosae. These studies have provided a varied range of hypotheses to explain not only the factors determining susceptibility to and onset of this disease, but also the immunologic mechanisms leading to the pathosis with which LP is associated. Much progress has been made, especially through in vitro studies, regarding detailed aspects of the immunology of LP. However, data is often conflicting or incomplete. In this review we attempt to bring together the currently available data regarding the immunologic basis of LP.
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Affiliation(s)
- S R Porter
- Department of Oral Medicine, Eastman Dental Institute, London, UK
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Affiliation(s)
- A Shai
- Department of Dermatology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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26
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Abstract
Lichen planus, a papulosquamous disease, in its classical presentation is characterized by pruritic violaceous papules most commonly on the extremities of middle-aged adults. It may or may not be accompanied by oral and genital mucous membrane involvement. Its course is generally self-limited for a period of several months to years, but it may last indefinitely. There are many clinical variants described, ranging from lichenoid drug eruptions to association with other diseases such as diabetes mellitus, autoimmune disease, and the graft-versus-host reaction. The relationship of these, if any, to classical lichen planus is questionable. Multiple therapeutic options exist including corticosteroids, retinoids, griseofulvin, PUVA, and cyclosporine.
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Affiliation(s)
- A S Boyd
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock 79430
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27
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Affiliation(s)
- W Küster
- Department of Dermatology, University of Düsseldorf, Federal Republic of Germany
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