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Bevans SL, Theos AJ, Fowler PG, Pavlidakey PG, Stoll M, Sami N. Pediatric ocular lichen planus and lichen planopilaris: One new case and a review of the literature. Pediatr Dermatol 2018; 35:859-863. [PMID: 30168195 DOI: 10.1111/pde.13606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
When lichen planus involves the scalp, it is known as lichen planopilaris, and when it involves the eye, it is known as ocular lichen planus; both are rare. Early detection and targeted therapy are crucial in preventing hair loss and scarring conjunctivitis. Little is known regarding appropriate treatment for lichen planopilaris. The objective of this case study is to present a new case of pediatric ocular lichen planus and lichen planopilaris and to identify all reported cases of pediatric lichen planopilaris, highlighting disease involvement, treatment, and response to treatment.
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Affiliation(s)
- Stephanie L Bevans
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amy J Theos
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Priscilla G Fowler
- Department of Ophthalmology, University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Peter G Pavlidakey
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Matthew Stoll
- Division of Pediatric Rheumatology, University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Naveed Sami
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Department of Medicine, University of Central Florida, Orlando, Florida, USA
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Errichetti E, Figini M, Croatto M, Stinco G. Therapeutic management of classic lichen planopilaris: a systematic review. Clin Cosmet Investig Dermatol 2018. [PMID: 29520159 PMCID: PMC5833781 DOI: 10.2147/ccid.s137870] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Several treatment strategies have been proposed in classic lichen planopilaris (LPP), although no gold standard therapeutic approach has been recognized so far due to the variable and, sometimes, contradictory results reported in the literature, as well as due to the lack of guidelines and randomized controlled trials. In the present review, we sought to provide an updated overview on the treatment of classic LPP by analyzing the level of evidence of published studies, also proposing a possible therapeutic strategy according to the findings highlighted in this systematic review.
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Matteo Figini
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Margherita Croatto
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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3
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Christensen KN, Lehman JS, Tollefson MM. Pediatric Lichen Planopilaris: Clinicopathologic Study of Four New Cases and a Review of the Literature. Pediatr Dermatol 2015; 32:621-7. [PMID: 26058419 DOI: 10.1111/pde.12624] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Lichen planopilaris (LPP) is a rare form of cicatricial alopecia that has occasionally been reported in children. Because of the limited number of patients reported, little information is available about demographic characteristics, clinical presentation, or treatment options for these patients. A retrospective chart review of LPP cases in patients under 18 years of age from 1976 to 2013 was performed to further define clinicopathologic features of pediatric LPP. Four pediatric LPP patients ages 13 to 16 years were identified (three male, one female). One patient had scalp pruritus and one had other cutaneous findings of lichen planus (LP). Perifollicular scale and scarring were the most common physical examination findings, although changes mimicking those of alopecia areata were observed. Three patients were treated with topical or intralesional steroids. One patient was treated with minocycline. Histopathologic findings included perifollicular interface and perifollicular fibrosis in all cases. There was focal interfollicular interface in two cases and mild dermal mucin in one case. LPP is exceedingly rare in children. It may be misdiagnosed as alopecia areata in children because of the lack of symptoms and other features of LP. There should be a high index of suspicion for LPP in children with alopecia that is unresponsive to standard treatment or who have findings that are atypical for more common childhood alopecias.
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Affiliation(s)
| | - Julia S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Megha M Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota.,Department of Pediatrics, Mayo Clinic, Rochester, Minnesota
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4
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Rácz E, Gho C, Moorman PW, Noordhoek Hegt V, Neumann HAM. Treatment of frontal fibrosing alopecia and lichen planopilaris: a systematic review. J Eur Acad Dermatol Venereol 2013; 27:1461-70. [PMID: 23531029 DOI: 10.1111/jdv.12139] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 02/18/2013] [Indexed: 02/06/2023]
Abstract
Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia with characteristic clinical pattern of progressive frontotemporal hairline recession, perifollicular erythema and hyperkeratosis and symptoms of itch and burning, occurring mainly in post-menopausal women. FFA is considered a subtype of lichen planopilaris (LPP), based on their identical histopathology. Currently, no evidence-based treatment is available for FFA. Our aim was to determine the effectiveness of available treatment options for FFA, and to identify promising treatment options for future studies. For this, literature search was conducted to find all primary studies on the treatment of FFA and LPP. From the primary studies, data were subtracted and analysed. No randomized controlled trials were found, and one controlled trial. Treatment of 114 patients is described in the literature. They received 10 different regimes, of which oral 5-alpha-reductase inhibitors were provided most often, resulting in good clinical response in 45% of them. Hydroxychloroquine resulted in good clinical response in 30% of the 29 treated patients. Topical corticosteroid preparations are ineffective in FFA. The remaining treatments were all reported in less than 10 patients. For the treatment of LPP, topical corticosteroid preparations are the first line of treatment, followed by oral cyclosporine and systemic corticosteroids, although they are characterized by a high relapse rate. Summarizing, there is currently no effective treatment of FFA, the most effective being oral 5-alpha-reductase inhibitors that possibly affect the accompanying androgenetic alopecia. We argue that oral cyclosporine A might be a good candidate for future studies on the treatment of FFA.
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Affiliation(s)
- E Rácz
- Department of Dermatology and Venereology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Cherobin ACFP, Oliveira FOD, Baeta IGR, Vale ECSD. Case for diagnosis. An Bras Dermatol 2012; 87:151-2. [PMID: 22481670 DOI: 10.1590/s0365-05962012000100025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 04/25/2011] [Indexed: 11/22/2022] Open
Abstract
Dyschromicum erythema perstans, or ashy dermatosis, is a rare chronic acquired skin disease characterized by gray hyperpigmented patches with erythematous borders. Its etiology is unknown and there is no specific treatment for the condition. We report a case of ashy dermatosis in a 41-year-old patient with extensive lesions on the trunk and limbs.
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Santos-Juanes J, Mas-Vidal A, Coto-Segura P, Sánchez del Río J, Galache Osuna C. Pigmented actinic lichen planus successfully treated with intense pulsed light. Br J Dermatol 2010; 163:662-3. [DOI: 10.1111/j.1365-2133.2010.09857.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zaynoun S, Rubeiz N, Kibbi AG. Ashy dermatoses--a critical review of the literature and a proposed simplified clinical classification. Int J Dermatol 2008; 47:542-4. [PMID: 18477140 DOI: 10.1111/j.1365-4632.2008.03625.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Shukrallah Zaynoun
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
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8
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Sebbag N, Lacour JP. [Erythema dyschromicum perstans]. Ann Dermatol Venereol 2006; 133:79-82. [PMID: 16495863 DOI: 10.1016/s0151-9638(06)70853-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- N Sebbag
- Service de Dermatologie, Hôpital Archet-2, CHU de Nice
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Abstract
UNLABELLED The cicatricial alopecias encompass a diverse group of disorders characterized by permanent destruction of the hair follicle and irreversible hair loss. Destruction of the hair follicle can result from primary, folliculocentric disease or as a secondary result. This article focuses on the former, or primary cicatricial alopecias. The cause and pathogenesis of many of these disorders are largely unknown. Although unique clinicopathologic features allow for accurate diagnosis in some cases, diagnostic certainty is often elusive and reflects the limits of present understanding. Classification of the primary cicatricial alopecias on the basis of pathology provides a diagnostic and investigational framework and, it is hoped, will facilitate future enlightenment. Details of classification, etiopathogenesis, clinicopathologic features, differential diagnosis, and practical management of the primary cicatricial alopecias will be discussed. LEARNING OBJECTIVES Upon completion of this learning activity, participants should be familiar with the following aspects of the primary cicatricial alopecias: (1) the new, consensus-issued classification scheme, (2) current understanding about etiopathogenesis, (3) salient clinicopathologic features, (4) differential diagnosis, and (5) therapeutic management.
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Affiliation(s)
- Elizabeth K Ross
- Department of Medicine, University of British Columbia, Vancouver Coastal Health Research Insitute, Vancouver, British Columbia, Canada
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10
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Affiliation(s)
- Robert A Schwartz
- Dermatology, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103-2714, USA.
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