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Pinchaleaw D, Limlawan P. Oral Chronic Mucositis in a Known Lichen Planus Pigmentosus Patient. Case Rep Dent 2024; 2024:1975932. [PMID: 38911258 PMCID: PMC11192598 DOI: 10.1155/2024/1975932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/09/2024] [Accepted: 06/03/2024] [Indexed: 06/25/2024] Open
Abstract
Oral manifestations of mucocutaneous inflammatory diseases such as lichenoid dermatoses often affect the patient's quality of life through the symptoms of pain and burning sensation. In this case report, a patient with known lichen planus pigmentosus (LPP), a variant of lichenoid dermatoses that rarely affect oral mucosa, presented with chronic pain in the oral cavity for 2 months. Her intraoral examination revealed multiple pseudomembranous ulcers with erythematous areas and white striae similar to erosive lichen planus. The histological assessment revealed chronic mucositis, while the direct immunofluorescent examination showed negative results, contradicting the diagnosis of both lichen planus and LPP. Thus, the diagnosis was given as chronic mucositis, and the topical steroid was given. After 6 weeks of steroid application, the lesion resolved. To the best of our knowledge, this is the first report of chronic mucositis in LPP patients. This report could raise the awareness of clinicians to carefully take history as the patient with LPP may suffer from chronic mucositis in the oral cavity as well.
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Affiliation(s)
- Dalad Pinchaleaw
- Residency TrainingDepartment of Oral MedicineFaculty of DentistryChulalongkorn University, Pathumwan, Bangkok 10330, Thailand
- Department of Oral MedicineFaculty of DentistryChulalongkorn University, Pathumwan, Bangkok 10330, Thailand
| | - Pirawish Limlawan
- Department of Oral MedicineFaculty of DentistryChulalongkorn University, Pathumwan, Bangkok 10330, Thailand
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2
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Cornman HL, Wei E, Manjunath J, Ma EZ, Imo BU, Kollhoff AL, Kambala A, Zhang J, Patel SS, Kwatra SG. Recalcitrant lichen planus pigmentosus treated with topical ruxolitinib. JAAD Case Rep 2023; 42:84-86. [PMID: 38156096 PMCID: PMC10753049 DOI: 10.1016/j.jdcr.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023] Open
Affiliation(s)
- Hannah L. Cornman
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elena Wei
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jaya Manjunath
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Emily Z. Ma
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brenda Umenita Imo
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alexander L. Kollhoff
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Anusha Kambala
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jingyi Zhang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Shawn G. Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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3
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Obeng-Nyarko CN, Dazé R, Dorton D. Lichen planus pigmentosus inversus: a rare clinical variant. J Osteopath Med 2023; 123:593-594. [PMID: 37691631 DOI: 10.1515/jom-2023-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023]
Affiliation(s)
| | | | - David Dorton
- Bay Dermatology & Cosmetic Surgery, Spring Hill, FL, USA
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4
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Shah S, Baskaran N, Vinay K, Bishnoi A, Parsad D, Kumaran MS. Acquired dermal macular hyperpigmentation: an overview of the recent updates. Int J Dermatol 2023; 62:1447-1457. [PMID: 37767951 DOI: 10.1111/ijd.16859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Acquired dermal macular hyperpigmentation (ADMH), previously known as macular pigmentation of uncertain etiology (MPUE), is an umbrella concept that unifies the distinct but overlapping acquired dermal pigmentary disorders like lichen planus pigmentosus, ashy dermatosis, erythema dyschromicum perstans, Riehl's melanosis and pigmented contact dermatitis. All of these disorders usually lack a clinically apparent inflammatory phase, are characterised by dermal pigmentation clinically and histologically, and have a variable protracted disease course. Recently, a proposal has been made to classify these disorders into those with and without contact sensitisation. Dermoscopy is essentially similar across the spectrum of these disorders, and is useful for diagnosis and therapeutic response monitoring. Scoring system has been validated for the same. The treatment of ADMH remains challenging, with multiple topicals, oral therapies including mycophenolate mofetil, and lasers tried. Need of the hour is randomised controlled trials to enhance the therapeutic armamentarium.
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Affiliation(s)
- Shikha Shah
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Narayanan Baskaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu S Kumaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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5
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Almarek RA, AlQadri NG, Alotaibi M. Coexistence of Lichen Planus Pigmentosus and Classic Lichen Planopilaris: A Case Report and Literature Review. Cureus 2023; 15:e46952. [PMID: 38021648 PMCID: PMC10640707 DOI: 10.7759/cureus.46952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Lichen planus (LP) is a common inflammatory skin disorder with multiple variants. The coexistence of lichen planus pigmentosus (LPPigm) and frontal fibrosing alopecia is well-established in the literature. However, the coexistence of LPPigm and classic lichen planopilaris (LPP) is rare. We report a case of LPPigm and classic LPP in a postmenopausal woman with a literature review.
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Affiliation(s)
- Rana A Almarek
- Department of Dermatology, King Saud Medical City, Riyadh, SAU
| | - Nada G AlQadri
- Department of Dermatology, King Saud Medical City, Riyadh, SAU
| | - Manar Alotaibi
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, SAU
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6
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Alasmari AA, Albrahim LI, Aleissa M. A unilateral linear pattern of lichen planus pigmentosus. Dermatol Reports 2023; 15:9650. [PMID: 37822984 PMCID: PMC10563022 DOI: 10.4081/dr.2023.9650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/10/2023] [Indexed: 10/13/2023] Open
Abstract
Lichen planus pigmentosus (LPP) is a rare chronic variant of lichen planus. LPP distribution tends to be symmetrical and is frequently seen on the face, neck, and trunk. Atypical clinical patterns of LPP, including segmental, zosteriform, and linear, were reported in the literature. Herein, we report a rare presentation of LPP in a 16- year-old female with a unilateral linear pattern along the Blascko lines.
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Affiliation(s)
- Amal Aboud Alasmari
- Division of Dermatology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh
| | - Latifah Ibrahim Albrahim
- Division of Dermatology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh
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7
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Jung CJ, Lee WJ, Won CH, Lee MW, Chang SE. Two Cases of Linear Lichen Planus Pigmentosus of the Chin in Korean Women Treated by Fractional Lasers and Polydeoxyribonucleotide Injection. Ann Dermatol 2023; 35:S38-S42. [PMID: 37853862 PMCID: PMC10608389 DOI: 10.5021/ad.21a.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/18/2021] [Accepted: 06/01/2021] [Indexed: 10/20/2023] Open
Abstract
Linear lichen planus pigmentosus is a rare subtype of lichen planus pigmentosus that follows Blaschko's lines, leaving long-standing residual atrophy and pigmentation, especially in dark-skinned populations. Conventional treatments have several limitations regarding the alleviation of pigmentation and atrophy. We report two cases of Korean women with linear lichen planus pigmentosus on their faces who were successfully treated with fractional lasers and intralesional injection of polydeoxyribonucleotide.
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Affiliation(s)
- Chang Jin Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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8
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Ho KH, Loo KN. A Case of Pigmented Macules Occurring After Ocular Myasthenia Gravis. Cureus 2023; 15:e34823. [PMID: 36919076 PMCID: PMC10008231 DOI: 10.7759/cureus.34823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 02/11/2023] Open
Abstract
Lichen planus pigmentosus inversus (LPP-I) is characterized by the presence of hyperpigmented or hypopigmented lesions on the flexural surfaces of the body. It is a rare variant of lichen planus pigmentosus with unknown etiology. We report a case of a male presented with LPP-I three months after diagnosis of ocular myasthenia gravis, highlighting the possible autoimmune association.
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Affiliation(s)
| | - Khang Ning Loo
- General Medicine, Sengkang General Hospital, Singapore, SGP
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9
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Rani S, Ahuja A. Chemical peel as an adjuvant treatment in pigmented contact dermatitis: a case series. J COSMET LASER THER 2022; 24:112-117. [DOI: 10.1080/14764172.2022.2147953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Seema Rani
- Department of Dermatology, ABVIMS DR RMLH, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, DR RMLH PGIMER, New Delhi, India
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10
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Yee CS, Wai CK, Shang-Ian T, Xiahong Z, Steven TTG. The role of in vivo reflectance confocal microscopy in the diagnosis and management of lichen planus pigmentosus. Australas J Dermatol 2022; 63:e369-e373. [PMID: 36054365 DOI: 10.1111/ajd.13916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/23/2022] [Accepted: 08/09/2022] [Indexed: 11/28/2022]
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11
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Bodnariuk N, Bastard D, Enz P. Alopecia frontal fibrosante y liquen plano pigmentoso ¿variantes de una misma entidad? ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:617-618. [DOI: 10.1016/j.ad.2020.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/29/2020] [Accepted: 08/08/2020] [Indexed: 10/19/2022] Open
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12
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[Translated article] Frontal Fibrosing Alopecia and Lichen Planus Pigmentosus: Variants of the Same Disease? ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Friedman PM, Dover JS, Chapas A, Rahman Z, Ross EV, Kilmer SL, Roberts WE, Sodha P, Stimmel JB, Moncrief MBC, Waibel JS. 1,550 nm Erbium-Doped and 1,927 nm Thulium Nonablative Fractional Laser System: Best Practices and Treatment Setting Recommendations. Dermatol Surg 2022; 48:195-200. [PMID: 35050945 PMCID: PMC8806037 DOI: 10.1097/dss.0000000000003321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The Fraxel Dual laser system (Solta Medical, Inc., Bothell, WA) contains a 1,550 and 1,927 nm wavelength single handpiece with different indications for each wavelength. OBJECTIVE To discuss treatment setting recommendations and best practices for select on-label and investigational applications of the 1,550 and 1,927 nm dual laser system. MATERIALS AND METHODS Eight board-certified dermatologists with 10 or more years of experience with the 1,550 and 1,927 nm laser system completed an online survey about their clinical experience with the system and then participated in a roundtable to share clinical perspectives and best practices for using the laser system. RESULTS For all Fitzpatrick skin types, treatment recommendations were described for selected approved indications for the 1,550 and 1,927 nm laser system, including both lasers in combination. Treatment recommendations were also reached for investigational applications with the 1,550 nm laser and 1,927 nm laser. Best practices for using the lasers during the treatment session to achieve optimal outcomes and decrease the post-treatment recovery time were compiled. CONCLUSION The 1,550 and 1,927 nm dual laser system is effective for a wide range of aesthetic and therapeutic applications, on and off the face and across all Fitzpatrick skin types.
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Affiliation(s)
| | | | - Anne Chapas
- Union Square Laser Dermatology, New York, New York
| | - Zakia Rahman
- Stanford Department of Dermatology, Redwood City, California
| | | | | | - Wendy E. Roberts
- Generational and Cosmetic Dermatology, Rancho Mirage, California
| | - Pooja Sodha
- Department of Dermatology, George Washington University, Washington, District of Columbia
| | - Julie B. Stimmel
- Synchrony Medical Communications, LLC, West Chester, Pennsylvania
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14
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Nofal A, Alakad R, Selim H, Anis N. Poikilodermatous lichen planus pigmentosus: A unique variant of a common disease. J Cosmet Dermatol 2022; 21:5215-5218. [PMID: 35037370 DOI: 10.1111/jocd.14754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/15/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ahmad Nofal
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Member of Interactive Dermatology Research Group, Egypt
| | - Rania Alakad
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Member of Interactive Dermatology Research Group, Egypt
| | - Heba Selim
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nourhan Anis
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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15
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Vinay K, Bishnoi A, Kamat D, Chatterjee D, Kumaran MS, Parsad D. Acquired Dermal Macular Hyperpigmentation: An Update. Indian Dermatol Online J 2021; 12:663-673. [PMID: 34667751 PMCID: PMC8456249 DOI: 10.4103/idoj.idoj_881_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/10/2021] [Accepted: 04/15/2021] [Indexed: 12/16/2022] Open
Abstract
Acquired dermal macular hyperpigmentation (ADMH) is an umbrella term that includes disorders clinically characterized by small and large pigmented macules/patches and histopathologically showing an evidence of current or resolved interface dermatitis with pigment incontinence, without clinically significant prior inflammatory phase. The term intends to include diseases previously described in the literature as lichen planus pigmentosus, Riehl's melanosis/pigmented cosmetic dermatitis and ashy dermatosis/erythema dyschromicum perstans. The nomenclature and origin of these disorders have always been a matter of discussion. These disorders share many clinicopathological similarities, are difficult to treat and adversely affect the quality of life. Recent consensus points towards the need for a unifying term to facilitate research and therapeutic trials. This article aims to provide a comprehensive review of the recent advances in ADMH.
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Affiliation(s)
- Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Kamat
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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16
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Yoo J. Differential diagnosis and management of hyperpigmentation. Clin Exp Dermatol 2021; 47:251-258. [PMID: 33999447 DOI: 10.1111/ced.14747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 11/27/2022]
Abstract
There is an increasing recognition of ethnic dermatology to reflect the increase in skin of colour (SOC) populations in the UK. Hyperpigmentary disorder is one of the commonest skin concerns in SOC but there has been limited training available in this field of dermatology. Variations in skin colour are genetically determined by the amount of melanin content, the eumelanin/pheomelanin ratio and the size of melanosomes, but is also influenced by other factors such as hormones and extrinsic factors such as ultraviolet radiation. Hyperpigmentation is a broad term to describe increased pigmentation in the skin, and making a correct diagnosis is an important first step in the successful management of hyperpigmentary disorders. A systematic approach based on the disease pathogenesis (e.g. reactive vs. nonreactive, increased melanin vs. increased number of cells or epidermal vs. dermal pigmentation) aided by a detailed history and clinical examination is the best way to diagnose a hyperpigmentary disorder. Based on its pathogenesis, management can be planned. For epidermal hyperpigmentation caused by increased melanin, topical skin-lightening agents targeting inhibition of tyrosinase or melanosome transfer and promotion of keratinocyte turnover can be used. Hydroquinone-containing cream is the gold-standard treatment for epidermal hyperpigmentation. Alternative treatments include laser toning or chemical peels. However, increased dermal pigmentation is more challenging to target with topical treatments. If hyperpigmentation is due to increased numbers of melanocytes or keratinocytes, high-fluence laser is the most appropriate treatment method.
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Affiliation(s)
- J Yoo
- Department of Dermatology, University Hospital Birmingham, Birmingham, UK
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17
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Bishnoi A, Vinay K, Parsad D, Kumar S, Chatterjee D, Nahar Saikia U, Sendhil Kumaran M. Oral mycophenolate mofetil in the treatment of acquired dermal macular hyperpigmentation: An open-label pilot study. Australas J Dermatol 2021; 62:278-285. [PMID: 33660856 DOI: 10.1111/ajd.13567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/23/2020] [Accepted: 12/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Literature on treating acquired dermal macular hyperpigmentation is sparse. AIMS AND OBJECTIVES To assess treatment response of mycophenolate mofetil in patients having acquired dermal macular hyperpigmentation. MATERIAL AND METHODS In this open-label, pilot study, patients of acquired dermal macular hyperpigmentation affecting at least the face and/or neck were included. Each participant was treated with mycophenolate mofetil 2 g/day for 24 weeks, with a follow-up of 12 weeks. Two aspects of disease severity were measured: activity (appearance of new lesions/extension of existing lesions), and degree of hyperpigmentation (measured using 'dermal pigmentation area and severity index'). Patient satisfaction was assessed on a scale of 0-10. RESULTS Forty-three of 46 patients who were prescribed mycophenolate, completed the study (40 females, 6 males; mean disease duration 2.8 ± 1.4 years). Amongst 20 (43.5%) patients with active disease, stability was achieved in 17, after a mean duration of 6.1 ± 2.5 weeks (range 4-12 weeks; median 4; IQR 4 weeks). Mean dermal pigmentation area and severity index at baseline was 18.8 ± 7.1 and decreased to 13.7 ± 6.3 at 24th week (27.5 ± 14.7%; P < 0.001). A significant decreasing trend in dermal pigmentation area and severity index (P < 0.001) was observed, and first significant difference from baseline was noted at the 16th week (P 0.008). Less than 10%, >10-20%, >20%-30%, >30%-40%, >40%-50%, and >50% reduction in dermal pigmentation area and severity index was observed in 8, 5, 4, 15, 10 and 1 patients/patient respectively. The maximum mean grade of pre-treatment dermatoscopic severity was 3 ± 0.7, and decreased to 2.1 ± 0.8 on the face (P < 0.001) and 2.4 ± 0.7 on the neck (P < 0.001) post-treatment. There were 9 (20.1%) non-responders. Self-assessment scores of the rest of the patients fell in the range of moderate/fair improvement (>5 to 7). No significant correlation was seen between patient satisfaction score and degree of reduction in dermal pigmentation area and severity index (r -0.39). Three developed adverse effects (leucopenia, n = 1; transaminitis and hyperbilirubinemia, n = 2) that resolved following discontinuation of mycophenolate. CONCLUSION Mycophenolate mofetil appears to be a promising treatment option in acquired dermal macular hyperpigmentation.
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Affiliation(s)
- Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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18
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Alkhowailed MS, Otayf M, Albasseet A, Almousa A, Alajlan Z, Altalhab S. Clinical Approach to Linear Hyperpigmentation: A Review Article. Clin Cosmet Investig Dermatol 2021; 14:23-35. [PMID: 33447068 PMCID: PMC7802900 DOI: 10.2147/ccid.s280819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022]
Abstract
Linear hyperpigmentation is an unusual anatomical configuration in clinical dermatology. Owing to its rarity, consensus on the most effective method of classification is lacking. While linear hyperpigmentation generally follows Blaschko's lines, this is not universal. Clinical findings such as adherence to Blaschko's lines, associated morphological findings (including other cutaneous lesions), and systemic manifestations can be used to further characterize and diagnose variants of the disorder. Early detection of any underlying disease is vital, especially in cases with effective management, because the disorder may make it difficult to manage hyperpigmentation. Herein, we introduce a logical clinical diagnostic approach that represents a useful tool for dermatologists to efficiently evaluate patients presenting with linear hyperpigmentation. A simplified systematic and evidence-based approach is useful for this clinical condition owing to the heterogeneous causes and lack of specific diagnostic tools.
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Affiliation(s)
- Mohammad S Alkhowailed
- Department of Dermatology, College of Medicine, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Mojahed Otayf
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Ziyad Alajlan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad Altalhab
- Department of Dermatology, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Dimova M, Damevska K, Nikolovska S, Dohcheva-Karajovanov I, Duma S, Kostovski M, Simeonovski V. Pediatric case of lichen planus pigmentosus inversus successfully treated with narrow band ultraviolet B phototherapy. Dermatol Ther 2020; 33:e14073. [PMID: 32713102 DOI: 10.1111/dth.14073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Maja Dimova
- University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University-Skopje, Skopje, Macedonia
| | - Katerina Damevska
- University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University-Skopje, Skopje, Macedonia
| | - Suzana Nikolovska
- University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University-Skopje, Skopje, Macedonia
| | - Ivana Dohcheva-Karajovanov
- University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University-Skopje, Skopje, Macedonia
| | - Silvija Duma
- University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University-Skopje, Skopje, Macedonia
| | - Marko Kostovski
- Institute of Medical Histology and Embryology, Faculty of Medicine, Ss. Cyril and Methodius University- Skopje, Skopje, Macedonia
| | - Viktor Simeonovski
- University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University-Skopje, Skopje, Macedonia
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Zenjari L, Elfetoiki FZ, Hali F, Skalli H, Chiheb S. [Oral tranexamic acid in the treatment of lichen planus pigmentosus: A prospective study of 20 cases]. Ann Dermatol Venereol 2020; 147:818-822. [PMID: 32747031 DOI: 10.1016/j.annder.2020.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/28/2020] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Lichen planus pigmentosus is a variant of lichen planus that is particularly difficult to treat. The aim of this study was to evaluate the efficacy and safety of tranexamic acid in lichen planus pigmentosus. PATIENTS AND METHODS This prospective study, conducted at the University Hospital of Casablanca from August 2017 to June 2019, included 20 patients with histologically confirmed lichen planus pigmentosus. The exclusion criteria were pregnancy, breastfeeding, known hypersensitivity to tranexamic acid, and thromboembolic disease. Evaluation was carried out by means of clinical examination and measurement of the affected area using the Visioface® RD hardware package at 6 and 12 months (M6 and M12). RESULTS Eighteen women and 2 men with an average age of 49 years (range: 26-65 years) were included. All patients were phototype 3 or 4. The average disease duration was 2.9 years (range: 2 months-15 years). Pigmented, slate-grey, well-delineated macules were observed in all patients on the face (n=19), neck (n=14) or arms (n=2). Pruritus was present in 9 patients. All patients received oral tranexamic acid 250mg/d for 4 to 6 months with external photoprotection that was prolonged beyond 6 months. At M6, partial improvement was noted in 10 patients, 3 patients showed no improvement, and 7 patients were lost to follow-up. Pruritus disappeared in all patients and no relapse was seen at M12. DISCUSSION Our study suggests that tranexamic acid could be an effective treatment for lichen planus pigmentosus with a good safety profile. However, the limitations of the study are the limited population and the high number of patients lost to follow-up at M6. Larger-scale studies are needed to provide more detailed results.
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Affiliation(s)
- L Zenjari
- Service de dermatologie et vénérologie, CHU Ibn Rochd, Casablanca, Maroc.
| | - F Z Elfetoiki
- Service de dermatologie et vénérologie, CHU Ibn Rochd, Casablanca, Maroc
| | - F Hali
- Service de dermatologie et vénérologie, CHU Ibn Rochd, Casablanca, Maroc
| | - H Skalli
- Service de dermatologie et vénérologie, CHU Ibn Rochd, Casablanca, Maroc
| | - S Chiheb
- Service de dermatologie et vénérologie, CHU Ibn Rochd, Casablanca, Maroc
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21
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Żychowska M, Żychowska M. No evidence for association between cutaneous lichen planus and hepatitis B and C virus infection in south Poland - a case-control study. Int J Dermatol 2020; 59:698-703. [PMID: 32307713 DOI: 10.1111/ijd.14880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/11/2020] [Accepted: 03/21/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The incidence of hepatitis C virus (HCV) infection among patients with lichen planus (LP) varies considerably. Currently, there is more evidence for the association between hepatitic C and oral LP (OLP) than cutaneous LP (CLP). There is also lack of data on the Polish population. The study aimed at assessing the prevalence of HCV infection and liver test abnormalities among patients with CLP in south Poland. METHODS Eighty-four patients with CLP and 130 patients with other dermatoses (controls) were included in this retrospective case-control study. Medical records were reviewed for the presence of anti-HCV antibodies and hepatitis B surface antigen (HBsAg) and serum levels of liver function tests: aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glumatyltranspeptidase (GGT). RESULTS Anti-HCV antibodies were not found in any of the patients in the study or control group. HBsAg was detected in one (1.19%) patient with CLP and none of the controls. Considering the prevalence of abnormal liver function parameters, there were no statistically significant differences in the frequencies of AST (P = 0.87), ALT (P = 0.9), and GGT (P = 0.81) above the upper limit between patients with CLP and patients with other dermatoses. CONCLUSIONS Currently, there is no evidence confirming the relationship between HCV infection and CLP in southern Poland. There is also no increased incidence of liver function abnormalities compared to patients with other dermatoses. However, there is a need for further research on larger groups of patients.
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22
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Comparison of topical clobetasol propionate 0.05% and topical tacrolimus 0.1% in the treatment of cutaneous lichen planus. Postepy Dermatol Alergol 2020; 36:722-726. [PMID: 31998001 PMCID: PMC6986297 DOI: 10.5114/ada.2019.91423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/18/2018] [Indexed: 01/20/2023] Open
Abstract
Introduction The effectiveness of topical tacrolimus in the treatment of oral and genital lichen planus has been verified in many randomized studies; however, there are only few case reports in treatment of cutaneous lichen planus (CLP). Aim We sought to compare the safety and efficacy of topical clobetasol propionate and tacrolimus ointment in the treatment of CLP. Material and methods Retrospective analysis of patient files was performed. We enrolled patients who were diagnosed with CLP and treated with topical tacrolimus 0.1% or topical clobetasol propionate 0.05%. Visual Analogue Scale (VAS) scores of pigmentation and pruritus, clinical response, laboratory data and adverse effects were obtained from medical records. Results A total of 27 patients were included in the clobetasol group and 23 patients in the tacrolimus group. Both groups showed an improvement in VAS scores regarding pruritus and pigmentation but a statistically significant difference was observed in the clobetasol group (p< 0.05). At week 12, a complete response was observed in 63% (n = 17) of the clobetasol and 26% (n = 6) of the tacrolimus group. Conclusions In our study, both treatments were found effective in the treatment of CLP but clobetasol propionate was more effective. However tacrolimus may be preferred before topical corticosteroids for lesions on the face, neck, and intertriginous regions of the body, which are sensitive to the cutaneous adverse effects of topical corticosteroids. Our study may be one of the first studies to compare the effects of topical clobetasol and tacrolimus ointment in the management of CLP.
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Ashy Dermatosis and Lichen Planus Pigmentosus: The Histopathological Differences. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5829185. [PMID: 31781623 PMCID: PMC6855079 DOI: 10.1155/2019/5829185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022]
Abstract
Background Ashy dermatosis (AD) and lichen planus pigmentosus (LPP) are both acquired macular pigmentation of uncertain aetiology. Despite the controversy surrounding their entities, recent global consensus has concluded that they are 2 different diseases with distinct clinical presentations. Nevertheless, there are limited data on their histopathological comparisons. Objective To evaluate the differences in histopathological findings between AD and LPP. Methods Electronic records and photographs of patients with the diagnosis of AD or LPP from January 2008 to December 2018 were retrospectively reviewed by a dermatologist. Patients were then classified into groups with AD and LPP, based on the clinical descriptions from the recent consensus. Those with history/clinical presentations suggestive of other causes of macular pigmentation were excluded. The histopathological diagnosis of AD and LPP was then reevaluated by a blinded dermatopathologist. Results One hundred and twenty-four patients with acquired macular pigmentation were identified; 24 were excluded due to clinical history or photographs being inconsistent with AD or LPP. Of the remaining 100 patients, 71 had clinical findings consistent with LPP while 29 had AD. The prevalence of epidermal hyperkeratosis was significantly higher in LPP when compared to AD (33.8% vs. 0%, p < 0.001), as well as epidermal hypergranulosis (35.2% vs. 0%, p < 0.001), lichenoid dermatitis (49.3% vs. 7.1%, p < 0.001), perifollicular infiltration (47.9% vs.10.3%, p < 0.001), and perifollicular fibrosis (35.2% vs. 10.3%, p=0.01). In addition, the degree of pigmentary incontinence was more severe in LPP (21.1% vs. 3.5%, p=0.015). For AD, vacuolization of the epidermal basal cell layer was more common (96.4% vs. 77.5%, p=0.02). Conclusions Although most cases of AD and LPP can be diagnosed clinically, in doubtful cases, histopathological findings of lichenoid dermatitis, epidermal hyperkeratosis/hypergranulosis, and moderate to severe pigmentary incontinence can help distinguish LPP from AD.
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Sonthalia S, Vedamurthy M, Thomas M, Goldust M, Jha AK, Srivastava S, Aggarwal I. Modified phenol peels for treatment-refractory hyperpigmentation of lichen planus pigmentosus: A retrospective clinico-dermoscopic analysis. J Cosmet Dermatol 2019; 18:1479-1486. [PMID: 30661300 DOI: 10.1111/jocd.12862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/08/2018] [Accepted: 09/05/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Lichen Planus Pigmentosus (LPP), a disorder with stubborn treatment-refractory hyperpigmentation predominantly affects the darker skin. Deep dermal pigmentary incontinence of LPP renders the condition treatment-refractory. OBJECTIVES Lack of a consistently effective depigmenting treatment protocol of inactive LPP mandates exploration of novel approaches. We analyzed the effect of six sessions of modified phenol peel on reduction of pigmentation of LPP in Indian patients. METHODS The results of a retrospective analysis of the efficacy and safety of six sessions of Croton oil free phenol combination (CFPC) peel done every 3 weeks, for inactive LPP-associated hyperpigmentation in 17 patients are presented. Efficacy evaluation was done with patient-reported improvement, physician-evaluated improvement (photographic comparison of baseline and post-treatment clinical images), and pre- and posttreatment comparison of dermoscopic images using a simple scale. RESULTS Out of 17, 5 (29%) patients sustained excellent improvement with >75% reduction of pigmentation. Overall 13 (76%) patients had moderate to excellent improvement, that is, at least 25% or more reduction in pigmentation. The patient-reported improvement, physician-graded improvement, and dermoscopic changes-all three measures showed harmonious overlap. Lightening of the background color and reduction in density and color intensity of pigmented structures was observed on dermoscopy in majority of patients. The treatment was well tolerated with no serious local/systemic adverse effects. CONCLUSIONS Modified phenol peels seem effective in reduction of hyperpigmentation of LPP. They are safe and well tolerated. Thorough priming, stringent sun protection and use of post-peel adjuvant topicals boost the peel effect and aid in maintaining the effect for up to a year.
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Affiliation(s)
- Sidharth Sonthalia
- Department of Dermatology & Dermatosurgery, Skinnocence: The Skin Clinic & Research Center, Gurugram, India
| | - Maya Vedamurthy
- Department of Dermatology & Dermatosurgery, RSV Skin & Laser Center, Chennai, India
| | - Mary Thomas
- Department of Dermatology, Poornima Hospital, Bengaluru, India
| | - Mohamad Goldust
- Department of Dermatology, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Sakshi Srivastava
- Department of Dermatology and Aesthetic Medicine, Jaypee Hospital, Noida, India
| | - Ishad Aggarwal
- Department of Dermatology, Purnam Skin Clinic, Kolkata, India
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Kumaran MS, Bishnoi A, Srivastava N, Tekumalla S, Vinay K, Bhatia A, Parsad D. Significant reduction in the expression of interleukins-17A, 22 and 23A, forkhead box p3 and interferon gamma delineates lichen planus pigmentosus from lichen planus. Arch Dermatol Res 2019; 311:519-527. [PMID: 31089878 DOI: 10.1007/s00403-019-01926-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/14/2019] [Accepted: 05/02/2019] [Indexed: 12/13/2022]
Abstract
Recent studies have noticed significant role of interleukin (IL)-17, 22, 23, Foxp3, interferon-gamma (IFN-γ) and Wnt5a in oral and cutaneous lichen planus (LP). This study was undertaken to assess whether similar expression exists in lichen planus pigmentosus (LPP). We recruited 30 patients of treatment-naïve 'LPP' (in absence of cutaneous/mucosal LP elsewhere, group 1), 10 patients having active treatment-naïve cutaneous 'LP' (group 2), 10 patients having 'post-LP' hyperpigmentation (in absence of active LP and off treatment for at least past 3 months, group 3), and 10 controls. Quantitative real-time polymerase chain reaction (qRT-PCR, peripheral blood mononuclear cells [PBMCs] and skin) and immunohistochemistry (IHC, skin) was performed. mRNA expression (in PBMCs) of IL-17A, IL-22, IL-23A, IFN-γ and Foxp3 was significantly decreased in group 1 and 3 as compared to group 2 (p < 0.05). Wnt5a expression was maximal in controls; and while there was no difference between group 1 and 2; whereas expression in group 3 was significantly lesser than group 1 and 2 (p < 0.05). qRT-PCR (skin) and IHC (skin) revealed similar results; and mRNA expression and mean fluorescence intensity of IL-17A, IL-22, IL-23A/R was significantly increased in group 2 and 3 compared to group 1 (p < 0.05). Mean fluorescence intensity and mRNA expression of IFN-γ, Foxp3 and Wnt5a were significantly increased in group 2 compared to group 1 (p < 0.05); whereas the difference between group 1 and 3 was not significant. Mean fluorescence intensity and mRNA expression of IL-17A, 1L-22 and IFN-γ showed no difference between group 2 and 3; whereas that of IL-23A/R, foxp3 and wnt5a were significantly higher in group 2 than group 3 (p < 0.05). Overall, maximal expression of IL-17A, IL-22, IL-23A, IFN-γ and Foxp3 (mRNA PBMCs) was observed in LP. Minimal expression of IL-17A, IL-22, IL-23A/R, IFN-γ and Foxp3 (mRNA skin and IHC skin) was seen in LPP patients. In contrast to LP, LPP lacks the expression of IFN-γ, Foxp3 and the cytokines representing Th17 pathway, and thus seems to have a distinct pathogenesis.
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Affiliation(s)
- Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Niharika Srivastava
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Sindhuja Tekumalla
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Alka Bhatia
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
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Arpa MG, Flores-Terry MÁ, González-Ruiz L, Villasanti-Rivas N. Linear facial lichen planus pigmentosus. An Bras Dermatol 2019; 94:378-379. [PMID: 31365680 PMCID: PMC6668947 DOI: 10.1590/abd1806-4841.20198537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/17/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Mónica García Arpa
- Department of Dermatology, Hospital General Universitario de Ciudad
Real, Ciudad Real, Spain
| | | | - Lucía González-Ruiz
- Department of Dermatology, Hospital General Universitario de Ciudad
Real, Ciudad Real, Spain
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Husein‐ElAhmed H, Gieler U, Steinhoff M. Lichen planus: a comprehensive evidence‐based analysis of medical treatment. J Eur Acad Dermatol Venereol 2019; 33:1847-1862. [DOI: 10.1111/jdv.15771] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 06/21/2019] [Indexed: 12/15/2022]
Affiliation(s)
- H. Husein‐ElAhmed
- Department of Dermatology and Venereology Hospital de Baza Granada Spain
- Translational Research Institute Academic Health System Medical School Hamad Medical Corporation Doha Qatar
| | - U. Gieler
- Translational Research Institute Academic Health System Medical School Hamad Medical Corporation Doha Qatar
- Department of Dermatology and Venereology Hamad Medical Corporation Doha Qatar
| | - M. Steinhoff
- Translational Research Institute Academic Health System Medical School Hamad Medical Corporation Doha Qatar
- Department of Dermatology and Venereology Hamad Medical Corporation Doha Qatar
- College of Medicine Weill Cornell Medicine‐Qatar Doha Qatar
- Medical School Qatar University Doha Qatar
- College of Medicine Weill Cornell University New York NY USA
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Vinay K, Kumar S, Bishnoi A, Aggarwal D, Radotra BD, Parsad D, Sendhil Kumaran M. A clinico‐demographic study of 344 patients with lichen planus pigmentosus seen in a tertiary care center in India over an 8‐year period. Int J Dermatol 2019; 59:245-252. [DOI: 10.1111/ijd.14540] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Divya Aggarwal
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Bishan Dass Radotra
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
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Mendiratta V, Sanke S, Chander R. Lichen Planus Pigmentosus: A Clinico-etiological Study. Indian Dermatol Online J 2019; 10:288-292. [PMID: 31149573 PMCID: PMC6536068 DOI: 10.4103/idoj.idoj_253_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Lichen planus pigmentosus (LPP) is a distinct clinical entity commonly encountered in the Indian population. AIM To study the clinicoetiological profile of LPP at a tertiary care hospital. METHODS A total of 100 patients with clinically and histopathologically confirmed diagnosis of LPP were included. Demographic details including the age of onset, duration of disease, symptoms, and family history were obtained. History regarding any precipitating factors, cosmetics, drug intake, and associated cutaneous or systemic diseases was taken. Clinical examination of the skin, oral cavity, hair, and nails was carried out. RESULTS Of the total 100 patients, 56 (56%) were females and 44 (44%) males with age ranging from 18 to 54 years (mean age - 31.23 years). The duration of disease ranged from 2 to 60 months with a mean of 19.31 months. Cosmetic disfigurement (68%) was the commonest complaint, followed by itching (41%) while, 30% of the patients were asymptomatic. History of topical mustard oil and hair dye application was present in 62% and 48% of the cases each. Other topicals included perfumes (24%), aftershave lotion (36%), and cosmetics (20%). Face (54%) and neck (48%) were the commonest sites affected, followed by upper back (36%), upper limbs, and chest (each 32%). A total of 11 patients showed only flexural involvement. The commonest pattern of pigmentation was diffuse (56%) followed by reticular in 16%. The color of the pigmentation varied from slate grey to brownish-black in varying proportions. A positive association was found between hypothyroidism with diffuse LPP where the P value was <0.001. CONCLUSION LPP is a distinct clinical entity caused by diverse etiological factors and shows varied clinical patterns. All the patients should be advised to stop using mustard oil/henna/hair dye/after shave lotions and cosmetics. Hypothyroidism can be considered to be a disease associated with LPP and all the patients should be investigated for the same.
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Affiliation(s)
- Vibhu Mendiratta
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Sarita Sanke
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Ram Chander
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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30
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Wu C, Lin F. A successful combination therapy of tacrolimus, hydroxychloroquine and picosecond laser for lichen planus pigmentosus. Australas J Dermatol 2019; 60:e336-e337. [DOI: 10.1111/ajd.13060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Chen‐Yu Wu
- Department of Dermatology Cathay General Hospital Taipei Taiwan
| | - Feng‐Ling Lin
- Department of Dermatology Cathay General Hospital Taipei Taiwan
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31
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Kumaran M, Dabas G, Vinay K, Parsad D. Reliability assessment and validation of the dermal pigmentation area and severity index: a new scoring method for acquired dermal macular hyperpigmentation. J Eur Acad Dermatol Venereol 2019; 33:1386-1392. [DOI: 10.1111/jdv.15516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/04/2019] [Indexed: 11/29/2022]
Affiliation(s)
- M.S. Kumaran
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - G. Dabas
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - K. Vinay
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - D. Parsad
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
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32
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Thandar Y, Maharajh R, Haffejee F, Mosam A. Treatment of cutaneous lichen planus (Part 1): A review of topical therapies and phototherapy. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1582467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Yasmeen Thandar
- Department of Basic Medical Sciences, Faculty of Heath Sciences, Durban University of Technology, Durban, South Africa
| | - Rivesh Maharajh
- Department of Basic Medical Sciences, Faculty of Heath Sciences, Durban University of Technology, Durban, South Africa
| | - Firoza Haffejee
- Department of Basic Medical Sciences, Faculty of Heath Sciences, Durban University of Technology, Durban, South Africa
| | - Anisa Mosam
- Department of Dermatology, University of KwaZulu-Natal & Nelson Mandela School of Medicine, Durban, South Africa
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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: 91] [Impact Index Per Article: 18.2] [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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Cozzani E, Gariazzo L, Cioni M, Parodi A. Could colchicine represent a new therapeutic approach for lichen planus pigmentosus? Dermatol Ther 2019; 32:e12809. [PMID: 30614614 DOI: 10.1111/dth.12809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/23/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Emanuele Cozzani
- Dissal Section of Dermatology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Lodovica Gariazzo
- Dissal Section of Dermatology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Margherita Cioni
- Dissal Section of Dermatology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Aurora Parodi
- Dissal Section of Dermatology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
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Navarro-Triviño FJ, Naranjo-Díaz MJ, Ruiz-Villaverde R. Annular Pigmented Plaque Under the Chin. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:911-912. [PMID: 30539730 DOI: 10.1016/j.ad.2017.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/23/2017] [Accepted: 08/25/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- F J Navarro-Triviño
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Complejo Hospitalario Universitario de Granada, Granada, España.
| | - M J Naranjo-Díaz
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Complejo Hospitalario Universitario de Granada, Granada, España
| | - R Ruiz-Villaverde
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Complejo Hospitalario Universitario de Granada, Granada, España
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Navarro-Triviño F, Naranjo-Díaz M, Ruiz-Villaverde R. Annular Pigmented Plaque Under the Chin. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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37
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Wu A, Vaidya S. Literature Review of Treatment Outcomes for Lichen Planus Pigmentosus, Erythema Dyschromicum Perstans, and Ashy Dermatosis. J Cutan Med Surg 2018; 22:643-645. [PMID: 30322299 DOI: 10.1177/1203475418782132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Albert Wu
- 1 Department of Dermatology, The Queen Elizabeth Hospital, Woodville, South Australia
| | - Sachin Vaidya
- 1 Department of Dermatology, The Queen Elizabeth Hospital, Woodville, South Australia
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Kumarasinghe SPW, Pandya A, Chandran V, Rodrigues M, Dlova NC, Kang HY, Ramam M, Dayrit JF, Goh BK, Parsad D. A global consensus statement on ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis. Int J Dermatol 2018; 58:263-272. [PMID: 30176055 DOI: 10.1111/ijd.14189] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/18/2018] [Accepted: 07/17/2018] [Indexed: 01/19/2023]
Abstract
Ashy dermatosis (AD), lichen planus pigmentosus (LPP), erythema dyschromicum perstans (EDP), and idiopathic eruptive macular pigmentation are several acquired macular hyperpigmentation disorders of uncertain etiology described in literature. Most of the published studies on these disorders are not exactly comparable, as there are no clear definitions and different regions in the world describe similar conditions under different names. A consensus on the terminology of various morphologies of acquired macular pigmentation of uncertain etiology was a long-felt need. Several meetings of pigmentary disorders experts were held to address this problem. A consensus was reached after several meetings and collation of e-mailed questionnaire responses and e-mail communications among the authors of publications on the above conditions. This was achieved by a global consensus forum on AD, LPP, and EDP, established after the 22nd International Pigment Cell Conference held in Singapore in 2014. Thirty-nine experts representing 18 countries participated in the deliberations. The main focus of the deliberations was terminology of the conditions; as such, we present here the consensus statement of the forum and briefly review the available literature on the subject. We have not attempted to discuss treatment modalities in detail.
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Affiliation(s)
| | - Amit Pandya
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Michelle Rodrigues
- Department of Dermatology, St Vincent's Hospital, Fitzroy, Vic, Australia
| | - Ncoza C Dlova
- Department of Dermatology, College of Health Sciences, Durban, South Africa
| | - Hee Young Kang
- Department of Dermatology, Ajou University, Suwon, South Korea
| | - M Ramam
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
| | - Johannes F Dayrit
- Department of Dermatology, Research Institute for Tropical Medicine, Metro Manila, Philippines
| | | | - Davinder Parsad
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Dabas G, Vinay K, Parsad D, Chatterjee D, Kumaran MS. A retrospective study of lichen planus pigmentosus with focus on palmoplantar involvement. Clin Exp Dermatol 2018; 44:190-193. [PMID: 29947025 DOI: 10.1111/ced.13696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2018] [Indexed: 11/28/2022]
Abstract
Lichen planus pigmentosus (LPP) is a rare disease characterized by persistent and asymptomatic slate-grey pigmentation, which mostly affects patients with skin types IV-VI. The face and neck are the most commonly involved sites, followed by the trunk and extremities. LPP is believed to spare the palms, soles and nails. In this report, we describe palmoplantar involvement in 10 (4.65%, 10/215) patients with LPP, and compare its clinicodemographic features with those of classic LPP. LPP lesions on the palms and soles present as asymptomatic, well-circumscribed, hyperpigmented, brown-black patches without any history of prior lichen planus lesions. They are mostly observed in young patients with rapidly spreading active disease, who often require systemic treatment to control the disease activity. Strikingly, palmoplantar involvement is frequently associated with other atypical LPP variants. It is important to identify palmoplantar involvement in LPP, as it has a different clinical course and associations compared with classic LPP.
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Affiliation(s)
- G Dabas
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigar, India
| | - K Vinay
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigar, India
| | - D Parsad
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigar, India
| | - D Chatterjee
- Department of Pathology, PGIMER, Chandigar, India
| | - M S Kumaran
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigar, India
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40
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Shah DSD, Aurangabadkar DS, Nikam DB. An open-label non-randomized prospective pilot study of the efficacy of Q-switched Nd-YAG laser in management of facial lichen planus pigmentosus. J COSMET LASER THER 2018; 21:108-115. [DOI: 10.1080/14764172.2018.1469770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Dr. Swapnil Deepak Shah
- Ashwini Rural Medical College Hospital and Research Center, Department of Dermatology Dermatology and Venereology, Solapur, India
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41
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Law DZ, Vahdani K, Ashdown M, Garrott H, Ford RL. Periorbital linear lichen planus pigmentosus-report of 2 cases and literature review. Can J Ophthalmol 2018; 54:e12-e14. [PMID: 30851786 DOI: 10.1016/j.jcjo.2018.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/18/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
Affiliation(s)
- David Zhiwei Law
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, U.K; National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces, Singapore.
| | - Kaveh Vahdani
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, U.K
| | - Morag Ashdown
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, U.K
| | - Helen Garrott
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, U.K
| | - Rebecca Louise Ford
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, U.K
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42
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Gupta V, Sharma VK. Ashy dermatosis, lichen planus pigmentosus and pigmented cosmetic dermatitis: Are we splitting the hair? Indian J Dermatol Venereol Leprol 2018; 84:470-474. [PMID: 29667610 DOI: 10.4103/ijdvl.ijdvl_549_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Kumar Sharma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Cheng HM, Chuah SY, Gan EY, Jhingan A, Thng STG. A retrospective clinico-pathological study comparing lichen planus pigmentosus with ashy dermatosis. Australas J Dermatol 2018; 59:322-327. [PMID: 29635779 DOI: 10.1111/ajd.12813] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/10/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND/OBJECTIVES Controversy persists as to whether lichen planus pigmentosus and ashy dermatosis are separate clinical entities. This study was conducted to examine the clinicopathological features and treatment outcome of the two conditions. METHODS A retrospective medical chart review of all patients who were diagnosed with lichen planus pigmentosus or ashy dermatosis was conducted. The information collected included the participants' age at onset, site of onset, duration of disease, presence of precipitating factors, distribution of disease, pigmentation and presence of symptoms. In patients from whom a biopsy was taken the histopathological reports were included. RESULTS Altogether 26 patients with ashy dermatosis and 29 with lichen planus pigmentosus were included in the study. Compared with ashy dermatosis, lichen planus pigmentosus had a more localised distribution with a preponderance for facial involvement, compared with the truncal preponderance in ashy dermatosis. Ashy dermatosis tended to have a more stable clinical course than lichen planus pigmentosus, which was more likely to wax and wane. The utility of histopathology in differentiating between the two conditions is low. CONCLUSION Ashy dermatosis and lichen planus pigmentosus, as defined in this study, appear to be two separate clinical entities with distinguishable clinical features and natural histories.
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Affiliation(s)
- Hui Mei Cheng
- Department of Dermatology, National Skin Centre, Singapore City, Singapore
| | - Sai Yee Chuah
- Department of Dermatology, National Skin Centre, Singapore City, Singapore
| | - Emily Yiping Gan
- Department of Dermatology, National Skin Centre, Singapore City, Singapore
| | - Anjali Jhingan
- Department of Dermatology, National Skin Centre, Singapore City, Singapore
| | - Steven Tien Guan Thng
- Department of Dermatology, National Skin Centre, Singapore City, Singapore.,Department of Material Science and Engineering, Nanyang Technological University, Singapore City, Singapore
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Mulinari-Brenner FA, Guilherme MR, Peretti MC, Werner B. Frontal fibrosing alopecia and lichen planus pigmentosus: diagnosis and therapeutic challenge. An Bras Dermatol 2018; 92:79-81. [PMID: 29267454 PMCID: PMC5726685 DOI: 10.1590/abd1806-4841.20175833] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 04/24/2016] [Indexed: 11/21/2022] Open
Abstract
Frontal fibrosing alopecia is a variant of lichen planopilaris with marginal progressive hair loss on the scalp, eyebrows and axillae. We report a case of frontal fibrosing alopecia and lichen planus pigmentosus in a postmenopausal woman, that started with alopecia on the eyebrows and then on the frontoparietal region, with periocular and cervical hyperpigmentation of difficult management. The condition was controlled with systemic corticosteroid therapy and finasteride. Lichen planus pigmentosus is an uncommon variant of lichen planus frequently associated with frontal fibrosing alopecia in darker phototipes. It should be considered in patients affected by scarring alopecia with a pattern of lichen planopilaris and areas of skin hyperpigmentation revealing perifollicular hyperpigmentation refractory to multiple treatments. This case illustrates diagnostic and therapeutic challenge in face of scarring alopecia and perifollicular hyperpigmentation.
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Affiliation(s)
| | | | - Murilo Calvo Peretti
- Department of Dermatology, Hospital de Clínicas da Universidade Federal do Paraná (HC- UFPR) - Curitiba (PR), Brazil
| | - Betina Werner
- Department of Basic Pathology, Universidade Federal do Paraná (UFPR) - Curitiba (PR), Brazil
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45
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Chronic graft versus host disease presenting as lichen planus pigmentosus. Bone Marrow Transplant 2018; 53:1048-1050. [PMID: 29410549 DOI: 10.1038/s41409-018-0110-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 12/10/2017] [Accepted: 12/14/2017] [Indexed: 11/08/2022]
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46
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Bilateral Symmetric Hyperpigmented Forehead Patches: Answer. Am J Dermatopathol 2018; 40:150. [PMID: 29381523 DOI: 10.1097/dad.0000000000000753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Robles-Méndez JC, Rizo-Frías P, Herz-Ruelas ME, Pandya AG, Ocampo Candiani J. Lichen planus pigmentosus and its variants: review and update. Int J Dermatol 2017; 57:505-514. [DOI: 10.1111/ijd.13806] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 07/19/2017] [Accepted: 09/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Juan Carlos Robles-Méndez
- Department of Dermatology; Hospital Universitario “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Nuevo León México
| | - Paulina Rizo-Frías
- Department of Dermatology; Hospital Universitario “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Nuevo León México
| | - Maira Elizabeth Herz-Ruelas
- Department of Dermatology; Hospital Universitario “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Nuevo León México
| | - Amit G. Pandya
- Department of Dermatology; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Jorge Ocampo Candiani
- Department of Dermatology; Hospital Universitario “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Nuevo León México
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48
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Vashi NA, Wirya SA, Inyang M, Kundu RV. Facial Hyperpigmentation in Skin of Color: Special Considerations and Treatment. Am J Clin Dermatol 2017; 18:215-230. [PMID: 27943085 DOI: 10.1007/s40257-016-0239-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Differences in cutaneous diseases in people of color call for nuanced evaluation and management. One of the most common dermatological complaints from patients with skin of color is dyspigmentation, particularly hyperpigmentation. The challenge for clinicians is to establish correct diagnoses along with consistently successful treatments to meet the needs of the increasingly diverse population served. This review focuses on facial hyperpigmentation and outlines the most common skin disorders and treatment options.
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Affiliation(s)
- Neelam A Vashi
- Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
| | - Stephen A Wirya
- Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
| | - Meyene Inyang
- Howard University College of Medicine, Washington, DC, USA
| | - Roopal V Kundu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 1600, Chicago, IL, 60611, USA.
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Romiti R, Biancardi Gavioli CF, Anzai A, Munck A, Costa Fechine CO, Valente NYS. Clinical and Histopathological Findings of Frontal Fibrosing Alopecia-Associated Lichen Planus Pigmentosus. Skin Appendage Disord 2017; 3:59-63. [PMID: 28560214 DOI: 10.1159/000456038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/11/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia occurring mainly in postmenopausal women. A range of facial lesions have been described in FFA, such as lichen planus (LP) pigmentosus, red dots, facial papules, and perifollicular and diffuse erythema. These lesions can be the first sign of FFA. LP pigmentosus is a rare variant of LP. The first description of LP pigmentosus associated with FFA (in 2012) reported 22 cases of LP pigmentosus among 44 cases of FFA affecting South African patients. METHODS We reviewed 16 FFA patients with LP pigmentosus and the histopathological findings of the biopsy of LP pigmentosus in 9 patients. RESULTS Most patients had intermediate skin phototypes (III-IV; n = 10; 62%). The age at onset of LP pigmentosus ranged from 30 to 60 years. The most common histopathological findings were epidermal atrophy, basal cell degeneration, interfollicular inflammatory infiltrate and melanophages, and perifollicular changes. Other findings not previously described in LP pigmentosus were inflammation and interface changes on sweat duct epithelia (acrosyringium and superior dermal duct), and lichenoid perisebaceitis. CONCLUSIONS Histology of our cases confirmed previous findings and showed a high incidence of perifollicular involvement with occasional changes affecting sebaceous and sweat glands.
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Affiliation(s)
- Ricardo Romiti
- Dermatological Outpatient Clinic, Hospital das Clínicas, Medical School of the University of São Paulo, São Paulo, Brazil
| | | | - Alessandra Anzai
- Dermatological Outpatient Clinic, Hospital das Clínicas, Medical School of the University of São Paulo, São Paulo, Brazil
| | - Andréia Munck
- Dermatological Outpatient Clinic, Hospital das Clínicas, Medical School of the University of São Paulo, São Paulo, Brazil
| | | | - Neusa Y S Valente
- Dermatological Outpatient Clinic, Hospital das Clínicas, Medical School of the University of São Paulo, São Paulo, Brazil
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Abstract
A pigmented variant of lichen planus (LP) was first reported from India in 1974 by Bhutani et al. who coined the term LP pigmentosus (LPP) to give a descriptive nomenclature to it. LP has a number of variants, one of which is LPP. This disease has also later been reported from the Middle East, Latin America, Korea, and Japan, especially in people with darker skin. It has an insidious onset. Initially, small, black or brown macules appear on sun-exposed areas. They later merge to form large hyperpigmented patches. The disease principally affects the sun-exposed areas of the body such as the face, trunk, and upper extremities. The oral mucosa may rarely be involved. However, the palms, soles, and nails are not affected. Histologically, the epidermis is atrophic along with vacuolar degeneration of basal cell layer. The dermis exhibits incontinence of pigment with scattered melanophages and a sparse follicular or perivascular infiltrate. There is a considerable similarity in histopathological findings between LPP and erythema dyschromicum perstans. However, there are immunologic and clinical differences between the two. These observations have led to a controversy regarding the identity of the two entities. While some dermatologists consider them to be the same, others have opined that the two should be considered as distinctly different diseases. A number of associations such as hepatitis C virus infection, frontal fibrosing alopecia, acrokeratosis of Bazex and nephrotic syndrome have been reported with LPP. A rare variant, LPP inversus, with similar clinical and histopathological findings was reported in 2001. As opposed to LPP, this variant occurs in covered intertriginous locations such as groins and axillae and mostly affects white-skinned persons.
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Affiliation(s)
- Aparajita Ghosh
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Arijit Coondoo
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
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