1
|
Malhi K, Singh S, Chatterjee D, De D, Handa S, Mahajan R. Disseminated verrucous and keratotic plaques in a young boy. Clin Exp Dermatol 2024; 49:1269-1271. [PMID: 38739692 DOI: 10.1093/ced/llae191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/02/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024]
Abstract
We present a rare case of verrucous discoid lupus erythematosus in a paediatric patient, with a focus on clinical and histopathological features. We discuss the differential diagnoses, including papulonecrotic tuberculid, verrucous psoriasis and pityriasis rubra pilaris, with a focus on histopathological clues for differentiation, and emphasize the pivotal role of histopathological examination and direct immunofluorescence in confirming the diagnosis.
Collapse
Affiliation(s)
- Kittu Malhi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sukhdeep Singh
- 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
| | - Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
2
|
Tekin B, Xie F, Lehman JS. Lichen Planus: What is New in Diagnosis and Treatment? Am J Clin Dermatol 2024; 25:735-764. [PMID: 38982032 DOI: 10.1007/s40257-024-00878-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/11/2024]
Abstract
Lichen planus (LP), an idiopathic, multifaceted chronic inflammatory disease with a heterogeneous clinical presentation, affects approximately 0.5-1% of the population. The various clinical manifestations of LP fall into three broad categories, namely cutaneous, appendageal, and mucosal, with further subclassification depending on the morphology and distribution patterns of individual lesions. There is mounting evidence that LP has systemic associations, including autoimmune conditions, glucose intolerance, dyslipidemia, and cardiovascular disorders. Cutaneous hypertrophic and mucosal forms of LP are at a heightened risk for malignant transformation. Familiarity with these potential associations in conjunction with long-term follow-up and regular screening could lead to a timely diagnosis and management of concomitant conditions. In addition, the frequent quality of life (QoL) impairment in LP underscores the need for a comprehensive approach including psychological evaluation and support. Several treatment strategies have been attempted, though most of them have not been adopted in clinical practice because of suboptimal benefit-to-risk ratios or lack of evidence. More recent studies toward pathogenesis-driven treatments have identified Janus kinase inhibitors such as tofacitinib, phosphodiesterase-4 inhibitors such as apremilast, and biologics targeting the interleukin-23/interleukin-17 pathway as novel therapeutic options, resulting in a dramatic change of the treatment landscape of LP. This contemporary review focuses on the diagnosis and management of LP, and places emphasis on more recently described targeted treatment options.
Collapse
Affiliation(s)
- Burak Tekin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Julia S Lehman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
3
|
Whittington CP, Saleh JS, Bresler SC, Patel RM. Hypertrophic Lichen Planus: An Up-to-Date Review and Differential Diagnosis. Arch Pathol Lab Med 2024; 148:659-665. [PMID: 37327190 DOI: 10.5858/arpa.2022-0515-ra] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 06/18/2023]
Abstract
CONTEXT.— Hypertrophic lichen planus (HLP) is a variant of lichen planus that can be difficult to diagnose based on histopathologic features alone. Thus, patient clinical history and clinicopathologic correlation are essential considerations to make the correct diagnosis. OBJECTIVE.— To discuss the clinical and histologic presentation of HLP and provide a thorough review of commonly encountered mimickers in the differential diagnosis. DATA SOURCES.— Data were derived from a literature review, personal clinical and research experiences, and a review of cases in the archives of a tertiary care referral center. CONCLUSIONS.— In general, HLP involves the lower extremities and is characterized by thickened, scaly nodules and plaques that are often pruritic and chronic in nature. HLP affects both males and females and is most common in adults 50 to 75 years of age. Unlike conventional lichen planus, HLP tends to have eosinophils and classically displays a lymphocytic infiltrate most concentrated around the tips of rete ridges. The differential diagnosis for HLP is broad and encompasses numerous entities in many different categories, including premalignant and malignant neoplasms, reactive squamoproliferative tumors, benign epidermal neoplasms, connective tissue disease, autoimmune bullous disease, infection, and drug-related reactions. Therefore, a high index of suspicion must be maintained to avoid a misdiagnosis and potential inappropriate treatments.
Collapse
Affiliation(s)
- Carli P Whittington
- From the Departments of Pathology (Whittington, Saleh, Bresler, Patel) and Dermatology (Whittington, Saleh, Bresler, Patel), University of Michigan, Ann Arbor
- the Department of Cutaneous Pathology, WCP Laboratories Inc, Maryland Heights, Missouri (Patel)
| | - Jasmine S Saleh
- From the Departments of Pathology (Whittington, Saleh, Bresler, Patel) and Dermatology (Whittington, Saleh, Bresler, Patel), University of Michigan, Ann Arbor
- the Department of Cutaneous Pathology, WCP Laboratories Inc, Maryland Heights, Missouri (Patel)
| | - Scott C Bresler
- From the Departments of Pathology (Whittington, Saleh, Bresler, Patel) and Dermatology (Whittington, Saleh, Bresler, Patel), University of Michigan, Ann Arbor
- the Department of Cutaneous Pathology, WCP Laboratories Inc, Maryland Heights, Missouri (Patel)
| | - Rajiv M Patel
- From the Departments of Pathology (Whittington, Saleh, Bresler, Patel) and Dermatology (Whittington, Saleh, Bresler, Patel), University of Michigan, Ann Arbor
- the Department of Cutaneous Pathology, WCP Laboratories Inc, Maryland Heights, Missouri (Patel)
| |
Collapse
|
4
|
Durusu Turkoglu IN, Gurel G, Özdemir C. What is This Black Mark on the Boy's Forehead? ACTAS DERMO-SIFILIOGRAFICAS 2023:S0001-7310(23)00938-9. [PMID: 38061454 DOI: 10.1016/j.ad.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/01/2024] Open
Affiliation(s)
- I N Durusu Turkoglu
- Afyonkarahisar Health Sciences University, Department of Dermatology, Afyonkarahisar, Turkey.
| | - G Gurel
- Afyonkarahisar Health Sciences University, Department of Dermatology, Afyonkarahisar, Turkey
| | - C Özdemir
- Afyonkarahisar Health Sciences University, Department of Pathology, Afyonkarahisar, Turkey
| |
Collapse
|
5
|
Thakur M, Kasi IK, Islary P, Bhatti SK. Nutritional and Health-Promoting Effects of Lichens Used in Food Applications. Curr Nutr Rep 2023; 12:555-566. [PMID: 37581862 DOI: 10.1007/s13668-023-00489-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE OF REVIEW Lichens have a huge significance which is used in nutrition due to the bioactive components within. Lichen is a nutrient-dense resourceful diet nearly every day meal and has long been used as food; also, these valuable natural resources are now being utilized for a wide range of other purposes. The purpose of this review was to evaluate the nutritional and edible qualities of lichens as well as the possible health benefits of lichens. It is interesting to note that lichen is a nutrient-dense and functional food. It is a nutritional resource that can mitigate the effects of malnutrition to some amount. RECENT FINDINGS There is an indication that an intake of lichens as natural foods was associated with nutritional and health-promoting properties. Lichens have proven to have theoretically rich nutritional value, and their extracts and active constituents have also been shown to have multiple health benefits. Low-fat content, high carbohydrate, and crude fibre content; plentiful mineral components; and good protein sources are all thought to contribute to lichen's nutritional value. There is a lot of potential for using lichens as an effective food source and ensuring people's food production.
Collapse
Affiliation(s)
- Monika Thakur
- Division Botany, Department of Bio-Sciences, Career Point University, Hamirpur, 176041, Himachal Pradesh, India.
| | - Indra Kumar Kasi
- Department of Entomology, Dr. Yaswant, Singh Parmar University of Horticulture and Forestry, Solan, 173230, Himachal Pradesh, India
| | - Pungbili Islary
- Department of Botany, Bodoland University, Kokrajhar, Assam, India
| | - Sayeeda Kousar Bhatti
- Department of Botany, Govt. Degree College Mendhar, Jammu and Kashmir, 185211, UT, India
| |
Collapse
|
6
|
Lee JJ, Kim R, Lee MY, Byun JY, Choi YW, Choi HY. A Case of Linear Hypertrophic Lichen Planus in a Pediatric Patient. Ann Dermatol 2023; 35:S256-S259. [PMID: 38061716 PMCID: PMC10727884 DOI: 10.5021/ad.21.300] [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: 12/14/2021] [Revised: 02/09/2022] [Accepted: 03/27/2022] [Indexed: 12/20/2023] Open
Abstract
Lichen planus (LP) is a chronic inflammatory disease of the skin and mucosa. Of the various types, the hypertrophic type is characterized by thickened, purplish hyperkeratotic plaques and nodules. The course of hypertrophic LP tends to be more chronic than those of other types. A 12-year-old girl presented with a 2-year history of warty papules and plaques in a zosteriform configuration along one flank. Histopathology revealed hyperkeratosis and papillomatosis with wedge-shaped hypergranulosis. A lichenoid lymphocytic infiltrate with vacuolar change in the basal layer was evident. She was prescribed oral doxycycline, a topical corticosteroid, and tacrolimus. After 7 weeks, the skin lesions became significantly flattened and faded. LP is less common but more severe in children than in adults. The unilateral, linear hypertrophic type of LP is uncommon. Herein, we report a rare case of linear hypertrophic LP in a child.
Collapse
Affiliation(s)
- Jin Ju Lee
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Rosa Kim
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Min Young Lee
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ji Yeon Byun
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - You Won Choi
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hae Young Choi
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea.
| |
Collapse
|
7
|
García-Pola M, Rodríguez-Fonseca L, Suárez-Fernández C, Sanjuán-Pardavila R, Seoane-Romero J, Rodríguez-López S. Bidirectional Association between Lichen Planus and Hepatitis C-An Update Systematic Review and Meta-Analysis. J Clin Med 2023; 12:5777. [PMID: 37762719 PMCID: PMC10531646 DOI: 10.3390/jcm12185777] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Lichen planus (LP) is a chronic, inflammatory mucocutaneous disorder associated with systemic diseases such as hepatitis C (HCV). The objective of this study is to evaluate the association between LP and HCV bidirectionally through a systematic review and meta-analysis. A comprehensive search of studies published was performed in the databases of PubMed, Embase, and Web of Science. Out of 18,491 articles, 192 studies were included. The global prevalence of HCV positive (HCV+) in LP patients registered from 143 studies was 9.42% [95% confidence interval (CI), 7.27-11.58%], and from these, 84 studies showed HCV+ 4-fold more frequent in LP than a control group (OR, 4.48; 95% CI, 3.48-5.77). The global prevalence of LP in patients HCV+ recorded from 49 studies was 7.05% (95% CI, 4.85-9.26%), and from these, 15 registered a 3-fold more LP in HCV (OR, 3.65; 95% CI, 2.14-6.24). HCV+ in LP patients showed great geographic variability (OR, 2.7 to 8.57), and the predominantly cutaneous location was higher (OR, 5.95) than the oral location (OR, 3.49). LP in HCV+ patients was more frequent in the Eastern Mediterranean (OR, 5.51; 95% CI, 1.40-15.57). There is a higher prevalence of HCV+ in LP and vice versa than in the control group, especially in certain geographical areas that should be taken into consideration when doing screening in countries with an upper prevalence of HCV among the general population.
Collapse
Affiliation(s)
- María García-Pola
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Oviedo, 33004 Oviedo, Spain; (L.R.-F.); (C.S.-F.); (R.S.-P.); (S.R.-L.)
| | - Lucia Rodríguez-Fonseca
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Oviedo, 33004 Oviedo, Spain; (L.R.-F.); (C.S.-F.); (R.S.-P.); (S.R.-L.)
| | - Carlota Suárez-Fernández
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Oviedo, 33004 Oviedo, Spain; (L.R.-F.); (C.S.-F.); (R.S.-P.); (S.R.-L.)
| | - Raquel Sanjuán-Pardavila
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Oviedo, 33004 Oviedo, Spain; (L.R.-F.); (C.S.-F.); (R.S.-P.); (S.R.-L.)
| | - Juan Seoane-Romero
- Department of Surgery and Medical-Surgical Specialties, School of Medicine and Dentistry, University of Santiago de Compostela, 15780 Santiago de Compostela, Spain;
| | - Samuel Rodríguez-López
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, University of Oviedo, 33004 Oviedo, Spain; (L.R.-F.); (C.S.-F.); (R.S.-P.); (S.R.-L.)
| |
Collapse
|
8
|
Spirito F, Caponio VCA, Lo Muzio E, Campisi G, Santarelli A, Lo Russo L, Rubini C, Favia G, Limongelli L, Coppola N, Lo Muzio L, Leuci S. Oral lichen planus in children: An Italian case series. Pediatr Dermatol 2023; 40:489-493. [PMID: 37019629 DOI: 10.1111/pde.15318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/25/2023] [Indexed: 04/07/2023]
Abstract
Oral lichen planus usually occurs in adults; there are no clear data regarding the incidence and the clinical features of oral lichen planus in children. This paper reports clinical findings, treatments, and outcomes of 13 Italian patients with oral lichen planus in childhood diagnosed between 2001 and 2021. The most common finding was keratotic lesions with reticular or papular/plaque-like patterns, confined to the tongue in seven patients. Although oral lichen planus in childhood is rare and the malignant transformation index is unknown, specialists must be aware of its characteristics and oral mucosal lesions must be correctly diagnosed and managed.
Collapse
Affiliation(s)
- Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | | | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Andrea Santarelli
- Department of Clinical Specialistic and Stomatological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Corrado Rubini
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, Odontostomatology Unit, "Aldo Moro" University, Bari, Italy
| | - Luisa Limongelli
- Department of Interdisciplinary Medicine, Odontostomatology Unit, "Aldo Moro" University, Bari, Italy
| | - Noemi Coppola
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Stefania Leuci
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| |
Collapse
|
9
|
Balakirski G, Löser CR. [Common nail diseases in children and adolescents : Recognize, advise, treat]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:199-212. [PMID: 36745230 PMCID: PMC9900549 DOI: 10.1007/s00105-022-05106-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 06/18/2023]
Abstract
There are a number of nail diseases that primarily occur in children and adolescents. Many of these nail changes are physiologic and are only transient. Thus, they do not need any therapy. Infectious nail diseases or nail involvement in chronic inflammatory dermatoses can be found in both children and adults, and may require specific treatment. Nail pigmentation such as longitudinal melanonychia occur significantly less frequently in children than in adult patients, and have different causes and a better prognosis. Knowledge about these child-specific peculiarities of nail diseases is necessary in order to provide the best possible advice to parents and to offer appropriate treatment. This article focuses on the most common and important nail diseases in children and adolescents and their treatment.
Collapse
Affiliation(s)
- Galina Balakirski
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Wuppertal, Deutschland
| | - Christoph R Löser
- Hautklinik, Hauttumorzentrum, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Bremserstr. 79, 67063, Ludwigshafen, Deutschland.
| |
Collapse
|
10
|
Mohandesi NA, Berry NA, Tollefson MM, Lehman JS, Davis DMR. Pediatric lichen planus: A single-center retrospective review of 26 patients with follow up. Pediatr Dermatol 2023; 40:84-89. [PMID: 36373243 DOI: 10.1111/pde.15170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND/OBJECTIVES Pediatric lichen planus (LP) is rare with variable prevalence and atypical presentations compared to adults. Data on LP are lacking for the pediatric population in the United States. We present demographics, presentations, and treatments for a pediatric LP cohort. METHODS We reviewed 26 patients diagnosed with LP at 20 years or younger. Treatment responses were defined as no response, partial response, and complete response. RESULTS Demographics included 54% females and median diagnosis age of 16 years (range 6-20). Most patients presented with cutaneous LP (65%), with fewer having associated oral (23%), nail (7.7%), or genital (3.8%) involvement. Some had cutaneous-only LP (38%) or strictly mucosal LP (oral-only 19% and genital-only 15%). LP lesions were pruritic (50%), painful (19%), and/or asymptomatic (35%). Complete/partial responses occurred with medium-potency topical corticosteroids in cutaneous (n = 7; 64%), oral (n = 3; 75%), and genital LP (n = 3; 100%), with high/ultra-high potency topical corticosteroids in oral LP (n = 6; 86%), and with topical calcineurin inhibitors in genital LP (n = 2; 100%). Side effects were clobetasol-related oral candidiasis and biopsy-related penile depressed scar. Most patients with available follow-up achieved remission (n = 17; 81%). CONCLUSIONS Pediatric LP usually presents in adolescence with cutaneous involvement and is symptomatic. However, patients frequently can have oral, genital, or nail lesions or may be asymptomatic, so they need thorough examinations and follow-up. Long-term remission is common due to treatment or natural disease course. Medium-potency corticosteroids are recommended for cutaneous, oral, and genital LP. Various other local and systemic therapies exist with successful treatment responses.
Collapse
Affiliation(s)
| | | | - Megha M Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Julia S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Dawn Marie R Davis
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
11
|
Grover C, Kharghoria G, Baran R. Nail lichen planus: A review of clinical presentation, diagnosis and therapy. Ann Dermatol Venereol 2022; 149:150-164. [PMID: 35272870 DOI: 10.1016/j.annder.2022.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/08/2021] [Accepted: 01/21/2022] [Indexed: 11/29/2022]
Abstract
Lichen planus is a multifaceted disease of complex etiopathogenesis. Nails are involved in up to 10% of patients with lichen planus. Although most cases are mild, serious consequences may occur due to rapid progression of the disease, the high risk of scarring, and the resulting irreversible damage to the nail structure. Permanent damage of at least one nail occurs in approximately 4-12% of patients with nail lichen planus. In this narrative review, we emphasize the pathophysiology of nail lichen planus, the emergent nature of the disease, and the spectrum of different clinical manifestations. Diagnosis of nail disease in general, and of nail lichen planus in particular, is rapidly evolving. This review provides a comprehensive account of the non-invasive and invasive diagnostic techniques and treatment options reported in the literature, with emphasis on the efficacy and safety of the drugs used, the associated evidence, and the factors to be taken into account in planning and providing adequate treatment. The role of aesthetic and camouflage options is also summarized.
Collapse
Affiliation(s)
- C Grover
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, 110091 Delhi, India.
| | - G Kharghoria
- Department of Dermatology and STD, All India Institute of Medical Sciences, 110029 Delhi, India
| | - R Baran
- Nail Disease Centre-42, Rue de Serbes, 06400 Cannes, France
| |
Collapse
|
12
|
Archana S. Unusual Occurrence Of Nail Lichen Planus In A Child And Response To Treatment. Dermatol Ther 2022; 35:e15319. [PMID: 35023605 DOI: 10.1111/dth.15319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Singal Archana
- Department of Dermatology & STD University College of Medical Sciences & GTB Hospital (University of Delhi), Delhi, 110095, India
| |
Collapse
|
13
|
Bansal D, Kamboj M, Anand R, Pandiar D, Narwal A, Sivakumar N, Devi A. Association of childhood vaccination with pediatric lichen planus: A systematic review. Int J Dermatol 2021; 62:22-31. [PMID: 34870853 DOI: 10.1111/ijd.15974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 09/21/2021] [Accepted: 10/23/2021] [Indexed: 12/23/2022]
Abstract
Lichen planus (LP) is a chronic T-cell-mediated mucocutaneous inflammatory disease, largely recognized in adults. It is uncommon in children, and the literature present still lacks comprehensive understanding mainly due to underreporting of such cases. LP shows atypical clinical features, when seen in children, mainly affecting the flexor aspect of the wrists, legs, and the oral and genital mucosae. It is largely considered an autoimmune response of the body with various etiologic factors. Its association with vaccination is still an interesting field for research. The focus of the present systematic review was to discover the link of vaccine in the pathogenesis of juvenile LP. An electronic search was carried out using MEDLINE by PubMed, Google Scholar, and Web of Science databases. Articles that reported LP in children with prior records for vaccination were selected for the present systematic review. Twenty-three published articles in the English language were included for the quantitative and qualitative syntheses. The demographic data, specific vaccine history, and clinical details of the lesions were recorded. The existing evidence supports that vaccines could play an important role in etiopathogenesis of pediatric LP.
Collapse
Affiliation(s)
- Deepty Bansal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Mala Kamboj
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Rahul Anand
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Deepak Pandiar
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Saveetha University (Tamil Nadu), Chennai, India
| | - Anjali Narwal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - N Sivakumar
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Anju Devi
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| |
Collapse
|
14
|
Daulatabad D, Pandhi D, Bhattacharya SN, Deuri D, Singal A, Malhotra RK. Insight into pediatric-versus adult-onset lichen planus: A retrospective analytical study from Northern India. Indian J Dermatol Venereol Leprol 2021; 88:112-114. [PMID: 34623054 DOI: 10.25259/ijdvl_1_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | - Deepika Pandhi
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India
| | - Sambit Nath Bhattacharya
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India
| | - Darshana Deuri
- Department of Dermatology, Guwahati Neurological Research Center and Hospital, North Guwahati, Assam, India
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India
| | - Rajeev Kumar Malhotra
- Department of Biomedical Statistics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
15
|
Hamid MAB, Tariq S. Scarring Alopecia With Coexisting Lichen Planus in a Child: A Rare Phenomenon. Cureus 2021; 13:e16730. [PMID: 34513361 PMCID: PMC8405352 DOI: 10.7759/cureus.16730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 11/05/2022] Open
Abstract
Lichen planopilaris (LPP) is characterized by chronic cicatricial alopecia that is lymphocytic in nature. The underlying pathophysiology of LPP is not well understood. Failure of therapeutic management occurs quite often resulting in significant psychosocial stress on the patient when they are unable to prevent further hair loss or reverse it. Although the occurrence of LPP is rare, it is especially seldom observed in the pediatric population. Herein, we discuss a case of a nine-year-old child who was recently diagnosed with LPP.
Collapse
Affiliation(s)
| | - Shahan Tariq
- Dermatology, National University of Medical Sciences, Rawalpindi, PAK
| |
Collapse
|
16
|
Sears S, Daftary K, Burch A, Todd P. A case of annular atrophic lichen planus in a child and review of the literature. Pediatr Dermatol 2021; 38:1283-1287. [PMID: 34561910 DOI: 10.1111/pde.14812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Lichen planus (LP) is an inflammatory disease affecting both adults and children that may present with numerous rare morphologies. LP and its many subtypes can prove difficult to treat and often leave patients with dyspigmentation. Additionally, pruritus associated with LP can be distressing to patients. The aim of this report is to highlight an uncommon subtype, annular atrophic lichen planus, which uniquely presented in a child, to emphasize the importance of early disease recognition and finally, to demonstrate successful treatment with topical monotherapy with clobetasol propionate ointment.
Collapse
Affiliation(s)
- Samantha Sears
- Division of Dermatology, Department of Internal Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - Karishma Daftary
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Andrea Burch
- Division of Dermatology, Department of Internal Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - Patricia Todd
- Division of Pediatric Dermatology, Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA
| |
Collapse
|
17
|
Merhy R, Sarkis AS, Assaf J, Afiouni R, Zeinaty P, Kechichian E, Tomb R, Helou J. Pediatric lichen planus: a systematic review of 985 published cases. Int J Dermatol 2021; 61:416-421. [PMID: 34370874 DOI: 10.1111/ijd.15678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/26/2021] [Accepted: 05/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory disorder usually occurring in middle-aged adults. Data are scarce in the pediatric population. OBJECTIVE To describe the patients' characteristics, clinical presentation, and management of pediatric LP. METHODS A systematic literature review of pediatric LP was performed in the Medline and Cochrane databases up to February 1, 2020. Demographic and clinical data were extracted for analysis, in addition to laboratory and histology findings, treatments used, and response to treatment. LP pemphigoides (LPP) was further pooled for a subcategory analysis. RESULTS One hundred and sixty-four articles were included representing 985 patients. The most common country of origin was India. The most common clinical signs were flat-topped papules (51%); the linear variant was present in 9%. Oral involvement was present in 22%. The most commonly used treatment was topical corticosteroids followed by systemic corticosteroids. The mean duration of treatment was 124.4 days. LPP patients had a short disease duration before diagnosis (4.1 months, P < 0.001) and failed previous treatment more frequently (P < 0.001). Systemic corticosteroids were more often prescribed in this subgroup (75%, P < 0.001) with more recurrence after treatment (31%, P = 0.048). LIMITATIONS Lack of randomized controlled studies, in addition to publication bias. CONCLUSION In children, LP had a wide polymorphous clinical presentation, and the reported cases were mostly from India. The linear variant was more common and the oral mucosa was less affected in children. LPP, a rare subtype in children, was treated with systemic corticosteroids and recurred more frequently.
Collapse
Affiliation(s)
- Reine Merhy
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Anne-Sophie Sarkis
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Joy Assaf
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Rym Afiouni
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Perla Zeinaty
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Elio Kechichian
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Roland Tomb
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Josiane Helou
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
18
|
Rodriguez Baisi K, Wentworth A, Chattha AJ, DiCaudo DJ, Mangold A, Nelson SA, Siegfried E, Wieland CN, Tollefson M. A rare case of childhood mucous membrane pemphigoid involving the oral and genital mucosa. Pediatr Dermatol 2021; 38:904-907. [PMID: 33977558 DOI: 10.1111/pde.14627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mucous membrane pemphigoid (MMP) is a rare chronic immunobullous disease that involves the mucous membranes and may result in significant scarring and complications if diagnosis is delayed. MMP typically occurs in elderly patients, with very few cases reported in children. Here, we present a 12-year-old female patient with childhood-onset oral and genital MMP, clinically suspected to be lichen sclerosus, but eventually diagnosed as MMP after multiple supportive biopsies and confirmatory direct immunofluorescence. Although treatment was challenging, the combined use of systemic corticosteroids, dapsone, and mycophenolate mofetil was ultimately successful in achieving disease control.
Collapse
Affiliation(s)
| | | | - Asma J Chattha
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
| | - David J DiCaudo
- Department of Dermatology, Mayo Clinic, Scottsdale, AZ, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, AZ, USA
| | - Aaron Mangold
- Department of Dermatology, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Elaine Siegfried
- Department of Pediatric Dermatology, Saint Louis University, Saint Louis, MO, USA
| | | | - Megha Tollefson
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA.,Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
19
|
Zhao Y, Wang M, Xu B. A comprehensive review on secondary metabolites and health-promoting effects of edible lichen. J Funct Foods 2021. [DOI: 10.1016/j.jff.2020.104283] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
|
20
|
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.
Collapse
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
| |
Collapse
|
21
|
Mutalik S, Belgaumkar V, Rasal Y. Current perspectives in the treatment of childhood lichen planus. INDIAN JOURNAL OF PAEDIATRIC DERMATOLOGY 2021. [DOI: 10.4103/ijpd.ijpd_165_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
22
|
Rathi S, Joshi A, Manchanda Y. Childhood lichen planus. INDIAN JOURNAL OF PAEDIATRIC DERMATOLOGY 2021. [DOI: 10.4103/ijpd.ijpd_132_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
23
|
Sonthalia S, Agrawal M, Sharma A, Pandey A. Genital lichen planus: Adding to the review of an “underrecognized entity”. Indian J Sex Transm Dis AIDS 2021; 43:104-105. [PMID: 35846528 PMCID: PMC9282707 DOI: 10.4103/ijstd.ijstd_11_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 09/04/2020] [Accepted: 01/27/2021] [Indexed: 11/15/2022] Open
|
24
|
Böer-Auer A, Lütgerath C. [Lichen planus: fundamentals, clinical variants, histological features, and differential diagnosis]. Hautarzt 2020; 71:1007-1021. [PMID: 33201324 DOI: 10.1007/s00105-020-04717-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Lichen planus (LP) is a relatively common inflammatory skin disease in dermatological practice. The typical presentation of LP is usually diagnosed clinically. Less common variants such as LP inversus, atrophic LP, the palmoplantar manifestation or childhood LP may pose diagnostic difficulties so that a biopsy is taken to confirm the diagnosis. Differentiation from LP-like drug eruption may be challenging and biologicals have to be considered as triggers. Etiology and pathogenesis of LP are discussed based on recent literature. Finally, an overview of therapeutic options for different variants of the condition includes most recent approaches to treatment.
Collapse
Affiliation(s)
- Almut Böer-Auer
- Klinik für Hautkrankheiten, Dermatologie, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland.
- Dermatologikum Hamburg, Stephansplatz 5, 20354, Hamburg, Deutschland.
| | | |
Collapse
|
25
|
Mitchell JC, Burden JG, Williams JV. Extensive pruritic eruption in a child. Pediatr Dermatol 2020; 37:e81-e82. [PMID: 33283929 DOI: 10.1111/pde.14303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/08/2020] [Accepted: 07/04/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Julia C Mitchell
- Ocean Lakes High School, Math and Science Academy, Virginia Beach, Virginia, USA
| | - Julia G Burden
- Children's Specialty Group, Division of Dermatology, Children's Hospital of The King's Daughters, Norfolk, Virginia, USA
| | - Judith V Williams
- Children's Specialty Group, Division of Dermatology, Children's Hospital of The King's Daughters, Norfolk, Virginia, USA
| |
Collapse
|
26
|
Razmara F, Khayamzadeh M, Shabankare G. Applying dental implant therapy in patients with oral lichen planus: a review of literature. Int J Implant Dent 2020; 6:21. [PMID: 32458407 PMCID: PMC7250998 DOI: 10.1186/s40729-020-00216-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
Lichen planus (LP) is a violent, paranormal inflammatory disease that can affect the skin or any lining of the mucous membrane. LPs are a branch of immune-mediated inflammatory disease (IMID) that collaborates with the function and structure of the immune system that are precipitated through various etiological infectious agents. Oral lichen planus (OLP) is one of the most common kinds of IMID. These traumas might limit the normal life of patients and, in some cases, can be treated spontaneously. In patients who are affected by OLP, the dental clinicians must be capable of the proper diagnosis of the disorder. Dental implants are progressively applied for the treatment of partial or complete edentulism. Implant rehabilitation in OLP patients is one of the main challenges for patients and dental clinicians. There is not enough knowledge about this condition, and also medical documents are limited. In this study, by conducting a comprehensive review of literature, we tried to collect related data around the safety and success rate of implant rehabilitation in patients who suffer from OLP disorder. There proved to be no relation between implant survival rate and OLP diseases, but it is proven that some factors such as bone quality and fracture resistance, parafunctional habits, and resection of the marginal mandible could powerfully affect it. For evaluation of the advantages and disadvantages of applying implants in patients with OLP disorders, implementation of controlled studies is required.
Collapse
Affiliation(s)
- Farnoosh Razmara
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Khayamzadeh
- Department of Oral and Maxillofacial Disease, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran.
| | - Ghazal Shabankare
- School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| |
Collapse
|
27
|
Belhareth K, Korbi M, Belhadjali H, Soua Y, Moussa A, Youssef M, Zili J. Pediatric lichen planus pigmentosus possibly triggered by mercury dental amalgams. Pediatr Dermatol 2020; 37:375-376. [PMID: 31876002 DOI: 10.1111/pde.14078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Lichen planus pigmentosus is uncommon in childhood and its treatment is often challenging. We report a case of cutaneous lichen planus pigmentosus in a 10-year-old boy, without oral mucosal involvement, two months after an amalgam dental restoration. The diagnosis was based on the histopathological examination of a skin biopsy, the positive patch test to mercury, and the improvement after amalgam removal. Our case report suggests that metal allergy may play a role, and amalgam replacement may be followed by clinical improvement.
Collapse
Affiliation(s)
- Kamar Belhareth
- Dermatology Department, Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia
| | - Mouna Korbi
- Dermatology Department, Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia
| | - Hichem Belhadjali
- Dermatology Department, Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia
| | - Yosra Soua
- Dermatology Department, Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia
| | - Adnene Moussa
- Anatomopathology Department, Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia
| | - Monia Youssef
- Dermatology Department, Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia
| | - Jameleddine Zili
- Dermatology Department, Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia
| |
Collapse
|
28
|
Iorizzo M, Tosti A, Starace M, Baran R, Daniel CR, Di Chiacchio N, Goettmann S, Grover C, Haneke E, Lipner SR, Rich P, Richert B, Rigopoulos D, Rubin AI, Zaiac M, Piraccini BM. Isolated nail lichen planus: An expert consensus on treatment of the classical form. J Am Acad Dermatol 2020; 83:1717-1723. [PMID: 32112995 DOI: 10.1016/j.jaad.2020.02.056] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/22/2022]
Abstract
Lichen planus is a benign inflammatory disorder of unknown etiology that may affect the skin, mucosae, scalp, and nails. When the nails are affected, it may lead to permanent destruction with severe functional and psychosocial consequences. Therefore, prompt diagnosis and early treatment are essential, even in mild cases. There are currently no guidelines for the management of nail lichen planus and the published literature on treatment is limited. The aim of this review is to provide practical management recommendations for the classical form of nail lichen planus, especially when restricted to the nails. Topical treatment has poor short-term efficacy and may cause long-term side effects. Instead, intralesional and intramuscular triamcinolone acetonide should be considered first-line therapies. Oral retinoids are second-line choices, and immunosuppressive agents may also be considered.
Collapse
Affiliation(s)
| | - Antonella Tosti
- University of Miami, Miller School of Medicine, Miami, Florida
| | - Michela Starace
- Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - Robert Baran
- University of Franche-Comté, Nail Disease Center, Cannes, France
| | - C Ralph Daniel
- University of Mississippi Medical Center, Jackson, Mississippi; University of Alabama, Birmingham, Alabama
| | - Nilton Di Chiacchio
- Department of Dermatology, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | | | - Chander Grover
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Eckart Haneke
- Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Phoebe Rich
- Oregon Health and Science University, Portland, Oregon
| | - Bertrand Richert
- Saint Pierre - Brugmann and Queen Fabiola Children's University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| | - Dimitris Rigopoulos
- University Hospital of Venereal and Skin Diseases "A. Sygros," Athens, Athens, Greece
| | - Adam I Rubin
- Department of Dermatology, Hospital of the University of Pennsylvania, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin Zaiac
- Greater Miami Skin and Laser Center, Department of Dermatology, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Bianca Maria Piraccini
- Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
| |
Collapse
|
29
|
Kotha S, Kolalapudi S, Saka S, Konala S, Palakurthi S, Arumilli P. Lichen planus in children: A prospective study over a period of 2.5 years. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2020. [DOI: 10.4103/jdrntruhs.jdrntruhs_99_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
30
|
Dermatologic Problems Commonly Seen by the Allergist/Immunologist. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:102-112. [PMID: 31351991 DOI: 10.1016/j.jaip.2019.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 11/23/2022]
Abstract
Allergists/immunologists see a variety of skin disorders, some of which have a known immunologic basis whereas others do not. We review the prevalence, etiology, clinical presentation, and effective and low-cost care of common dermatologic conditions seen in outpatient practices. Conditions discussed include pityriasis alba, seborrheic dermatitis, rosacea, acne, tinea infections, intertrigo, lichen planus, tinea versicolor, lichen simplex chronicus, scabies, pityriasis rosea, keratosis pilaris, and seborrheic keratosis. An understanding of frequently encountered cutaneous diseases and their therapies will help provide immediate access to treatment and improve the experience for both the affected patient and the clinician.
Collapse
|
31
|
Witte M, Zillikens D, Sadik CD. Ein ungewöhnlicher Fall von Lichen ruber planus mit vorausgegangenem bullösem Pemphigoid bei einem 20‐jährigen Patienten. J Dtsch Dermatol Ges 2019; 17 Suppl 2:7-8. [DOI: 10.1111/ddg.13780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
32
|
Tziotzios C, Lee JYW, Brier T, Saito R, Hsu CK, Bhargava K, Stefanato CM, Fenton DA, McGrath JA. Lichen planus and lichenoid dermatoses: Clinical overview and molecular basis. J Am Acad Dermatol 2019; 79:789-804. [PMID: 30318136 DOI: 10.1016/j.jaad.2018.02.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Deriving from the Greek word λειχήν for "tree moss" and the Latin word planus for "planar," lichen planus is a relatively uncommon and heterogeneous cutaneous disorder that typically develops in middle-aged adults. Despite the significant clinical burden associated with the disorder, little well-conducted molecular research has been undertaken, possibly because of heterogeneity impeding consistent and confident phenotyping. The multiple variants of lichenoid disease bear overlapping clinical and pathologic features despite manifesting as distinct clinical disorders. The first article in this 2-part continuing medical education series provides a comprehensive overview of the clinical and pathologic characteristics of cutaneous lichenoid dermatoses and links these manifestations to recent advances in our understanding of the underlying pathobiology of such diseases.
Collapse
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
| |
Collapse
|
33
|
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.
Collapse
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
| |
Collapse
|
34
|
Gutierrez D, Gaulding J, Motta Beltran A, Lim H, Pritchett E. Photodermatoses in skin of colour. J Eur Acad Dermatol Venereol 2018; 32:1879-1886. [DOI: 10.1111/jdv.15115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 05/30/2018] [Indexed: 02/06/2023]
Affiliation(s)
- D. Gutierrez
- The Ronald O. Perelman Department of Dermatology New York University New York NY USA
| | - J.V. Gaulding
- Department of Dermatology Henry Ford Hospital Detroit MI USA
| | | | - H.W. Lim
- Department of Dermatology Henry Ford Hospital Detroit MI USA
| | - E.N. Pritchett
- Department of Dermatology Henry Ford Hospital Detroit MI USA
| |
Collapse
|
35
|
Robledo-Sierra J, van der Waal I. How general dentists could manage a patient with oral lichen planus. Med Oral Patol Oral Cir Bucal 2018; 23:e198-e202. [PMID: 29476684 PMCID: PMC5911349 DOI: 10.4317/medoral.22368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/22/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. MATERIAL AND METHODS Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. RESULTS In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confirmation of the diagnosis, possibly a biopsy procedure, and management of the patient in case of severe symptoms. Proper patient information is of utmost importance in the management. CONCLUSIONS General dentists can be expected to manage the majority of patients with oral lichen planus. Some patients may need to be referred for diagnostic purposes to a specialist; this is also the case for the rare patient with severe symptoms, possibly requiring systemic treatment.
Collapse
Affiliation(s)
- J Robledo-Sierra
- VU University Medical Center (VUmc)/ ACTA, Department of Oral and Maxillofacial Surgery and Pathology, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands,
| | | |
Collapse
|
36
|
Abstract
Inflammatory dermatoses encompass a variety of histologic patterns that affect different portions of the skin. In spongiotic, psoriasiform, lichenoid, pityriasiform, and blistering disorders, there are predominately epidermal and junctional activities with variable superficial dermal inflammation. Hypersensitivity reactions can show either epidermal or mostly dermal changes depending on whether the exposure of the exogenous allergen occurs through an external or internal route, respectively. Exceptions include erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis, where the etiology is often due to infection or ingested medications, but the histologic features are almost exclusively confined to the epidermis and dermoepidermal junction. Autoimmune disorders are unique in that lesions typically incorporate a mixture of epidermal and dermal inflammatory patterns with periadnexal inflammation, while the vast majority of vasculitis/vasculopathy and alopecia have changes limited to only the vessels and hair follicles, respectively. It is critical to recognize that a relatively limited number of histologic patterns are seen in a large array of clinical entities. Therefore, clinicopathologic correlation and careful examination of histologic details are of the utmost importance when evaluating skin biopsies for inflammatory disorders.
Collapse
Affiliation(s)
- Andy C Hsi
- 1 Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Ilana S Rosman
- 1 Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri.,2 Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri
| |
Collapse
|
37
|
Oliveira A, Mendes-Bastos P. Multiple annular plaques on a 9-year-old boy. Pediatr Dermatol 2017; 34:713-714. [PMID: 29144040 DOI: 10.1111/pde.13280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- André Oliveira
- Department of Dermatology, Hospital de Santa Maria, Lisbon, Portugal.,Centro Académico de Medicina de Lisboa, University of Lisbon, Lisbon, Portugal
| | | |
Collapse
|
38
|
Góes HFDO, Dias MFRG, Salles SDAN, Lima CDS, Vieira MDS, Pantaleão L. Lichen planopilaris developed during childhood. An Bras Dermatol 2017; 92:543-545. [PMID: 28954108 PMCID: PMC5595606 DOI: 10.1590/abd1806-4841.20174890] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 02/20/2016] [Indexed: 11/22/2022] Open
Abstract
Lichen planopilaris is a disease that appears with lymphocytic cicatricial alopecia. It is considered a follicular variant of lichen planus. The examination of affected areas shows alopecia with perifollicular erythema and scaling, revealing a predilection for hair follicles. The involvement of children is uncommon, with few reports in this population in the literature. This study presents a clinical case of a male patient of 15 years of age with characteristic lesions of lichen planopilaris.
Collapse
Affiliation(s)
| | | | | | - Caren Dos Santos Lima
- Department of Dermatology, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | | | - Luciana Pantaleão
- Department of Pathology, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| |
Collapse
|
39
|
Fahy CMR, Torgerson RR, Davis MDP. Final Diagnosis of 112 Girls Presenting With Genital Mucocutaneous Symptoms and Signs: The Mayo Clinic Experience. Pediatr Dermatol 2017; 34:e279-e280. [PMID: 28884911 DOI: 10.1111/pde.13247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pediatric genital mucocutaneous diseases are rare. A retrospective review was performed of children presenting with symptomatology of genital dermatoses to a hospital-based dermatology service. This study highlights that the range of genital diseases in children is not as broad as in adults. The diagnosis of genital mucocutaneous disease in children is usually genital lichen sclerosus, but other diagnoses should be considered.
Collapse
Affiliation(s)
| | | | - Mark D P Davis
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
40
|
Cascone M, Celentano A, Adamo D, Leuci S, Ruoppo E, Mignogna MD. Oral lichen planus in childhood: a case series. Int J Dermatol 2017; 56:641-652. [PMID: 28256018 DOI: 10.1111/ijd.13571] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/09/2016] [Accepted: 01/10/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the exact incidence of pediatric oral lichen planus (OLP) is unknown, the oral mucosa seems to be less commonly involved, and the clinical presentation is often atypical. The aim of the study is to present a case series of OLP in childhood. METHODS From our database, we retrospectively selected and analyzed the clinical data of OLP patients under the age of 18 where the diagnosis had been confirmed by histopathological analysis. RESULTS The case series from our database shows eight patients, four males and four females. The mean (±SD) age at the time of diagnosis of the disease was 13.5 (±2.73) years, ranging in age from 9 to 17. Clinically, a reticular pattern was present in six patients (75%), and the tongue was the most commonly involved oral site (six cases, 75%). We also report the first case of OLP in a 9-year-old girl affected by autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. CONCLUSIONS We report the largest case series of pediatric OLP published in literature thus far. Differences in the disease between adults and pediatric patients have been detected, but further investigation and a larger case series are needed to establish any detailed differences in clinical outcomes.
Collapse
Affiliation(s)
- Marco Cascone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Antonio Celentano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Daniela Adamo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Stefania Leuci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Elvira Ruoppo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Michele D Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| |
Collapse
|
41
|
Halteh P, Scher RK, Brinster NK, Lipner SR. A 10-Year-Old Boy with Dystrophy of the Fingernails. Pediatr Dermatol 2017; 34:193-194. [PMID: 28297137 DOI: 10.1111/pde.13111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Pierre Halteh
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Richard K Scher
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Nooshin K Brinster
- Dermatopathology Section, Ronald O. Perelman Department of Dermatology, School of Medicine, New York University, New York, New York
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| |
Collapse
|
42
|
Oral lichenoid lesions: distinguishing the benign from the deadly. Mod Pathol 2017; 30:S54-S67. [PMID: 28060366 DOI: 10.1038/modpathol.2016.121] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 05/31/2016] [Accepted: 06/02/2016] [Indexed: 12/25/2022]
Abstract
Oral lichen planus is a chronic inflammatory disease of unknown etiology or pathogenesis with varied disease severity that waxes and wanes over a long period of time. Although a common oral mucosal disease, accurate diagnosis is often challenging due to the overlapping clinical and histopathological features of oral lichen planus and other mucosal diseases. Other immune-mediated mucocutaneous diseases can exhibit lichenoid features including mucous membrane pemphigoid, chronic graft-versus-host disease, and discoid lupus erythematosus. Reactive changes to dental materials or to systemic medications can mimic oral lichen planus both clinically and histologically. In these situations the clinical presentation can be useful, as oral lichen planus presents as a multifocal process and is usually symmetrical and bilateral. Dysplasia of the oral cavity can exhibit a lichenoid histology, which may mask the potentially premalignant features. Proliferative verrucous leukoplakia, an unusual clinical disease, can often mimic oral lichen planus clinically, requiring careful correlation of the clinical and pathologic features.
Collapse
|
43
|
Tziotzios C, Stefanato CM, Fenton DA, Simpson MA, McGrath JA. Frontal fibrosing alopecia: reflections and hypotheses on aetiology and pathogenesis. Exp Dermatol 2016; 25:847-852. [DOI: 10.1111/exd.13071] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Christos Tziotzios
- St John's Institute of Dermatology; King's College London (Guy's Campus); London UK
| | | | - David A. Fenton
- St John's Institute of Dermatology; King's College London (Guy's Campus); London UK
| | - Michael A. Simpson
- Division of Genetics and Molecular Medicine; King's College London; Guy's Hospital; London UK
| | - John A. McGrath
- St John's Institute of Dermatology; King's College London (Guy's Campus); London UK
| |
Collapse
|
44
|
Nahidi Y, Tayyebi Meibodi N, Ghazvini K, Esmaily H, Esmaeelzadeh M. Association of classic lichen planus with human herpesvirus-7 infection. Int J Dermatol 2016; 56:49-53. [PMID: 27778320 DOI: 10.1111/ijd.13416] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 05/19/2016] [Accepted: 06/06/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Lichen planus is a mucocutaneous papulosquamous itchy disease with unknown etiology. A number of factors such as immune mechanisms, viral agents, and drugs have been implicated in pathogenesis of lichen planus. In recent years, several studies have indicated the role of viral agents in this disease, including human herpesvirus-7 (HHV-7). Studies have given contradictory results, which is why we decided to study the possible association between lichen planus with HHV-7. METHODS In this case-control study, which was conducted on 60 cutaneous classic lichen planus samples as well as 60 healthy control skin samples after matching the two groups in terms of gender and age, tissue samples of patients and controls were studied by real time polymerase chain reaction to detect for HHV-7. RESULTS According to this study, HHV-7 DNA was found in 18 samples of the case group (30.0%) and in six (10.0%) of the control group (P = 0.006). CONCLUSION The results of this study support the likely role of HHV-7 in pathogenesis of lichen planus. As an exogenous antigen, this virus may be involved in cellular immune-mediated destruction of keratinocytes.
Collapse
Affiliation(s)
- Yalda Nahidi
- Cutaneous Leishmaniasis Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad, Iran
| | - Naser Tayyebi Meibodi
- Cutaneous Leishmaniasis Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad, Iran
| | - Kiarash Ghazvini
- Research Center for Microbiology and Virology, Imam Reza Hospital, Faculty of Medicine, Mashhad, Iran
| | - Habibollah Esmaily
- Health Sciences Research Center, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | | |
Collapse
|
45
|
Stoopler ET, Alfaris S, Alomar D, Alawi F. Oral lichen planus preceding concomitant lichen planopilaris. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e82-5. [PMID: 27544399 DOI: 10.1016/j.oooo.2016.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 12/19/2022]
Abstract
Lichen planus (LP) is an immune-mediated mucocutaneous disorder with a wide array of clinical presentations. Oral lichen planus (OLP) is characterized clinically by striae, desquamation, and/or ulceration. Lichen planopilaris (LPP), a variant of LP, affects the scalp, resulting in perifollicular erythema and scarring of cutaneous surfaces accompanied by hair loss. The association between OLP and LPP has been reported previously with scant information on concomitant or sequential disease presentation. We describe a patient with concomitant OLP and LPP, and to the best of our knowledge, this is the first report on OLP preceding the onset of LPP.
Collapse
Affiliation(s)
- Eric T Stoopler
- Associate Professor of Oral Medicine, Division of Oral Medicine, Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.
| | - Sausan Alfaris
- Resident, Division of Oral Medicine, Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Dalal Alomar
- Resident, Division of Oral Medicine, Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Faizan Alawi
- Associate Professor of Pathology, Section of Oral and Maxillofacial Pathology, Division of Dermatopathology, Department of Dermatology, University of Pennsylvania Health System, Philadelphia, PA, USA
| |
Collapse
|
46
|
Cheng YSL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:332-54. [PMID: 27401683 DOI: 10.1016/j.oooo.2016.05.004] [Citation(s) in RCA: 278] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/03/2016] [Accepted: 05/11/2016] [Indexed: 12/26/2022]
Abstract
Despite being one of the most common oral mucosal diseases and recognized as early as 1866, oral lichen planus (OLP) is still a disease without a clear etiology or pathogenesis, and with uncertain premalignant potential. More research is urgently needed; however, the research material must be based on an accurate diagnosis. Accurate identification of OLP is often challenging, mandating inclusion of clinico-pathological correlation in the diagnostic process. This article summarizes current knowledge regarding OLP, discusses the challenges of making an accurate diagnosis, and proposes a new set of diagnostic criteria upon which to base future research studies. A checklist is also recommended for clinicians to provide specific information to pathologists when submitting biopsy material. The diagnostic process of OLP requires continued clinical follow-up after initial biopsy, because OLP mimics can manifest, necessitating an additional biopsy for direct immunofluorescence study and/or histopathological evaluation in order to reach a final diagnosis.
Collapse
Affiliation(s)
- Yi-Shing Lisa Cheng
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA.
| | - Alan Gould
- Louisville Oral Pathology Laboratory, Louisville, KY, USA
| | - Zoya Kurago
- Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Augusta University, Augusta, GA, USA
| | - John Fantasia
- Department of Dental Medicine, Hofstra North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA
| | - Susan Muller
- Professor Emeritus, Emory University School of Medicine, Atlanta, GA; Atlanta Oral Pathology, Decatur, GA, USA
| |
Collapse
|
47
|
Sonthalia S, Das A, Sharma S. Co-localization of Linear Lichen Planus Pigmentosus and Milia in a Child. Indian J Dermatol 2016; 61:237. [PMID: 27057056 PMCID: PMC4817481 DOI: 10.4103/0019-5154.177790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sidharth Sonthalia
- Department of Dermatology, Skinnocence: The Skin Clinic, Gurgaon, Haryana, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India. E-mail:
| | - Sonal Sharma
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| |
Collapse
|
48
|
Garcia-Pola MJ, Llorente-Pendás S, Seoane-Romero JM, Berasaluce MJ, García-Martín JM. Thyroid Disease and Oral Lichen Planus as Comorbidity: A Prospective Case-Control Study. Dermatology 2016; 232:214-9. [PMID: 26784745 DOI: 10.1159/000442438] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/10/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Thyroid disease has been mentioned to have a possible relation to the development of oral lichen planus (OLP). OBJECTIVE Because goiter is considered endemic in many countries, we proposed to determine whether thyroid disease constitutes a comorbidity of OLP. METHODS Two hundred and fifteen patients diagnosed as having OLP were evaluated concerning their serum thyroid-stimulating hormone and thyroxine (T4) levels. The results were contrasted with those obtained in control series of the same number of subjects matched for age and sex. RESULTS Diagnosis of thyroid disease was present in 15.3% of OLP patients (33/215) and in 5.2% (12/215) of the control group. In relation to OLP patients, the odds ratio of presence of thyroid disorders was 3.06 and that of using levothyroxine medication 3.21. CONCLUSIONS In the present study, OLP patients were associated with thyroid disease, specifically with hypothyroidism. Because most thyroid patients need T4 treatment, our findings confirmed that OLP and thyroid disease could be comorbidities.
Collapse
|
49
|
|
50
|
Weston G, Payette M. Update on lichen planus and its clinical variants. Int J Womens Dermatol 2015; 1:140-149. [PMID: 28491978 PMCID: PMC5418875 DOI: 10.1016/j.ijwd.2015.04.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 04/02/2015] [Accepted: 04/06/2015] [Indexed: 12/24/2022] Open
Abstract
Lichen planus (LP) is an inflammatory skin condition with characteristic clinical and histopathological findings. Classic LP typically presents as pruritic, polygonal, violaceous flat-topped papules and plaques; many variants in morphology and location also exist, including oral, nail, linear, annular, atrophic, hypertrophic, inverse, eruptive, bullous, ulcerative, lichen planus pigmentosus, lichen planopilaris, vulvovaginal, actinic, lichen planus-lupus erythematosus overlap syndrome, and lichen planus pemphigoides. Clinical presentation of the rarer variant lesions may be largely dissimilar to classic LP and therefore difficult to diagnose based solely on clinical examination. However, histopathological examination of LP and LP-variant lesions reveal similar features, aiding in the proper diagnosis of the disease. Management of LP and LP variants aims to control symptoms and to decrease time from onset to resolution; it often involves topical corticosteroids, but varies depending on the severity and location of the lesion. The literature contains an array of reports on the variations in presentation and successful management of LP and its variants. A familiarity with LP and its variants is important in achieving timely recognition and management of the disease.
Collapse
Affiliation(s)
- Gillian Weston
- University of Connecticut School of Medicine, Farmington, CT
| | - Michael Payette
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
| |
Collapse
|