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Lichen sclerosus

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https://www.readbyqxmd.com/read/29332706/skin-mapping-for-the-classification-of-generalized-morphea
#1
Noelle Teske, Joseph Welser, Heidi Jacobe
BACKGROUND: Generalized morphea lacks cohesive clinical features, limiting its clinical and investigative utility. OBJECTIVE: We sought to use computerized lesion mapping to objectively subtype morphea. METHODS: We conducted a 2-part cross-sectional study. In part 1, we created a discovery cohort of patients with generalized morphea of whom lesion maps were created to characterize subsets. Clinical and demographic features were compared between proposed subsets to determine if they identified clinically relevant differences...
February 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29315793/mood-changes-with-methotrexate-therapy-for-dermatologic-disease
#2
Trisha Bhat, Carrie C Coughlin
Neurotoxicity and cognitive effects of low-dose methotrexate for rheumatologic disease have often been described, but the neuropsychiatric effects of low-dose methotrexate for cutaneous disease have been underreported in the dermatology literature. We describe two children who experienced mood changes with methotrexate treatment for lichen sclerosus with morphea overlap and psoriasis, with rapid resolution of these symptoms after methotrexate cessation. We also detail possible mechanisms underlying psychiatric changes with methotrexate therapy...
January 9, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314207/vitiligoid-variant-of-lichen-sclerosus-in-young-girls-with-darker-skin-types
#3
Margaret H Dennin, Sarah L Stein, Adena E Rosenblatt
BACKGROUND/OBJECTIVES: Vitiligo and lichen sclerosus are autoimmune disorders characterized by white discoloration, and both frequently affect the anogenital region. Vitiligoid lichen sclerosus refers to a superficial variant of lichen sclerosus in which the lesion appears clinically to be vitiligo based on the predominant presentation of depigmentation and minimal inflammation and sclerosis but histologically is consistent with lichen sclerosus. A limited number of reports have described vitiligoid lichen sclerosus, and from these reports, it appears to primarily affect darker-skinned people...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29313955/oral-lichen-sclerosus-a-systematic-review-of-reported-cases-and-two-new-cases
#4
REVIEW
Tuomas Kakko, Tuula Salo, Maria K Siponen
Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disease with uncertain etiology. It occurs as white plaque-like lesions mostly in the anogenital skin. Oral mucosal involvement is extremely rare. This study aims to summarize the features of published oral lichen sclerosus (OLS) and two new cases. A systematic search of the English literature from 1955 to 2016 was performed in MEDLINE, Scopus, and Web of Science, and cross-references were searched manually. Search phrases included "lichen sclerosus," "mouth," "oral," "lip," "palate," "floor of mouth," "tongue," "gingiva," "buccal mucosa," and "mouth diseases...
January 4, 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29313888/british-association-of-dermatologists-guidelines-for-the-management-of-lichen-sclerosus-2018
#5
F M Lewis, F M Tatnall, S S Velangi, C B Bunker, A Kumar, F Brackenbury, M F Mohd Mustapa, L S Exton
The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of lichen sclerosus (LS) in adults (18+ years), children (0-12 years) and young people (13-17 years). The document aims to. offer an appraisal of all relevant literature up to July 2017, focusing on any key developments. address important, practical clinical questions relating to the primary guideline objective. provide guideline recommendations and if appropriate research recommendations. The guideline is presented as a detailed review with highlighted recommendations for practical use in primary care and in secondary care clinics, in addition to an updated Patient Information Leaflet (PIL; available on the BAD website, http://www...
January 4, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29298401/penile-lichen-sclerosus-treated-with-1927%C3%A2-nm-thulium-fiber-laser-and-photodynamic-therapy-a-new-possible-therapeutic-approach
#6
Santo Raffaele Mercuri, Pina Brianti, Antonio Foti, Marco Bartolucci, Annunziata Dattola, Steven Paul Nisticò
OBJECTIVE: We treated two patients with recalcitrant lichen sclerosus (LS) of the penis with a combination of 1927 nm thulium fiber laser and methyl-aminolevulinate (MAL) photodynamic therapy (PDT). BACKGROUND DATA: Therapy of LS is based on topical potent steroids, emollients, and topical calcineurin inhibitors. Circumcision is effective, but not always accepted. PDT represents a valid therapeutic option in refractory cases, but there are no reports about the association with 1927 nm thulium laser in the treatment of this pathology...
January 3, 2018: Photomedicine and Laser Surgery
https://www.readbyqxmd.com/read/29295880/evaluation-of-ajcc-and-an-alternative-tumor-classification-system-for-primary-vulvar-squamous-cell-carcinoma
#7
Sarah T Le, Pritesh S Karia, Beverley J Vollenhoven, Robert J Besaw, Colleen M Feltmate, Chrysalyne D Schmults
Background: Currently, no studies have attempted to validate the AJCC tumor (T) class for vulvar cancer or examine its performance via clinical data. The goal of this study was to identify risk factors associated with poor outcomes in vulvar squamous cell carcinoma (vSCC) and compare prognostic discrimination of these outcomes between the AJCC T-classification system and the newly developed Brigham and Women's Vulvar Tumor Classification system (BWVTC). Methods: A 15-year, 2-center retrospective cohort study of primary vSCCs (N=226) was undertaken...
January 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29258952/5-aminolevulinic-acid-photodynamic-therapy-in-refractory-vulvar-lichen-sclerosus-et-atrophicus-series-of-ten-cases
#8
Ting Lan, Yongzhen Zou, Michael R Hamblin, Rui Yin
BACKGROUND: Vulvar lichen sclerosus et atrophicus (VLSA) is a chronic inflammatory skin disease of unknown etiology that mainly affects postmenopausal and perimenopausal women. The primary clinical symptoms of VLSA are itching, burning pain, and dyspareunia that can results in decreased quality of life. Existing therapies including topical corticosteroid ointment, topical calcineurin inhibitors, estrogens, are not very effective for treatment of VLSA. OBJECTIVE: To evaluate the effectiveness and safety of 5-aminolevulinic acid mediated photodynamic therapy (ALA-PDT) in the treatment of VLSA...
December 16, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/29249126/dyspareunia-in-vulvar-lichen-sclerosus-an-overview-of-a-distressing-symptom
#9
Monica Corazza, Annarosa Virgili, Sara Minghetti, Alessandro Borghi
BACKGROUND: Dyspareunia is a symptom of vulvar lichen sclerosus (VLS). This study specifically addressed prevalence and severity of dyspareunia in patients affected with VLS as well as the factors that can influence its occurrence. Changes in the severity of dyspareunia with treatment were also explored. METHODS: In this retrospective, cohort study we included VLS patients who had undergone any topical treatment for 12 weeks, between January 2011 and March 2016, at our Vulva Unit; demographics, history and clinical features recorded at baseline and at treatment completion were elaborated...
December 15, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29237158/dermoscopy-of-morphea-and-cutaneous-lichen-sclerosus-clinicopathological-correlation-study-and-comparative-analysis
#10
Enzo Errichetti, Aimilios Lallas, Zoe Apalla, Alessandro Di Stefani, Giuseppe Stinco
BACKGROUND: Dermoscopy of morphea and cutaneous lichen sclerosus (CLS) has been described by various studies, with none of them considering variability according to clinical phases and investigating dermoscopic-histological correlations. OBJECTIVE: To evaluate dermoscopic features in general and according to clinical stage, identify possible distinctive dermoscopic clues, and assess dermoscopy accuracy in detecting subclinical alterations in morphea and CLS. METHODS: A representative dermoscopic image of target lesions was evaluated for the presence of specific features, correlating them with clinical subtype (inflammatory, inflammatory-sclerotic, sclerotic, or sclerotic-atrophic)...
December 14, 2017: Dermatology: International Journal for Clinical and Investigative Dermatology
https://www.readbyqxmd.com/read/29234717/vulvar-lichen-planus-pemphigoides
#11
J Loyal, S Rashtak
Lichen planus pemphigoides (LPP) is a rare blistering disease with features of both lichen planus and bullous pemphigoid. LPP typically appears on the extremities and occasionally involves the oral mucosa. Herein, we describe a case of LPP of the vulva of an 80-year-old woman, an uncommon location for this disease process. This clinical scenario can be confused with a number of similarly appearing entities such as erosive vulvar lichen planus, mucous membrane pemphigoid, and erosive lichen sclerosus et atrophicus...
December 2017: International Journal of Women's Dermatology
https://www.readbyqxmd.com/read/29210715/blistering-and-skin-fragility-due-to-imatinib-therapy-loss-of-laminin-and-collagen-iv-as-a-possible-cause-of-cutaneous-basement-membrane-instability
#12
Sebastian Mühl, Jan Ehrchen, Dieter Metze
Imatinib mesylate (Glivec; Novartis AG, Basel, Switzerland) is a tyrosine kinase inhibitor which is used in the treatment of oncologic diseases like chronic myeloid leukemia and gastrointestinal stroma tumor (GIST). Among cutaneous side effects, bullous reactions are rare. The authors describe the case of a 66-year-old woman developing blistering and skin fragility on her hands, foot, lower legs, and back after intake of imatinib for treatment of GIST. Biopsy showed vacuolar alteration at the dermoepidermal junction (DEJ) associated with a few lymphocytes and a subepidermal blister...
November 22, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/29202553/extramammary-paget-s-disease-associated-with-genital-wart-and-lichen-sclerosus
#13
Rana Rafiei, Hojat Eftekhari, Siamak Granmayeh, Nahid Nickhah, Behnam Rafiee
Extramammary Paget's disease is an uncommon intraepithelial adenocarcinoma in genital and perianal regions. Genital wart is the most common sexually transmitted disease caused by human papilloma viruses and vulval lichen sclerosus is chronic pruritic dermatitis in genital area which could be able to change to invasive squamous cell carcinoma. We report a patient who had simultaneous lichen sclerosus, genital wart and extramammary Paget's disease of the vulva. We could not find any significant association between them in literature...
September 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29194107/vestibulovaginal-sclerosis-versus-lichen-sclerosus
#14
Tania Day, Kate Burston, Graeme Dennerstein, Ross Pagano, James Scurry
To determine if vestibulovaginal sclerosis and lichen sclerosus (LS) are 2 distinct entities. Biopsies obtained from the vagina or vulvar vestibule that contained abnormal subepithelial collagen were reviewed. Cases were categorized either as LS or vestibulovaginal sclerosis based on presence or absence of basal layer degeneration and lymphocytic infiltrate. Clinical data collected included examination findings, biopsy site and indication, previous vulvovaginal surgery, medications at time of biopsy, vulvar LS, treatment, and response...
November 30, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/29182032/squamous-cell-carcinoma-of-the-bulbar-urethra-accompanied-by-lichen-sclerosus-a-case-report
#15
Xufeng Peng, Hailin Guo, Chongrui Jin, Lin Wang, Yinglong Sa
Squamous cell carcinoma (SCC) of the bulbar urethra accompanied by lichen sclerosus (LS) is rarely reported. This study reports the case of a 56-year-old man with urethral squamous cell carcinoma (USCC) accompanied by a long history of genital LS. The man presented with a painful perineal mass and had a long-term history of urethral strictures and urethral dilatation. The patient developed a periurethral abscess that expanded to the perineum and formed an urethrocutaneousperineal fistula. An organ-sparing perineal resection and fistulectomy was performed according to the patient's wishes...
November 1, 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/29140882/extravascular-migratory-metastasis-pericytic-mimicry-in-sarcomatoid-squamous-cell-carcinoma-of-the-vulva-a-report-of-2-cases
#16
M H Eleanor Koay, Colin J R Stewart
Extravascular migratory metastasis (EVMM), also known as pericytic mimicry or angiotropism, is a mechanism of angiocentric tumor spread that has been investigated mainly in cutaneous malignant melanoma where it has been associated with an increased risk of metastasis. In EVMM, the tumor cells spread along the external (ablumenal) aspect of vessels without breaching the endothelium, a process that is therefore distinct from the more widely recognized intraluminal invasion. Although EVMM has also been reported in a limited range of other tumor types, to our knowledge it has not been described in squamous cell carcinoma (SCC)...
November 14, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/29137809/prognostic-factors-for-local-recurrence-of-squamous-cell-carcinoma-of-the-vulva-a-systematic-review
#17
REVIEW
Nienke C Te Grootenhuis, Anne-Floor W Pouwer, Geertruida H de Bock, Harry Hollema, Johan Bulten, Ate G J van der Zee, Joanne A de Hullu, Maaike H M Oonk
BACKGROUND: In patients treated for early-stage squamous cell vulvar carcinoma local recurrence is reported in up to 40% after ten years. Knowledge on prognostic factors related to local recurrences should be helpful to select high risk patients and/or to develop strategies to prevent local recurrences. OBJECTIVE: This systematic review aims to evaluate the current knowledge on the incidence of local recurrences in vulvar carcinoma related to clinicopathologic and cell biologic variables...
November 12, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29126556/vulvar-intraepithelial-neoplasia-risk-factors-for-recurrence
#18
W Satmary, C H Holschneider, L L Brunette, S Natarajan
OBJECTIVE: We studied a large population of women with high-grade vulvar intraepithelial neoplasia (VIN) in order to identify patient and treatment-related risk factors for recurrence and progression to cancer. METHODS: For this retrospective cohort study of women with a histologic diagnosis of VIN within Southern California Permanente Medical Group between 1995 and 2007 medical records were reviewed; clinical, demographic and pathologic data were collected. Statistical analyses included Chi-squared and Student's t-tests, univariate and multivariate logistic regression, and cumulative incidence analysis...
November 7, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29107132/staged-urethroplasty-for-penile-urethral-strictures-from-lichen-sclerosus-and-failed-hypospadias-repair
#19
Bradley D Figler, Andrew Gomella, Logan Hubbard
OBJECTIVE: To present our technique for staged urethroplasty with buccal mucosa graft. METHODS: The patient presented is a 42 year-old male with a history of congenital hypospadias repaired as a child. He developed a penile urethral stricture at age 30 and was managed with self intermittent dilation. Recently, dilation became more difficult, and he was referred for reconstruction. Work-up revealed a high-grade stricture extending from the meatus to the site of the previous anastomosis at the penoscrotal junction...
October 26, 2017: Urology
https://www.readbyqxmd.com/read/29095746/development-of-the-adult-vulvar-lichen-sclerosus-severity-scale-a-delphi-consensus-exercise-for-item-generation
#20
Michal Sheinis, Amanda Selk
OBJECTIVE: To generate a list of items through international expert consensus consisting of both symptoms and clinical signs for inclusion in an adult vulvar lichen sclerosus severity scale. METHODS: This study was carried out as a three-stage Delphi consensus exercise. After an extensive literature review, any items used to determine disease severity in previous clinical trials were compiled into a survey. The Delphi participants were recruited from the International Society for the Study of Vulvovaginal Disease most of whom were gynecologists and in practice for more than 20 years...
November 1, 2017: Journal of Lower Genital Tract Disease
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