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Cutaneous lichen planus

Ana Karina Alves de Medeiros, Reinhart Speeckaert, Eline Desmet, Mireille Van Gele, Sofie De Schepper, Jo Lambert
The recent interest and elucidation of the JAK/STAT signaling pathway created new targets for the treatment of inflammatory skin diseases (ISDs). JAK inhibitors in oral and topical formulations have shown beneficial results in psoriasis and alopecia areata. Patients suffering from other ISDs might also benefit from JAK inhibition. Given the development of specific JAK inhibitors, the expression patterns of JAKs in different ISDs needs to be clarified. We aimed to analyze the expression of JAK/STAT family members in a set of prevalent ISDs: psoriasis, lichen planus (LP), cutaneous lupus erythematosus (CLE), atopic dermatitis (AD), pyoderma gangrenosum (PG) and alopecia areata (AA) versus healthy controls for (p)JAK1, (p)JAK2, (p)JAK3, (p)TYK2, pSTAT1, pSTAT2 and pSTAT3...
2016: PloS One
B Weber, C Schlapbach, M Stuck, H-U Simon, L Borradori, H Beltraminelli, D Simon
BACKGROUND: Cutaneous (CLP) and oral lichen planus (OLP) as the main subtypes of lichen planus (LP) present with different clinical manifestation and disease course, although their histopathologic features such as the band-like lymphocyte infiltrate and keratinocyte apoptosis are similar. So far, the underlying cellular and molecular mechanisms remain poorly understood. OBJECTIVE: The aim of this study was to characterize and compare the in situ cellular infiltrates, cytokine expression profiles and apoptosis markers in CLP and OLP...
October 1, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Enzo Errichetti, Giuseppe Stinco
Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides and subacute cutaneous lupus erythematosus), papulosquamous/papulokeratotic dermatoses (lichen planus, pityriasis rosea, papulosquamous sarcoidosis, guttate psoriasis, pityriasis lichenoides chronica, classical pityriasis rubra pilaris, porokeratosis, lymphomatoid papulosis, papulosquamous chronic GVHD, parakeratosis variegata, Grover disease, Darier disease and BRAF-inhibitor-induced acantholytic dyskeratosis), facial inflammatory skin diseases (rosacea, seborrheic dermatitis, discoid lupus erythematosus, sarcoidosis, cutaneous leishmaniasis, lupus vulgaris, granuloma faciale and demodicidosis), acquired keratodermas (chronic hand eczema, palmar psoriasis, keratoderma due to mycosis fungoides, keratoderma resulting from pityriasis rubra pilaris, tinea manuum, palmar lichen planus and aquagenic palmar keratoderma), sclero-atrophic dermatoses (necrobiosis lipoidica, morphea and cutaneous lichen sclerosus), hypopigmented macular diseases (extragenital guttate lichen sclerosus, achromic pityriasis versicolor, guttate vitiligo, idiopathic guttate hypomelanosis, progressive macular hypomelanosis and postinflammatory hypopigmentations), hyperpigmented maculopapular diseases (pityriasis versicolor, lichen planus pigmentosus, Gougerot-Carteaud syndrome, Dowling-Degos disease, erythema ab igne, macular amyloidosis, lichen amyloidosus, friction melanosis, terra firma-forme dermatosis, urticaria pigmentosa and telangiectasia macularis eruptiva perstans), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), erythrodermas (due to psoriasis, atopic dermatitis, mycosis fungoides, pityriasis rubra pilaris and scabies), noninfectious balanitis (Zoon's plasma cell balanitis, psoriatic balanitis, seborrheic dermatitis and non-specific balanitis) and erythroplasia of Queyrat, inflammatory cicatricial alopecias (scalp discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia and folliculitis decalvans), nonscarring alopecias (alopecia areata, trichotillomania, androgenetic alopecia and telogen effluvium) and scaling disorders of the scalp (tinea capitis, scalp psoriasis, seborrheic dermatitis and pityriasis amiantacea)...
September 9, 2016: Dermatology and Therapy
Tabi Anika Leslie
Itch is a common symptom in the elderly population over 65 years old, and is often a chronic condition lasting more than 6 weeks. As in all age groups, but especially in the elderly, there can be a significant effect on the general health status and quality of life, with impaired daily activities and lack of sleep, which can also lead in some cases to depression or anxiety. The cause of chronic itch in the elderly is often multifactorial due to physiological changes in the aging skin, including impaired skin barrier function, and also due to decline in immunological (immunosenescence), neurological, and psychological changes associated with age...
2016: Current Problems in Dermatology
Eric T Stoopler, Sausan Alfaris, Dalal Alomar, Faizan Alawi
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...
September 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
J Walker, R Baran, N Vélez, N Jellinek
Koilonychia, a concave nail dystrophy, has multiple aetiologies and may be hereditary, acquired or idiopathic. Within dermatology, koilonychia is often a manifestation of an inflammatory dermatosis such as psoriasis or lichen planus, or a sign of onychomycosis. Other disease associations include iron store abnormalities, Plummer-Vinson Syndrome, nutritional deficiencies and occupational or traumatic aetiologies. In young children, koilonychia of the toenails is commonly transient and idiopathic, although familial and syndromic cases are reported...
August 17, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Yumiko Nagao, Kanae Kimura, Yuji Kawahigashi, Michio Sata
OBJECTIVES: Oral lichen planus (OLP) is one of the extrahepatic manifestations of hepatitis C virus (HCV) infection. Presently developed interferon (IFN)-free direct-acting antivirals (DAAs) used to treat HCV infection have low side effect profiles and high efficacy. However, there are no studies examining the relationship between OLP and IFN-free DAAs. The aim of this study was to evaluate the disease course in patients with HCV-associated OLP, who received treatment with IFN-free DAAs...
2016: Clinical and Translational Gastroenterology
Flora Poon, Ryan De Cruz, Anthony Hall
Lichen planus (LP) is an incompletely understood T-cell mediated auto-immune dermatosis. When LP involves the genitalia it may present as painful, pruritic erosions that can be exquisitely tender, causing distress and genitourinary and sexual dysfunction. Management of erosive genital LP is often suboptimal. Despite higher order evidence demonstrating the efficacy of oral acitretin in the management of cutaneous and oral LP, it still features below other immunosuppressive and immunomodulatory therapies in many clinicians' therapeutic ladder...
June 30, 2016: Australasian Journal of Dermatology
Keshavmurthy A Adya, Arun C Inamadar, Aparna Palit
Anticoagulants are the cornerstone of treatment of venous thromboembolism associated with various medical conditions and surgical procedures. They act on different steps of the coagulation pathway and are broadly categorized into heparins, vitamin K antagonists, and inhibitors of thrombin and factor Xa. The classification is evolving as newer and better oral and parenteral anticoagulants are being added. Anticoagulants in dermatology are important not only for their therapeutic application in cutaneous thrombotic dermatoses such as livedoid vasculitis, purpura fulminans, superficial and deep venous thrombosis and others but also for their use in non-thrombotic dermatoses such as lichen planus, recurrent oral aphthosis, chronic urticaria and several others...
June 16, 2016: Indian Journal of Dermatology, Venereology and Leprology
E Wong, A Kurian
Topical calcineurin inhibitors (TCIs) have been proposed as an alternative, long-term treatment option to topical corticosteroids, without the side effects commonly associated with steroid use. Currently, TCIs are only approved for treatment of atopic dermatitis in patients 2 years of age or older. This article reviews the off-label uses of TCIs and their efficacy in the treatment of cutaneous diseases. Studies show that TCIs may be effective in treating/managing a variety of skin conditions. The strongest evidence based support on clinical outcomes has been reported for allergic contact dermatitis, lichen planus, psoriasis, seborrheic dermatitis and vitiligo...
January 2016: Skin Therapy Letter
A Neil Crowson, Jad Saab, Cynthia M Magro
BACKGROUND: The cutaneous manifestations of herpes infection are primarily in the context of active infection and of the post-herpetic zosteriform eruption. The former manifests cytopathic alterations diagnostic of herpes. The latter includes lichen planus-like and granuloma annulare-like eruptions and lymphocytoma cutis. METHODS: We encountered skin biopsies from 28 patients whose acute or chronic herpetic or post-herpetic zosteriform lesions manifested folliculocentricity...
May 3, 2016: American Journal of Dermatopathology
Ana Maria Abreu Velez, Yulieth Alexandra Upegui Zapata, Michael S Howard
BACKGROUND: In many countries and laboratories, techniques such as direct immunofluorescence (DIF) are not available for the diagnosis of skin diseases. Thus, these laboratories are limited in the full diagnoses of autoimmune skin diseases, vasculitis, and rheumatologic diseases. In our experience with these diseases and the patient's skin biopsies, we have noted a positive correlation between periodic acid-Schiff (PAS) staining and immunofluorescence patterns; however, these were just empiric observations...
March 2016: North American Journal of Medical Sciences
Tania Day, Ailsa Borbolla Foster, Samuel Phillips, Ross Pagano, Delwyn Dyall-Smith, James Scurry, Suzanne M Garland
OBJECTIVES: This study aimed to determine if vulvar cutaneous candidosis and dermatophytosis can be distinguished by routine histopathology. MATERIALS AND METHODS: Twenty-four cases of periodic acid-Schiff-stained vulvar biopsies with a diagnosis of cutaneous mycosis were reviewed and histopathological characteristics on both periodic acid-Schiff and hematoxylin and eosin were recorded. Data were collected on age, clinical impression, microbiological results, and treatment, and all specimens underwent multiplex polymerase chain reaction analysis...
July 2016: Journal of Lower Genital Tract Disease
Lars Hofmann, Andrea Forschner, Carmen Loquai, Simone M Goldinger, Lisa Zimmer, Selma Ugurel, Maria I Schmidgen, Ralf Gutzmer, Jochen S Utikal, Daniela Göppner, Jessica C Hassel, Friedegund Meier, Julia K Tietze, Ioannis Thomas, Carsten Weishaupt, Martin Leverkus, Renate Wahl, Ursula Dietrich, Claus Garbe, Michael C Kirchberger, Thomas Eigentler, Carola Berking, Anja Gesierich, Angela M Krackhardt, Dirk Schadendorf, Gerold Schuler, Reinhard Dummer, Lucie M Heinzerling
BACKGROUND: Anti-programmed cell death receptor-1 (PD-1) antibodies represent an effective treatment option for metastatic melanoma as well as for other cancer entities. They act via blockade of the PD-1 receptor, an inhibitor of the T-cell effector mechanisms that limit immune responses against tumours. As reported for ipilimumab, the anti-PD-1 antibodies pembrolizumab and nivolumab can induce immune-related adverse events (irAEs). These side-effects affect skin, gastrointestinal tract, liver, endocrine system and other organ systems...
June 2016: European Journal of Cancer
Sendhil Kumaran Muthu, Tarun Narang, Uma N Saikia, Amrinder Jit Kanwar, Davinder Parsad, Sunil Dogra
BACKGROUND: Lichen planus pigmentosus (LPP) is a cosmetically distressing pigmentary disorder often posing a therapeutic challenge. Isotretinoin has been shown to be effective in oral and cutaneous LP, but its role in LPP is yet unknown. OBJECTIVE: To evaluate the efficacy and safety of isotretinoin in the management of LPP. METHODS: In this prospective study, 32 clinically and histologically proven patients with LPP were recruited. Subjects were treated with fixed low-dose (20 mg/day) oral isotretinoin once daily for 6 months along with topical sunscreens...
September 2016: International Journal of Dermatology
Paolo Nuzzolo, Antonio Celentano, Paolo Bucci, Daniela Adamo, Elvira Ruoppo, Stefania Leuci, Michele Davide Mignogna
BACKGROUND: Lichen planus of the lips (LPL) is not frequently described in the literature. The objective of this study is to investigate the clinical outline, behavior, and prognosis of LPL. METHODS: Clinical data of patients with true oral lichen planus (LP) involving the lips, diagnosed and treated at our Oral Medicine Unit (University Federico II of Naples, Italy), have been collected and analyzed. Concurrently, a PubMed search was carried out from 1950 to March 2014 to assess epidemiological and clinical data about LPL...
September 2016: International Journal of Dermatology
Yue Zheng, Jie Zhang, Haiyan Chen, Wei Lai, Howard I Maibach
Drug-induced lichen planus has been induced by antibiotics, anticonvulsants, antidiabetics, antimalarials, antitubercular drugs, antihypertensives, psychiatric drugs, chemotherapeutic agents, diuretic, heavy metals, NSAIDs, etc. Terbinafine, an antifungal agent, is widely used for dermatophyte infections and onychomycosis. Cutaneous adverse effects of terbinafine are rarely reported. Here, we report a case of terbinafine-induced lichenoid drug eruption in a 22-year-old who presented with generalized lichenoid eruption 2 weeks after terbinafine initiation of...
March 30, 2016: Cutaneous and Ocular Toxicology
Dana Badr, Rami Abadi, Mazen Kurban, Ossama Abbas
BACKGROUND/OBJECTIVES: In addition to several infectious and neoplastic cutaneous entities, plasmacytoid dendritic cells (pDCs) have been shown to be involved in the pathogenesis of multiple cutaneous inflammatory and autoimmune disorders, including those characterized histologically by an "interface dermatitis" pattern such as lupus or lichen planus (LP), but their role in lichen striatus (LS), which is also known to have this histologic inflammatory pattern, has never been studied. The objective of the study was to investigate the role of pDCs in LS...
May 2016: Pediatric Dermatology
Billy Sin, Morgan Miller, Edward Chew
Lichen planus (LP) is a mucocutaneous inflammatory disease that involves papulosquamous eruption of the skin, scalp, nails, and mucous membranes. This uncommon condition has a higher prevalence in African Americans and females. Women accounts for 50% of cutaneous LP (CLP) and 60% to 75% of oral LP (OLP) cases. Diagnosis is centered around clinical presentation. Patient evaluation requires a comprehensive physical examination to identify any potential sites of involvement. LP is usually described by the "Six P's": planar, purple, polygonal, pruritic, papules, and plaques...
February 9, 2016: Journal of Pharmacy Practice
Prativa S A Jayasekera, Maeve L Walsh, Daniel Hurrell, Richard A G Parslew
A 12-year-old girl with extended oligoarthritis treated with adalimumab presented with a short history of a progressive cutaneous eruption involving the legs and scalp. Physical examination and histologic results were consistent with lichen planopilaris. The adalimumab was discontinued. She received treatment with topical clobetasol propionate and the majority of the lesions resolved. Residual lesions and the extended oligoarthritis were then treated with sulfasalazine. Adalimumab is a tumor necrosis factor α (TNF-α) inhibitor used for the treatment of a variety of immunologically mediated conditions, including lichen planus and lichen planopilaris...
March 2016: Pediatric Dermatology
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