Concomitant Lichen Research Articles

Frontal Fibrosing Alopecia: An Observational Single-Center Study of 306 Cases.

(1) Background: Frontal fibrosing alopecia (FFA) is a scarring alopecia that predominantly affects postmenopausal women; (2) Methods: A retrospective, observational, single-center study was conducted in the Hospital General Universitario in Ciudad Real, Spain, including all patients diagnosed with FFA between 2010 and 2021; (3) Results: A total of 306 patients (296 women and 10 men) were included in our study. The mean age of onset was 59.5 years. The severity of this disease was evenly distributed between mild (147 patients) and severe (149 patients) forms. There was a positive, statistically significant, medium correlation between the severity of the disease and its time of progression. Moreover, hypothyroidism was present in 70 patients (22.9%) and classic signs of concomitant lichen planopilaris were observed in just 30 patients (9.8%), while other forms of lichen planus were uncommon. The estimated prevalence in our population is 0.15% and the incidence is 15.47 new cases per 100,000 inhabitants; (4) Conclusions: The time of progression was positively correlated with the severity of FFA. However, the presence of clinical signs, such as inflammatory trichoscopic signs, was not associated with the progression of this condition.

A Scoping Review and Population Study Regarding Prevalence and Histopathology of Juvenile Vulvar Melanocytic Lesions. A Recommendation

Cases of vulvar melanocytic lesions in juveniles are rarely reported. We analyze the evidence regarding vulvar melanocytic lesions in juveniles with or without vulvar lichen sclerosus to help decision making by clinicians and pathologists. A scoping review on vulvar melanocytic lesions with or without vulvar lichen sclerosus, including malignant vulvar melanomas, in females up to age 18 years was performed. In addition, the histopathology records of the cohort of all such lesions in The Netherlands from 1991 through 2020 were investigated, and a structured analysis of tissue samples of the subset of cases with lichen sclerosus was performed. The literature study performed confirms that vulvar melanomas in juveniles are extremely rare and that published case reports are often disputed. In The Netherlands, there are no cases of malignant vulvar melanomas up to age 18 years recorded from 1991 through 2020. Atypical histopathological features are often found in biopsies of vulvar nevi in juveniles, especially with concomitant lichen sclerosus, confirming earlier case studies in the literature. We conclude that even with atypical findings, vulvar melanocytic lesions in juveniles have a benign course. To avoid unnecessary and possibly mutilating procedures, we advise referral to an expert center and adaption of existing guidelines for vulvar melanocytic lesions in juveniles.

Graham-Little-Piccardi-Lassueur Syndrome—A Rare Case Report with Concomitant Lichen Planus Pigmentosus and Oral Lichen Planus in a Pregnant Female

Graham-Little-Piccardi-Lassueur syndrome is a rare variant of lichen planopilaris. It is characterized by multifocal, patchy, cicatricial alopecia of the scalp, noncicatricial alopecia of axilla and pubic region, and keratotic follicular papules involving the trunk and extremities. Trichoscopy shows perifollicular erythema, tubular perifollicular scales, fibrotic white dots, and hair casts along the hair shafts. We are reporting this rare syndrome in a 26-year-old pregnant woman with concomitant oral lichen planus and lichen planus pigmentosus. This case is unique as no previous report of coexistence of these variants of lichen planus has been published.

Trachyonychia in a child with concomitant alopecia areata and lichen planus

<p>Trachyonychia of nails has been found to be associated with dermatoses such as lichen planus, psoriasis, alopecia areata etc. When involving all the finger and toe nails bilaterally, it is referred to as ‘twenty nail dystrophies. We, hereby, report a case of trachyonychia in an 8-year-old boy, with concomitant lichen planus and alopecia areata. He was successfully treated with biweekly pulse systemic corticosteroid therapy for duration of 6 months. Significant response was noted at the end of 6 months in terms of hair re-growth; improvement of nail texture, thickness and subungual hyperkeratosis; and resolution of skin lesions.</p>

Clinical characteristics, trichoscopy, histopathology and treatment outcomes of frontal fibrosing alopecia in an Asian population: A retro-prospective cohort study.

Frontal fibrosing alopecia (FFA) is a distinctive lymphocytic scarring alopecia with rapid increase in prevalence. Most FFA series are retrospectively reported from Caucasians with only few from Asians. The objective of this study was to characterize the clinical, trichoscopic and histopathological findings as well as treatment outcomes. This was a retro-prospective cohort study of patients diagnosed with FFA from 1January 2010 to 1November 2019. All patients were asked to present for re-examination. Clinical, trichoscopic, histopathological and laboratory data were recorded. A questionnaire was used to investigate hair care, hairstyle and facial skin care compared with age-matched normal controls. Multivariate analysis was performed in order to clarify factors associated with severity. All 58 FFA patients were female, of whom 27.6% were premenopausal, 37.7% had a history of surgical menopause, 13.8% had thyroid diseases, 69% had eyebrow loss and 32.8% facial papules. On physical examination, 10.3% showed linear pattern, 46.6% diffuse pattern and 43.1% pseudo-fringe sign. Concomitant lichen planopilaris was found in 25.9%, lichen planus pigmentosus in 24.1% and female pattern hair loss in 48.3%. The most common trichoscopic characteristics in the frontal hairline were lack of follicular ostia (91.4%), perifollicular scales (79.3%) and perifollicular erythema (63.8%). Up to 90% of patients reported FFA as improved or stable after receiving antiandrogen (finasteride or dutasteride) or antimalarial with topical treatment. Multivariate analyses revealed that facial lentiginous macules and trichoscopic perifollicular erythema at the frontal area were FFA severity-associated factors. "Front puff" Thai hairstyle was associated with FFA, while sunscreens and other cosmetic products were not. In conclusion, diffuse and pseudo-fringe sign pattern are common in Asian FFA. The most common autoimmune systemic comorbidity is thyroid disease, while common concomitant dermatological diseases are female pattern hair loss, lichen planopilaris and lichen planus pigmentosus. Antiandrogens or antimalarial plus topical treatment are the most useful therapy.

SnapshotDx Quiz: December 2018

SnapshotDx Quiz: December 2018

Concomitant lichen sclerosus and interstitial granuloma annulare in a 56-year-old female with suspected autoimmune disease

Concomitant lichen sclerosus and interstitial granuloma annulare in a 56-year-old female with suspected autoimmune disease

Riesenkondylom des Penis mit maligner Transformation bei vorbestehendem Lichen sclerosus et atrophicus

A 72-year old patient presented with a 6 months history of a rapidly growing tumor of the glans and foreskin. He had a long history of phimosis with lichen sclerosus et atrophicus-like lesions on the foreskin which had not been treated. The rest of the personal, family and sexual history was unremarkable. Treatment consists of circumcision and tumor excision. Histopathology confirmed a squamous cell carcinoma within a giant condyloma with a concomitant lichen sclerosus et atrophicus. CT- and ultrasound scans showed no metastases. Giant condylomas are a rare sexually transmitted disease usually caused by human papilloma virus subtypes 6, 11, but also by 16 and 18 among others. They are expansive, cauliflower-like destructive lesions that most frequently affect the anogenital region. In about 30 percent a giant condyloma progresses into a squamous cell carcinoma. Therapy of choice is the histopathologically controlled excision. Recurrences are often seen, so the patients should be monitored frequently after therapy.

Esophageal lichen planus: the Mayo Clinic experience.

Lichen planus (LP) is an inflammatory papulosquamous disease which may affect the squamous epithelium of the esophagus. We reviewed six patients with esophageal lichen planus (ELP) seen at Mayo Clinic Rochester between 1984 and 1998. The presenting symptoms were dysphagia (in all six patients) and odynophagia (two patients). Cervical esophageal strictures were seen in four patients; average number of esophageal dilatations required was 15 (range, 10-18). Esophageal biopsies demonstrated the classical histologic findings of ELP in two patients, and a lymphocytic infiltrate in the other four. Concomitant lichen planus (LP) was seen at other sites in five patients: all five had oral LP preceeded by ELP symptoms in all five; three had genital LP preceeded by ELP symptoms in all three; two had dermal LP, preceeded by ELP symptoms in one. Proton pump inhibitors were tried unsuccessfully in all patients. Four patients were started on systemic steroid medication; three had resolution of symptoms within 1 month.

Verruciform xanthoma and concomitant lichen planus of the oral mucosa.. A report of three cases

Verruciform xanthomas are benign muco-cutaneous lesions of unknown aetiology. They have a papillated surface and histologically they are characterised by the presence of foam cells in connective tissue papillae between elongated parakeratinised epithelial rete ridges. Three cases are reported in which oral mucosal verruciform xanthoma and oral mucosal lichen planus occurred concomitantly.

Verruciform xanthoma and concomitant lichen planus of the oral mucosa: A report of three cases

Verruciform xanthomas are benign muco-cutaneous lesions of unknown aetiology. They have a papillated surface and histologically they are characterised by the presence of foam cells in connective tissue papillae between elongated parakeratinised epithelial rete ridges. Three cases are reported in which oral mucosal verruciform xanthoma and oral mucosal lichen planus occurred concomitantly.

Lichen planus and hepatitis C virus infection: An epidemiologic study

Hepatitis C virus (HCY) accounts for the majority of transfusion-associated cases of hepatitis. Parenteral transmission is well documented, especially in intravenous drug users. A low level of sexual transmission is also probable. The prevalence of HCY antibodies is constant worldwide and ranges from 0.3% to 1.5%.1 Because blood donors are now screened for HCY antibodies, the risk of posttransfusion hepatitis is declining.2 Many cutaneous eruptions associated with hepatitis A and B have been described, such as purpura, dermatomyositis-like syndrome, periarteritis nodosa, and Giannotti-Crosti syndrome. 3, 4 Essential mixed cryoglobulinemiaand porphyria cutanea tarda'' are strongly associated with HCY infection. Isolated cases of erythema multiforme.? erythema nodosum, and urticaria? associated with HCY infection have been reported, but they could be fortuitous because no controlled study has ever shown a significant association of these diseases with HCV infection. The association of chronic hepatitis with lichen planus was established by several studies, especially in Italian patients; LO recently, a few cases of concomitant lichen planus and HeV infection have been described.U'I Lichen planus is considered by certain authors as a possible marker of an HCY infection, but the link between these diseases has not been clearly established. We describe a prospective case-controlled study of the prevalence of HCY antibodies in a group of 52 patients with lichen planus.