Cases Of Lichen Planus Research Articles

Lichen Planus – A clinical and histopathological correlation

Introduction: History and characteristic examination findings are often sufficient to diagnose cutaneous lichen planus. Although lichen planus has distinctive clinical features, the diagnosis may present a problem due to variations in clinical pattern. Skin biopsy may be useful to confirm the diagnosis and is of ten required in a typical presentation. In all cases, it is important to consider the possibility of the eruption being drug induced. Lichen planus is not an infectious disease. Aim: Main aim of this study was to correlate clinical features with histopathologic study in all clinically diagnosed and suspected cases of lichen planus and to know its clinical and histopathological variants and assess the clinical versus the pathological agreement in diagnosis. Materials and methods: A prospective cross-sectional study was conducted with clinico pathological examination of skin biopsy specimens in the Department of Pathology, Vydehi institute of medical sciences and research centre over a period of 2 years between 2010–2012. Statistical analysis: This study demonstrated no significant association between variants of LP and sex of the patient (p> 0.05) with χ2 = 5.92, 0.05< p< 0.10 using the probability level (alpha) and degree of freedom (df=1). Results: 60 cases of lichen planus were studied. 49 cases were confirmed on histological examination.11 cases were diagnosed only on histology. Maximum number of cases occurred in the age group of 18 - 50 years.Males were affected more commonly than females. Conclusion: The possibility of this lesion to turn malignant justifies the importance of long term follow up for patients with such disease. Clinico pathological correlation is the key to confirm the diagnosis for further patient care and treatment.

Immunohistochemical Expression of Foxp3 in Lesions of Oral Lichen Planus: Cutaneous and Inflammatory Fibrous Hyperplasias

Objective: To examine Foxp3 immunoexpression in 25 cases of oral lichen planus (OLP), 14 cases of cutaneous lichen planus (CLP) and 11 cases of inflammatory fibrous hyperplasia (IFH).

Using Stratum Corneum Thickness and Configuration to Distinguish Lichenoid Dermatoses.

Clues in the stratum corneum (SC) can aide in histopathologic diagnosis of many conditions. To determine if SC configuration and thickness could help differentiate the lichenoid dermatoses. A retrospective study was performed. A total of 305 cases (55 lichenoid keratosis, 51 lichen planus, 7 hypertrophic lichen planus, 40 lichenoid drug eruption, 19 lichenoid graft-vs.-host disease, 14 hypertrophic lupus, 46 lichenoid actinic keratosis, 73 lentigo maligna) fulfilled the selection criteria. Cases were digitally scanned using the 40× (0.23 μm/pixel) mode of a Hamamatsu NanoZoomer 2.0-HT Slide Scanner (Hamamatsu Photonics, Hamamatsu City, Japan), allowing for the creation of virtual (digital) slides. SC thicknesses and configuration were assessed for each case. Mixed SC patterns were common in cases of lichenoid keratoses. Compact parakeratosis was the most common pattern in lichenoid drug eruption. Tiered parakeratosis was the most predominant pattern in cases of lichenoid graft versus host disease and lichenoid actinic keratosis. Hypertrophic lupus had the highest average SC thickness. The sample size for cases of hypertrophic lupus and hypertrophic lichen planus was low. SC thickness and configuration can be utilized to help differentiate the lichenoid dermatoses.

Lichenoid dermatoses in hospitals in Lomé, Togo: 959 cases.

The aim of this study was to describe the epidemiologic, clinical, and therapeutic profiles of cases of lichenoid dermatosis in Lomé, together with their outcomes. This retrospective descriptive study reviewed records of patients receiving care for lichenoid dermatosis from January 1997 to December 2016 in the dermatology departments of Lomé. In total, 959 (2.2%) cases of lichenoid dermatoses including 813 (84.8%) of lichen planus and 123 (12.8%) of lichen striatus were recorded. The mean age of the patients was 29.60 +/- 14 years and the sex ratio (M/F) was 0.7. Lichen planus was papular and found most often on the lower limbs (56.0%). Lichen striatus was banded along the lines of Blaschko, mainly on the lower limbs (55.3%). There were 23 patients with lichen nitidus lesions, most often on the trunk (47.8%). The treatment was based on corticosteroid therapy. Recurrences were noted in 40 (11.6%) cases of lichen planus and 4 (3.2%) of lichen striatus. This study shows that the principal lichenoid dermatoses in Lomé are lichen planus, and their management is based on corticosteroid treatment.

To assess serum uric acid level in patients with lichen planus: A clinical study serum uric acid &amp; lichen planus

Background: Lichen planus is a Subacute to chronic, inflammatory, papulosquamous disorder characterized by typical lesions. The present study was conducted to assess serum uric acid level in patients with lichen planus. Materials & Methods: The present study was conducted on 46 cases (Group I) of lichen planus of both genders reported to the department. Equal number of controls (Group II) was also included. Detailed clinical history followed by general physical examination, systemic examination and mucocutaneous examination was done in all. Serum Uric acid was assayed using Cora lab 3000 semiautoanalyser by uricase method. Results: Out of 46 patients, males were 11 and females were 35. The mean serum uric acid level in group I was 3.51 mg% and in group II was 3.98 mg%. The difference was significant (P< 0.05). Common type of lichen planus was classical seen in 13, eruptive in 10, linear in 8, hypertrophic in 4, actinic in 6, annular in 3 and follicular in 2. The difference was significant (P

Squamous Cell Carcinomas in Two Cases of Nail Lichen Planus: Is There a Real Association?

Lichen planus (LP) is a chronic inflammatory disease that affects the skin and oral mucosa. Although its etiology is unknown, its potential for cancerization has been confirmed. We herein report the cases of a brother and sister, both with a 15-year history of nail lichen planus of the fingers and toes, who developed squamous cell carcinomas of the nail bed and matrix. This article shows the potential for malignant transformation in lichen planus disease and highlights the importance of periodic clinical follow-up.

Prevalence and characteristics of various types of lichen planus in the Moscow Region

Rationale: Lichen planus (LP) is an important problem for the healthcare due to its increasing prevalence, as well as typical, atypical and prone to malignization types of the disease that can be both severe and poorly responding to treatment. Accurate data on the prevalence of LP are lacking. Aim: To assess the prevalence of various LP types in the patient population of the Moscow Region. Materials and methods: We analyzed the results of examination of 338 patients with LP, who were getting standard treatment in the Department of Dermatovenereology and Dermato-oncology of the Moscow Regional Research and Clinical Institute (MONIKI) in 1999 to 2017. Results: Among 338 LP patients, atypical LP of the skin was diagnosed in 81 (23.96%): hypertrophic type, in 31 (38.27%), pigmented, in 23 (28.4%), atrophic, in 11 (13.58%), follicular, in 8 (9.88%), lichen obtusus, in 3 (3.7%), bullous, in 1 (1.23%), erythematous, in 1 (1.23%), vulvovaginal-gingival syndrome, in 2 (2.47%), and Grinspan's syndrome, in 1 (1.23%). In 35 (43.21%) of patients, cutaneous LP was associated with atypical oral LP (OLP): in 17 (48.57%) of cases with hyperkeratotic, in 11 (31.43%), with erosive, and in 7 (20%), with exudative-hyperemic type. In 19 (23.46%) cases, atypical cutaneous LP was associated with LP of the genital mucosae, including in 12 (63.16%) cases with a typical reticular type, in 6 (31.58%), with atypical erosive, and in 1 (5.26%), with hypertrophic type. In 16 (4.73%) of the patients there was atypical OLP only; in 6 (37.5%) of them it had the exudative-hyperemic type, in 5 (31.25%), erosive, and in 5 (31.25%), hyperkeratotic. The most severe course of the dermatosis was observed for follicular, atrophic, hypertrophic types of cutaneous LP, vulvovaginal-gingival syndrome, and erosive OLP. Conclusion: Atypical LP was diagnosed in 81 (23.96%) cases, and in 45 (55.6%) cases it was associated with the OLP. The latter in 35 (43.21%) of cases was characterized by atypical lesions of OLP, including 11 (31.43%) cases of obligate precancerous erosive LP, which necessitates that this patient category should be managed with high cancer vigilance.

Drug Delivery Tailored for the Need– Case Series of Oral Lichen Planus

: Lichen planus is an inflammatory mucocutaneous disorder. The pathogenesis of lichen planus is predominantly T cell mediated. The condition is associated with it are hepatitis C, graft versus host disease, medications , dental materials etc. Immune modulators have been widely used in the management of lichen planus. Corticosteroids are the most widely used among them. There is various mode of delivering corticosteroids in oral lichen planus. The systemic administration is reported to cause more adverse drug reaction when compared to local drug delivery systems. The case series describes three cases of lichen planus at different sites. It also high lights the site-specific treatment applied in them.Key words: Lichen planus, Local drug delivery, Corticosteroids, Systemic steroids.

Possible role of plasmacytoid dendritic cells in pityriasis lichenoides.

Plasmacytoid dendritic cells (pDCs) and their product, type I interferons (IFNs), have been implicated in the pathogenesis of several skin disorders characterized by an interface dermatitis (ID) pattern, such as lichen planus (LP). A type I IFN signature has previously been documented in pityriasis lichenoides (PL). Although pDCs are known to be the main source and most potent producers of local type I IFNs, their role in PL has not been investigated. To investigate the role of pDCs in PL. In total, 20 cases of PL and 20 comparable cases of LP were immunohistochemically tested for pDC occurrence and type I IFN production using anti-blood-derived dendritic cell antigen-2 (BDCA2; a specific pDC marker) and anti-myxovirus protein A (anti-MxA) antibodies (indirect marker of pDC activity), respectively. MxA is a well-established surrogate marker for local type 1 IFN production. A semiquantitative scoring system was used. pDCs were present in all 40 cases with no statistically significant difference between the two groups. MxA expression was intense and diffuse in the majority of PL and LP cases. pDCs constitute a central component of the inflammatory infiltrate in PL, suggesting that PL shares with the other entities that exhibit an ID a common pDC-driven process through type I IFN production, which ultimately leads to the cytotoxic attack.

Nonvenereal Penile Dermatoses: A Retrospective Study.

Context:A variety of nonvenereal diseases can affect the penis and diminish quality of life. Many present similar clinical features and a cutaneous biopsy may be necessary to clarify the diagnosis.Aims:To characterize nonvenereal penile dermatoses with histological confirmation in a southwestern Europe hospital during a 9-year period.Materials and Methods:A retrospective study was conducted. We reviewed all penile biopsies performed between January 1, 2007 and December 31, 2015 and studied the causes of the nonvenereal penile dermatoses.Results:The sample included a total of 108 patients, aged 62.9 (±17.8) years, between 16 years and 96 years of age. Eighteen dermatoses were identified. Inflammatory diseases were present in 65. 7% of patients (71/108) and neoplastic dermatoses in 34. 3% (37/108). Concerning inflammatory dermatoses, the most frequent were Zoon balanitis (27.8%, 30/108), followed by lichen sclerosus (15.7%, 17/108), psoriasis (11.1%, 12/108), and lichen planus (4.6%, 5/108). In patients with psoriasis, 10 had lesions only in the penis, similarly to all patients with lichen planus. The most frequent malignant tumor was squamous cell carcinoma (SCC) (15.7%, 17/108). The most common in-situ tumor was erythroplasia of Queyrat (8.3%, 9/108). A case of basal cell carcinoma (BCC) was found. Kaposi sarcoma and mycosis fungoides on penis were also diagnosed, as an additional form of presentation to their generalized disease.Conclusions:In this study, inflammatory diseases were the most frequently diagnosed dermatoses, while SCC was the most common malignant tumor found. In the majority of psoriasis and lichen planus cases, clinical lesions were only present in the genital area.

Role of Mast Cells in Oral Lichen Planus and Oral Lichenoid Reactions.

Introduction Oral lichen planus (OLP) is a chronic T cell mediated disease of oral mucosa, skin, and its appendages with a prevalence of 0.5 to 2.6% worldwide. Oral lichenoid reactions (OLR) are a group of lesions with diverse aetiologies but have clinical and histological features similar to OLP, thereby posing a great challenge in differentiating both lesions. Mast cells are multifunctional immune cells that play a major role in the pathogenesis of lichen planus by release of certain chemical mediators. Increased mast cell densities with significant percentage of degranulation have been observed as a consistent finding in pathogenesis of oral lichen planus. Aim The current study was aimed at quantifying the mast cells in histopathological sections of OLP and OLR thereby aiding a means of distinguishing these lesions. Materials and Methods The study group involved 21 cases of oral lichen planus, 21 cases of oral lichenoid reactions, and 10 control specimens of normal buccal mucosa. All the cases were stained with Toluidine Blue and routine haematoxylin and eosin and the mast cells were quantified. Statistical Analysis Used The results were analyzed using the Kruskal–Wallis test and an intergroup analysis was performed using Mann–Whitney U test. Conclusion The number of mast cells showed an increased value in oral lichen planus when compared to oral lichenoid reaction and thus an estimation of mast cells count could aid in distinguishing OLP from OLR histopathologically.

Phenotypic alteration of basal cells in oral lichen planus; switching keratin 19 and desmoglein 1 expression.

In oral lichen planus, extracellular matrix and basal cells are damaged by T-lymphocytes. As a consequence, changes in expression of collagen fibers within the connective tissue and cytoskeletons of the epithelial tissue can be observed. With the goal of examining the characteristic changes undergone by basal cells as a consequence of T-lymphocytes damage in oral lichen planus, we investigated protein expression in the epithelial-connective junction. We selected 20 cases of oral lichen planus and 5 control samples of buccal mucosa. Subsequently, we divided the oral lichen planus cases into thin and thick parts based on the mean values of epithelial thickness from the control samples, and counted the positive rate of collagen IV, keratin 19, desmoglein 1, and Ki-67. Collagen IV immune-reactivity partially disappeared or thickened in oral lichen planus. The keratin 19 positive rate in oral lichen planus cases was significantly lower than in the controls. Desmoglein 1 positive rate of the thick part was significantly higher compared to the thin part of oral lichen planus. Thus, modifications in basal cells with both reduced keratin 19 expression and alterations of desmoglein 1 expression suggest that in oral lichen planus, as a consequence of cell injury or regeneration in the interface area, there is a disappearance of the "true basal cell nature".

Nail Changes in Chilblains Mimicking Lichen Planus

Nail Changes in Chilblains Mimicking Lichen Planus

Ulcerative lichen planus of lower lip – Case series

Lichen planus (LP) involving lips is a rare occurrence. It can occur isolated or with cutaneous or oral lesions. Clinical features include radiated streaks, lace-like papules, and erosions, usually confined to vermilion border. When isolated, it should be differentiated from cheilitis, discoid lupus erythematosus, and other ulcerative conditions. Herein, we report nine cases of LP involving lower lip, with persistent ulceration and crusting. Of the nine patients in our series, eight were females and one was male. Age varied from 25 to 44 years, and the average duration was 4 years. Cutaneous examination revealed diffuse involvement of the lower lip with ulceration, hemorrhagic crusting in eight and localized involvement in one. Biopsy was suggestive of LP with no dysplasia or malignancy. Treatment with topical corticosteroids, tacrolimus, sunscreens, and Hydroxy chloroquine has shown variable results with frequent relapses. Because lesions on the lips are highly susceptible to actinic changes and malignant transformation, these patients require regular and long-term follow-up.

Quantitative Expression of Cell-Free Salivary Transcriptomes (IL8, IL1β, And H3F3A) in Oral Squamous Cell Carcinoma and Oral Erosive Lichen Planus

Objective: Diagnosis of oral SCC at its earliest stage is crucial for increasing survival rate. Salivary transcriptome meets demands for noninvasive, accessible, and highly efficient diagnostic medium. This study designed to investigate whether quantification of cell-free salivary mRNA of certain genes (IL8, IL1β, H3F3A) is an informative diagnostic tool for early detection of oral SCC and malignant transformation in erosive oral lichen planus.&#x0D; Methods: The mRNA of salivary transcriptomes of IL8, IL1B, and H3F3A genes were examined in 18 individuals (six oral SCC, six oral lichen planus, and six healthy people). Up to 5 ml of unstimulated saliva was collected from each person. The total RNA was extracted from the cell-free saliva samples and converted to cDNA. The mRNA expression level of the indicated genes was quantified by a qRT-PCR technique using specific primers and SyberGreen reagent. The data obtained from the qRT-PCR reaction was analyzed using the comparative CT (2-ΔΔCT) method. Independent t-test was performed to find the relation between variables. P-value &lt; 0.05 was considered significant.&#x0D; Results: The results show that the mRNA expression of all the three indicated genes (IL8, IL1B, and H3F3A) was up-regulated in all OSCC and erosive oral lichen planus cases in comparison to normal cases. &#x0D; Conclusions: This work demonstrates a significant correlation between cell-free salivary mRNA of certain genes and cases of OSCC and oral lichen planus. These findings suggest that detection of salivary mRNA of certain related genes hold promises as future biomarkers for accurate and early diagnosis of oral malignancies.

Zero prevalence of hepatitis B and hepatitis C infections in clinicopathologically proven lichen planus cases: a cross sectional study at a tertiary care centre in south India

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Lichen planus (LP) is a common chronic mucocutaneous inflammatory disorder of unknown etiology. Several editorials, chapters, studies have suggested an association between hepatitis C virus and hepatitis B virus (to a lesser extent) in LP. This association was not seen in various parts of the world including India.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Patients attending the dermatology outpatient department with lichen planus confirmed by histopathologic examination were included in the study and along with clinic-epidemiological data, all the patients were tested for hepatitis B and hepatitis C infection.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 84 patients of clinico-pathologically proven lichen planus were included in the study out of which 31 were males and 53 were females. The most common age group of lichen planus in our study group was 40-50 years. Major histopathological findings were basal cell degeneration (92.7%), hyperkeratosis (89%), pigment incontinence (73%) and lymphohistiocytic infiltration (70%). All patients in this study group tested negative for HBsAg and anti-HCV antibodies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Although numerous studies around the world have suggested an association between HCV and HBV infections with lichen planus- multiple subsequent studies including the present study shows contrasting results especially in this part of the world. The authors believe routine screening of lichen planus patients for presence of hepatitis B and hepatitis C infection is not warranted, particularly in Indian population. &lt;/p&gt;

Autoantibodies to desmogleins 1 and 3 in patients with lichen planus

There is controversy about the role of autoantibodies against desmoglein 1 and 3 (Dsg1 and 3) in the pathogenesis of lichen planus (LP); the authors planned this study to determine the presence of circulating levels of these antibodies in patients with different types of oral LP and to compare that with cutaneous LP and healthy controls. The enzyme-linked immunosorbent assay test was performed on serum samples of 24 cases of erosive oral LP, 29 cases of reticular oral LP, 30 cases of cutaneous LP and 30 healthy controls. The severity of oral LP was evaluated by Reticulation, Erosion and Ulceration scoring system. There were no significant differences in the concentrations of autoantibodies to Dsg1 between the four groups. Autoantibodies to Dsg3 were increased in erosive oral LP compared with healthy controls (p value=0.005) but no increase was observed between other groups. We did not detect a correlation between the severity of the disease and the levels of anti-Dsg1 and 3 in patients with erosive and reticular types of oral LP. In conclusion, regardless of the increased level of anti-Dsg3 antibody in erosive oral LP, serum concentrations of antibodies were under cut-off values. Moreover, the pathogenic role of anti-Dsg3 antibodies in erosive oral LP is uncertain.

Reflectometric Analysis for Identification of Various Pathological Conditions Associated with Lichen Planus

Reflectometric technique for analyzing urine strips represents a simple, fast and inexpensive method, with no risk and discomfort for the patient. In the present paper, the authors conducted a retrospective study on the possible association between lichen planus (LP) and a number of pathological conditions that produce changes of urine metabolites. A retrospective study was made on 77 patients with LP (49 cases of cutaneous LP - CLP, 28 cases of oral LP - OLP) who were diagnosed and treated in the dermatology department of Victor Babes Hospital for Infectious and Tropical Diseases. The quantification of certain urine metabolites in the spontaneous urine through reflectometric technique may reveal liver diseases (urobilinogen, bilirubin), kidney diseases (erythrocytes, proteins, albumin, creatinine, albumin/creatinine ratio, urine specific gravity, pH), metabolic disorders (glucose, ketones, pH, ascorbic acid) and urinary diseases (leucocyturia, nitrites, proteins, erythrocytes). The evaluation of the patients included clinical examination and laboratory and imaging tests. Among the investigated patients with LP we found: 16 cases of hepatic dysfunction (20.8%), 7 cases of renal dysfunction (9.1%), 11 cases of metabolic disorders (14.3%) and 14 cases of urinary tract infections (18.2%). No differences were found between patients with cutaneous and oral LP. The linear regression analysis revealed: positive association between concentrations of urobilinogen and bilirubin (r = 0.174, p = 0.044), negative association between albumin and creatinine (r = -0.316, p = 0.007), positive association between glucose and ketones (r = 0.266, p = 0.098) and positive association between leucocyturia and urine nitrite levels (r = 0.202, p = 0.050). Based on clinical and laboratory data, 85.7% of results obtained from urine biochemistry were confirmed. This analysis did not find any difference between patients with cutaneous and oral LP. By determining a full panel of urine metabolites through reflectometric analysis we were able to identify the main pathological changes in patients with LP.

口腔扁平苔癬130例の臨床的検討

口腔扁平苔癬130例の臨床的検討

Clinicopathological Profile and Malignant Transformation in Oral Lichen Planus: A Retrospective Study.

Objectives:The aim of this study was to analyze the histopathologically diagnosed cases of oral lichen planus (OLP) in terms of age, gender, clinical variant, site, hyperpigmentation, systemic illness, grade of dysplasia, and associated malignant transformation. This study also intended to do a review of reported cases of OLP with malignant transformation.Materials and Methods:One hundred and forty-three cases of histopathologically diagnosed OLP between 2010 and 2016 were retrospectively reviewed. Demographic and clinicopathological data including malignant transformation were obtained. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) software for Windows version 20.0 (IBM SPSS, SPSS Inc., Chicago, IL, USA). A review of published literature on OLP with malignant transformation was also done from 1988 to 2017 and tabulated.Results:OLP in this study showed a male predilection with most of the patients in the third decade. The buccal mucosa (bilateral presentation) was the most common site (79.72%), and reticular type was the most common clinical type (79.02%) followed by erosive type (20.98%). The majority (92.31%) of cases were diagnosed with OLP without dysplasia. The rest (7.69%) of dysplastic cases were predominantly seen in the buccal mucosa of 58 years and above, female patients manifesting mainly as erosive type. Two patients (1.4%) previously diagnosed clinically and histopathologically as OLP developed oral squamous cell carcinoma.Conclusion:The present investigation revealed the predominance of OLP among middle-aged male population and the prevalence of bilateral involvement of buccal mucosa. Two of our cases showed malignant transformation over an average period of 3.5 years. The outcome of this study emphasizes the role of clinical follow-up of patients with OLP.