Plaque-like Forms Research Articles

Evaluation of the classification and clinical characteristics of oral lichen planus and its treatment effect in different clinical types: A retrospective study

PurposeOral lichen planus (OLP) is an intractable chronic inflammatory disease associated with dyskeratosis. This study aimed to investigate the clinical features of OLP at the initial diagnosis and classified it using the clinical visual examination type classification. Furthermore, we evaluated whether the clinical characteristics and effectiveness of symptomatic treatment differ between the typical reticular type and other types of OLP. MethodsWe evaluated the age, sex, chief complaints, clinical morphological forms, lesion sites, cytological and histopathological findings, therapeutic strategies, and therapeutic responsiveness of 132 patients with OLP. ResultsOf 132 patients, there were 42 men and 90 women (mean age, 66.4 ± 13.0 years). The buccal mucosa was the most affected site (n = 95). The reticular form was the most common clinical morphological form (n = 124). Biopsy was performed in 48 patients. The erosive form was the most common among the biopsied lesions. Regarding therapeutic strategies, topical steroids were prescribed to 85 patients, 47 of whom experienced symptomatic relief and 38 showed no changes in symptoms. The rates of symptomatic relief following topical steroid use were 70.4% and 15.9% for the reticular and erosive forms, respectively. In patients with erosive and plaque-like forms, symptomatic relief with topical steroid use was difficult to achieve, whereas in those with other forms, a moderate response was observed. ConclusionTopical steroids are often ineffective in patients with erosive or mixed forms, and these clinical morphological forms are associated with a higher risk of malignant transformation than the other forms. Therefore, early histological examination is important.

Treatment of Plaque-Like Oral Lichen Planus with CO2 Laser.

Background:Oral lichen planus (OLP) is a chronic autoimmune disease, which annoys the patients for several years. It presents with various clinical forms. Although plaque-like form of OLP is usually asymptomatic, it could transform to a malignant lesion. Therefore, treatment considerations are essential to reduce the development of oral cancer. Laser therapy is a newer modality for treatment of plaque-like lesions.Aims:This study aimed to perform laser therapy for plaque-like lesions of OLP.Methods:We described some plaque-like OLP lesions evaporated with CO2 laser. The power of 4–7 watt as continuous wave (CW) and defocused mode was employed for evaporation. The complications and recurrence were evaluated in the follow-up sessions.Results:In some patients, mild keratotic lesions were observed in the follow-up sessions. Most patients were satisfied with treatment process and reported mild burning after treatment. No complication was observed in the patients.Conclusion:CO2 laser could be employed for OLP lesions; however, some degrees of recurrence may occur.

Congenital plaque‐like glomangioma treated successfully with dual wavelength pulsed‐dye and neodymium:yttrium‐aluminum‐garnet laser

Glomovenous malformations are disseminated variants of cutaneous glomus tumors. These malformations are subdivided into regional or localized, disseminated, and congenital plaque-like forms. The congenital plaque-like form is the rarest variant. Most treatment modalities have been disappointing in the treatment of large glomangiomas, leading to high recurrence rates. We report a case of a 34-year-old man with a congenital plaque-like glomangioma on his left arm and forearm treated successfully with sequential pulsed-dye neodymium yttrium aluminum garnet laser.

P53 as a Neoplastic Biomarker in Patients with Erosive and Plaque Like Forms of Oral Lichen Planus

Unstimulated whole salivary p53 was assessed in patients suffering from erosive and plaque-like form of oral lichen planus (OLP). Eighteen patients with erosive form, 17 patients suffering from plaque-like form and 38 noninvolvement subjects were enrolled. The unstimulated whole saliva p53 level was assayed by ELISA. The mean concentration of salivary p53 was significantly higher in patients with plaque-like form compared to both patients with erosive form and the control group. We conclude that plaque like form of OLP is important in view of the potential for malignancy and is not safety form. It seems that all forms of OLP must be considered accurately, should be followed up with biannual examinations, and if possible, assessment of salivary p53 every year.

Na+/K+-ATPase Is Present in Scrapie-Associated Fibrils, Modulates PrP Misfolding In Vitro and Links PrP Function and Dysfunction

Transmissible spongiform encephalopathies are characterised by widespread deposition of fibrillar and/or plaque-like forms of the prion protein. These aggregated forms are produced by misfolding of the normal prion protein, PrPC, to the disease-associated form, PrPSc, through mechanisms that remain elusive but which require either direct or indirect interaction between PrPC and PrPSc isoforms. A wealth of evidence implicates other non-PrP molecules as active participants in the misfolding process, to catalyse and direct the conformational conversion of PrPC or to provide a scaffold ensuring correct alignment of PrPC and PrPSc during conversion. Such molecules may be specific to different scrapie strains to facilitate differential prion protein misfolding. Since molecular cofactors may become integrated into the growing protein fibril during prion conversion, we have investigated the proteins contained in prion disease-specific deposits by shotgun proteomics of scrapie-associated fibrils (SAF) from mice infected with 3 different strains of mouse-passaged scrapie. Concomitant use of negative control preparations allowed us to identify and discount proteins that are enriched non-specifically by the SAF isolation protocol. We found several proteins that co-purified specifically with SAF from infected brains but none of these were reproducibly and demonstrably specific for particular scrapie strains. The α-chain of Na+/K+-ATPase was common to SAF from all 3 strains and we tested the ability of this protein to modulate in vitro misfolding of recombinant PrP. Na+/K+-ATPase enhanced the efficiency of disease-specific conversion of recombinant PrP suggesting that it may act as a molecular cofactor. Consistent with previous results, the same protein inhibited fibrillisation kinetics of recombinant PrP. Since functional interactions between PrPC and Na+/K+-ATPase have previously been reported in astrocytes, our data highlight this molecule as a key link between PrP function, dysfunction and misfolding.

Diode laser treatment is effective for plaque-like lichen planus of the tongue: a case report

IntroductionLichen planus is a chronic mucocutaneous disease thatoften affects the oral mucosa and tongue, without involvingthe skin. It affects 1–2% of the general population. Its causeis unknown in most cases. It is classifiable by severalclinical features. The atrophic and erosive forms may bepainful. The reticular and plaque-like forms are the mostcommon, affecting almost 60% of patients. The mostfrequently affected site is the tongue [1]. The diagnosisrelies on clinical and histological evidence in associationwith direct immunofluorescence. OLP treatment dependson the related symptoms. Numerous drugs have been usedwith variable results, but topical corticosteroids remain themainstay of therapy [2]. The use of laser therapies in theoral cavity has also gained acceptance for the treatment ofpremalignant oral lesions, such as leukoplakia. Many typesof laser are now available. Mona Soliman [3] and Cafaro[4] reported using the diode laser on OLP. Here, the authorsdescribe a case of OLP characterized by raised, plaque-like,keratotic lesions on the dorsum of the tongue that provedrefractory to conventional therapy, but were effectivelytreated with the diode laser with no clinical evidence ofrecurrence 18.6 months after starting the laser treatment.Case descriptionA 49-year-old woman came to our attention with atrophic,white plaque-like oral lesions, particularly on the tongue,which had persisted for 10 years.She reported soreness and a burning sensation on thetonguebuttheproblemsheconsideredmostimportantwasthecosmetic effect. Her medical history was positive for arthritis.She was taking COX-2 selective inhibitors (Etoricoxib,Tauxib, Sigma Tau, Rome, Italy) as necessary and localcorticosteroid infiltration treatments once or twice a year. Theorallesionshaddevelopedbeforeshestartedbeingtreatedforarthritis.Examination of the oral cavity revealed mild marginalgingivitis, severe plaque and tartar accumulation, whitekeratotic lines (Wickham’s striae) interlacing with erythema-tousareasandmultifocalerosivelesions,locatedbilaterallyonthe posterior buccal mucosa, Wickham’s striae on the ventraland lateral portions of the tongue, and atrophic and plaque-like lesions ranging from flat to raised areas on the dorsum ofthe tongue (Fig. 1). In particular, the dorsal surface of thetongue showed four areas of depapillation and a whitepapular patch measuring approximately 1.0 × 0.7 cm. Therewere no lesions on the floor of the mouth. Furtherexamination revealed no cutaneous lesions. The symptomsof tongue discomfort were periodical events. Routinehematological investigations and biochemistry yielded nega-tive results.Two incisional biopsies, approximately 5 mm in diam-eter, were obtained under local anesthesia, one from the

Superficial Esophageal Cancer: Esophagographic Findings Correlated with Histopathologic Findings

To retrospectively determine and evaluate the findings of superficial esophageal cancer at esophagography and to correlate the esophagographic findings with the depth of tumor invasion. The institutional review boards required neither their approval nor informed patient consent for this retrospective study. One hundred thirteen patients with superficial esophageal cancer who underwent esophagectomy at three institutions were included in this study. Double-contrast esophagograms were reviewed independently by two reviewers. For assessment of histopathologic findings, pathology reports were reviewed. Findings at esophagography, including morphologic type of the lesion, lesion extent, presence or absence of elevated or depressed component, margin and extent of elevated or depressed component, presence or absence of nodularity, extent of nodularity, esophageal luminal narrowing, and esophageal wall rigidity, were compared between mucosal and submucosal cancers by using chi2, Fisher exact, and independent-sample t tests. Of 122 histopathologically proved superficial esophageal cancers in 113 patients, 100 (82%) were detected at esophagography. The most common morphologic type was the plaquelike form; 50 (50%) such lesions were depicted at esophagography. Morphologic types were significantly different between the mucosal and submucosal cancers (P < .001). Protruded and plaquelike lesions were more frequent among submucosal cancers, whereas most flat lesions were mucosal cancers. An elevated component (P < .001), a rigid esophageal wall (P < .001), and a lobulated or irregular margin of the elevated component (P = .023) were significantly more frequent among submucosal cancers. Also, total extent of the lesion (P < .001), size of the largest nodule (P < .001), and extent of nodularity (P = .036) were significantly larger in the submucosal cancers. In the evaluation of patients with superficial esophageal cancer, esophagography appears to be helpful for diagnosing the tumor and differentiating mucosal from submucosal cancers.

Morphea-like cutaneous mucinosis

A whitish, indurated, oval plaque, lasting for 1.5 year, was observed in the right paraumbilical skin of a middle-aged man in otherwise good health. No erythema was present or referred. Histological examination revealed massive deposits of a globular, slightly basophilic, amorphous substance in the dermis, accompanied by a slight perivascular mononuclear cell infiltrate and scattered mast cells. Special staining with Alcian blue at pH 2.5 confirmed the intense deposition of mucin involving the entire dermis, sparing epidermis, adnexa and perivascular areas. No abnormal laboratory results indicating lupus erythematosus or thyroid dysfunction were present. Morphea was excluded on clinical and histological grounds. A plaque-like form of cutaneous mucinosis was diagnosed. Plaque-like mucinosis and reticular erythematous mucinosis (REM) syndrome are currently considered to be the same disease, although some authors noted a different response to treatment. Clinical presentation of our case was unusual: no erythema preceded or accompanied the plaque growth, which had a whitish, indurated, morphea-like appearance from the beginning but with preservation of hair follicles, quite different from archetypical REM syndrome based on clinical grounds.

Plaque-like form of cutaneous mucinosis.

That mucin may be deposited in the skin independent of any apparent associated endocrinopathy is now a well-established fact. Initially, generalized myxedema in association with hypothyroidism was considered the only situation in which this occurred. Subsequently, nodules and large plaques of mucin were found, particularly in the pretibial area, in association with patients who had, or had been treated for, hyperthyroidism. As the problem of localized pretibial myxedema was further studied, it was appreciated that patches of localized myxedema could occur in the absence of any thyroid dysfunction; cutaneous deposits of mucin were found in the skin widespread over the body, and in this group of patients a normal endocrine function so far has been the rule. The term myxedematosus'' (papular mucinosis, lichen fibromucinoidosis) has been employed to classify this latter group clinically. The deposits of mucin in cutaneous mucinosis, referred to in the past as lichen myxedematosus, occur

The use of amodiaquin (camoquin) in the treatment of polymorphous light eruption.

The antimalarial drugs quinacrine (Atabrine), chloroquine (Aralen), and hydroxychloroquine (Plaquenil) are effective agents for the prevention and treatment of polymorphous light eruption 1-6 and also for the treatment of discoid lupus erythematosus. 5,7 A new antimalarial compound, amodiaquin (Camoquin), recently has been reported to be equally valuable in the treatment of discoid lupus erythematosus. 8,9 The present study was done to evaluate the effectiveness of this drug in the treatment and suppression of polymorphous light eruption. Nine patients with a history of recurrent prurigo and plaque-like forms of polymorphous light eruption were studied. These patients had had recurrences of their sunlight-induced eruption each summer, for periods ranging from 6 to 23 years. The eruption had been suppressed in eight of the nine patients during the preceding three summers (1953-1955) by chloroquine. The patients were not given suppressive antimalarial therapy during the spring and early summer of 1956 and were

Unusual forms of solar dermatitis.

IN PREVIOUS publications by this group,1a tentative classification of the light-sensitive skin eruptions was formulated. The following working classification based on types of lesions was adopted: (1) plaque-like type, (2) contact eczematous type, (3) papular and prurigo-like types, and (4) erythematous type—erythema solare perstans The plaque-like form has been the subject of a previous publication,1presented in considerable detail. The first patient to be reported on here had vesiculobullous and prurigo-like lesions with scarring, a peculiar yellowish-brown color, and a leathery texture. He did not have porphyria but had cirrhosis of the liver. Nekam2described a similar severe light-sensitive eruption in a farmer aged 37 in whom the disease developed at the age of 20. He had bullous lesions, pigmentation, and atrophy of the face and hands. There was no mention of liver disease. The lesions of the second and third patients are not readily