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Lichen planus is a heterogeneous chronic inflammatory dermatosis occurring in middle-aged adults. It can affect the skin, mucous membranes and dander. The pathophysiology involves an immune reaction mediated by T lymphocytes, which attack the basal keratinocytes inducing their apoptosis. Dermoscopy is a non-invasive examination allowing the visualization of structures, invisible to the naked eye, located at the epidermis, the dermo-epidermal junction and the dermis. In this article we describe the dermoscopic aspects of lichen planus and its topographic variants. [ABSTRACT FROM AUTHOR]

Background and Aim: Lichen planus (LP) is a skin-mucosal disease that can affect skin, hair follicles, mucosa and nail. Oral mucosa is a common site of involvement. The aim of this study was to evaluate blood sugar levels and its relationship with demographic and clinical features in the patients with LP. Materials and Methods: This was a descriptive-analytical cross-sectional study. Fifty-eight patients with LP were included from 2016 to 2019. For data collection, we used database of the patients with LP of Kurdistan University of Medical Sciences. Results: The mean age of the patients was 43.69 ± 15.08 years and the mean duration of the disease was 1.32±2.4 years. 55.2% of the patients were female and most of the patients were housewives (44.8%). The most common presentation was involvement of multiple sites which was encountered in 41.4% of the patients followed by involvement of the foot (24.1%). 31% of the patients had a history of other diseases, 8.6% had a family history of LP, and 25.9% had a history of use of medications. The most commonly used drug was losartan (6.9%). Conclusion: The results showed that patients' blood sugar levels had no statistically significant relationship with gender, occupation, location of lesions, family history of LP, and stress, but there was a significant relationship between mean blood sugar levels of the LP patients with history of other diseases.

The rainbow pattern was initially associated almost exclusively with Kaposi's sarcoma. In recent years, it has been described in other inflammatory pathologies and especially tumours. We report a case of chronic palmoplantar keratoderma with a rainbow pattern on dermoscopy, in which skin biopsy revealed lichen planus. The presence of a rainbow pattern in lichen planus, especially palmoplantar lichen planus, is certainly rare, but it can sometimes be useful in the aetiological investigation and help in the positive diagnosis. [ABSTRACT FROM AUTHOR]

Lichen planus is a heterogeneous chronic inflammatory dermatosis occurring in middle-aged adults. It can affect the skin, mucous membranes and dander. The pathophysiology involves an immune reaction mediated by T lymphocytes, which attack the basal keratinocytes inducing their apoptosis. Dermoscopy is a non-invasive examination allowing the visualization of structures, invisible to the naked eye, located at the epidermis, the dermo-epidermal junction and the dermis. In this article we describe the dermoscopic aspects of lichen planus and its topographic variants. [ABSTRACT FROM AUTHOR]

Frontal fibrosing alopecia (FFA), a form of lichen planopilaris (LPP), is primary cicatricial alopecia commonly affecting postmenopausal women. For the first time, we investigated the diagnosis of FFA and LPP in patients presenting with the chief complaint of facial papules and roughness. This cross-sectional was performed among 68 patients with facial papules. We described the epidemiology, comorbidities, clinical presentations, and the association between facial papules and LPP or FFA. All the patients were female with a mean age of 47.84 years. Scalp alopecia was observed in all the patients presenting with facial papules, of which 89.7% had FFA. Five patients were diagnosed with LPP without FFA. Most of the patients were premenopausal (73.5%), and 70.6% had grade I FFA. Concomitant cutaneous lichen planus involvement was observed more frequently than mucosal involvement. The most frequent comorbidities were hypothyroidism, dyslipidemia, and hypertension. History of alopecia areata was detected in 8.8% of the patients. Androgenetic alopecia (AGA) was present in 17 patients (25%). Facial papules are the silent and early signs of FFA and LPP. Paying attention to these early signs along with metabolic disturbances can help with the early diagnosis of the disease, especially among premenopausal women.

Lesions which are clinically and/or histopathologically compatible with a diagnosis of lichen planus seem to develop as readily when electrical microcurrents are present as do lesions that are compatible with a diagnosis of leukoplakia. We report a case of oral electro galvanism in a 60-year-old woman. These microcurrents are the result of the simultaneous use of dissimilar metals (precious metals, stainless-steel alloys, amalgam) in dentistry. The role of electrogalvanic microcurrents in the development of white lesions of the oral mucosa is substantiated by the disappearance or regression of lesions after change of the different metals. [ABSTRACT FROM AUTHOR]

Frontal fibrosing alopecia (FFA), a form of lichen planopilaris (LPP), is primary cicatricial alopecia commonly affecting postmenopausal women. For the first time, we investigated the diagnosis of FFA and LPP in patients presenting with the chief complaint of facial papules and roughness. This cross-sectional was performed among 68 patients with facial papules. We described the epidemiology, comorbidities, clinical presentations, and the association between facial papules and LPP or FFA. All the patients were female with a mean age of 47.84 years. Scalp alopecia was observed in all the patients presenting with facial papules, of which 89.7% had FFA. Five patients were diagnosed with LPP without FFA. Most of the patients were premenopausal (73.5%), and 70.6% had grade I FFA. Concomitant cutaneous lichen planus involvement was observed more frequently than mucosal involvement. The most frequent comorbidities were hypothyroidism, dyslipidemia, and hypertension. History of alopecia areata was detected in 8.8% of the patients. Androgenetic alopecia (AGA) was present in 17 patients (25%). Facial papules are the silent and early signs of FFA and LPP. Paying attention to these early signs along with metabolic disturbances can help with the early diagnosis of the disease, especially among premenopausal women. [ABSTRACT FROM AUTHOR]

Lichen planus is an immunologically mediated mucocutaneous disease that is triggered by multiple etiological agents. Oral lichen planus (OLP) is characterized by a slow evolution without complete remission, nor spontaneous healing. The establishment of an early diagnosis is essential to be able to support and to relieve patients with oral lichen plan lesions especially those in active phase. This requires recognition by the dentists of the signs and symptoms, characteristics and different clinical forms under which this pathological entity may occur. The purpose of our survey was to evaluate the knowledge of dentists (teachers and Master students) in the Faculty of Dental Medicine of Saint Joseph University, Beirut, on the oral lichen planus by means of a survey study. [ABSTRACT FROM AUTHOR]

Based on the latest medical research, it is supposed that lichen planus is an inflammatory disorder, associated with autoimmune diseases, hepatitis C infection, oxidative stress or antioxidant deficiency. The purpose of the present work is to determine a panel of serum antioxidants, possibly involved in the development/persistence of the disease. The determination of extracellular antioxidants (bilirubin, uric acid, albumin, iron, transferrin, ferritin, copper, ceruloplasmin, total antioxidant capacity) in patients with lichen planus during exacerbations have revealed a significant reduction in non-enzymatic antioxidant systems. Hepatitis C virus enhances the deficit of antioxidants in patients with lichen planus. Based on these findings, the authors consider that lichen planus is a complex disease of unidentified cause and its pathogenic mechanisms are still incompletely elucidated. It may be speculated that several interconnected mechanisms are involved in the onset and evolution of lichen planus. [ABSTRACT FROM AUTHOR]

Le lichen plan verruqueux (LPV), est une dermatose inflammatoire chronique, qui siège électivement au niveau desmembres inférieurs. La localisation périnéale est rare, souvent associée à d�autres lésions de lichen cutanéo-muqueux. Nous rapportant un cas à localisation périnéale isolée. Il s'agit d'un patient âgé de 51 ans, sans antécédent pathologique notable, qui consultait pour des lésions verruqueuses indolores, légèrement prurigineuses, au niveau périnéal, augmentant progressivement de taille depuis 8 ans. L'examen clinique révélait la présence de multiples lésions bourgeonnantes, fermes, grisâtres à surface rugueuse, de 1 à 4 cm de diamètre, siégeant au niveau péri anal et scrotal(A). Le reste de l'examen somatique était sans particularité. L'étude histologique montrait un épiderme acanthosique d'aspect verruqueux, associé à un infiltrat inflammatoire à prédominance lymphocytaire grignotant la membrane basale, et une incontinence pigmentaire avec des corps apoptotiques au niveau de l'assise basale épidermique, sans objectiver de signes d'infection virale ou de transformation maligne (B). Le diagnostic d'un lichen plan verruqueux était retenu. La sérologie de l'hépatite C, le bilan lipidique, ainsi que l'échographie abdominale étaient sans anomalies. Une corticothérapie locale classe très forte a été prescrite. L'évolution était favorable sans récidive, avec un recul de 18 mois.

Résumé La toxicité cutanée de la radiothérapie est maintenant bien individualisée, que ce soient les effets aigus (radiodermites aiguës) ou chroniques (radiodermites chroniques, carcinomes cutanés secondaires, séquelles esthétiques). Beaucoup plus exceptionnellement, la radiothérapie peut aussi induire, par réaction isomorphique ou phénomène de Koebner, certaines dermatoses spécifiques. Nous rapportons ici cinq nouvelles observations de ces complications inhabituelles de la radiothérapie, survenues dans des délais très variables après la fin d’une irradiation mammaire et restant strictement localisées dans le territoire initialement irradié (mastocytose cutanée, syndromes de Sweet, lichen plan et vitiligo segmentaires). Ces cas soulignent la nécessité de réaliser un examen histologique systématique devant toute lésion cutanée atypique apparaissant après une radiothérapie, même longtemps après. Radiotherapy's main skin toxicities are now well-separated, acute (acute radiation dermatitis) or chronic complications (chronic radiation dermatitis, induced cutaneous carcinoma, aesthetic sequelae). Exceptionally, radiotherapy may induce, by isomorphic reaction or Koebner's phenomenon, some specific dermatosis. In this article, we report five new observations of these unusual complications of radiation therapy, occurring in very variable time after breast irradiation and remaining strictly localized in the irradiated field (cutaneous mastocytosis, Sweet syndrome, lichen planus, vitiligo). These cases emphasize the need to realize a systematic histological exam if any atypical skin lesion appears after radiotherapy, even long after. [ABSTRACT FROM AUTHOR]

Lichen planus (LP) is an autoimmune, inflammatory skin disorder commonly associated with hepatitis C virus (HCV) infection. Gamma-glutamyl transpeptidase (GGT) plays an important role in modulating the skin response to various internal or external injuries. In order to evaluate the effects of HCV on GGT pro-oxidative activities, we performed a comparative study between LP patients without viral infections and patients with asymptomatic HCV infection (HCV carriers). Our conclusion is that asymptomatic HCV infection induces a functional GGT deficiency, resulting in the alteration of the enzyme’s ability to reduce the toxic effects of free radicals, neutralize unstable oxygen species and prevent the oxidation of certain molecules in the infected tissue. [ABSTRACT FROM AUTHOR]

La variété pigmentogène du lichen plan est rare chez l'enfant ainsi que sa forme généralisée. L'étiologie reste inconnue. Peu de traitements se sont avérés efficaces sur le lichen pigmentaire. Notre patiente a bien évolué après des corticoïdes retards, des dermocorticoïdes et une photoprotection. Nous rapportons le cas d'une fillette de 10 ans qui consultait pour des lésions maculeuses prurigineuses brunâtres étendues évoluant depuis 5 ans chez qui l'examen trouvait une hyperpigmentation cutanée généralisée, diffuse et réticulée associée à des papules violacées, brillantes et réticulées. Le bilan biologique était normal en dehors d'une hyperéosinophilie à 1000/mm3. L'étude histologique était compatible avec un lichen pigmentaire. Le traitement était basé sur les corticoïdes retards type triamcinolone (Kenacort), des antihistaminiques et une protection solaire. L'évolution était marquée par la disparition du prurit et des papules dès la 1ère injection et un éclaircissement à la 3ème injection.

The evalution of s to m a to g ic a l d is o rd e rs can be c h a lle n g in g even fo r e x p e rt eyes. M a n y p a th o lo g ic a l fin d in g s a re ra re an d a re se e n s c a re c e ly in p riv a te d e n ta l p ra c tic e o ve r tim e . S to m a to lo g ic a l s e rv ic e s in s p e c ia liz e d d e n ta l c lin ic s ca n h e lp to fin d th e rig h t c ia g n o s is to le s io n s o f o ra l tis s u e a n d to a s s u re an a p p ro p ria te th e ra p y . T h is a rtic le p ro v id e s a g e n e ra l su rve y o f fre q u e n t fin d ir g s in o u r s to m a to lo g y s e rvice . [ABSTRACT FROM AUTHOR]

Introduction. Many epidemiological, clinical and experimental studies have sugested a possible role of infectious agents in the etiopathogenesis of lichen planus. In this paper, the authors performed a retrospective analysis for the presence of hepatitis B (HBV) and C (HCV) viruses in patients with lichen planus, between 2004-2016. Material & Method. The serological screening was realised for 157 patients with lichen planus in order to detect anti-HCV antibodies and HBs antigen. In the case of a positive result for anti-HCV antibodies, confirmatory tests were performed. Results. Among patients with lichen planus diagnosed based on clinical and histopathological aspects, it was found that 12 patients were infected with HCV (7.6%), 4 patients were infected with HBV (2.6%) and 1 patient with HBV/HCV coinfection (0.6%). Conclusions. Based on these results, the authors do not consider that hepatitis viruses play an essential role in the pathophysiology of lichen planus. However it should be noticed the high percentage of cases of HCV infection among these patients. Early identification and treatment of these infections in patients with lichen planus could influence in a positive way the course of the cutaneous disease. [ABSTRACT FROM AUTHOR]

Introduction: Recent developments in implantology have led to an extension of its indications, especially regarding special care patients. This paper offers a review of the literature on the subject of implantology in cases of oral mucosal lesions. Methods: A review of the literature was performed using MEDLINE, without a date range, searching for articles describing oral implant treatments in patients with oral mucosal alterations. Results: Few cases of oral implant treatments in such patients are described. The results of the literature review showed that oral implant treatments greatly enhance the quality of life of these patients. Discussion: Although these pathologies used to be considered contraindications to dental implant placement, recent data shows the feasibility of such treatments. Conclusion: Nonetheless, both strict oral hygiene and regular maintenance are essential to intercept any potential pathology reactivation. [ABSTRACT FROM AUTHOR]

La variété pigmentogène du lichen plan est rare chez l'enfant ainsi que sa forme généralisée. L'étiologie reste inconnue. Peu de traitements se sont avérés efficaces sur le lichen pigmentaire. Notre patiente a bien évolué après des corticoïdes retards, des dermocorticoïdes et une photoprotection. Nous rapportons le cas d'une fillette de 10 ans qui consultait pour des lésions maculeuses prurigineuses brunâtres étendues évoluant depuis 5 ans chez qui l'examen trouvait une hyperpigmentation cutanée généralisée, diffuse et réticulée associée à des papules violacées, brillantes et réticulées. Le bilan biologique était normal en dehors d'une hyperéosinophilie à 1000/mm³. L'étude histologique était compatible avec un lichen pigmentaire. Le traitement était basé sur les corticoïdes retards type triamcinolone (Kenacort®), des antihistaminiques et une protection solaire. L'évolution était marquée par la disparition du prurit et des papules dès la 1ère injection et un éclaircissement à la 3ème injection. [ABSTRACT FROM AUTHOR]

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After having reviewed the literature in the first part of this paper, we now present 6 selected cases to confirm the malignant potential of oral lichen planus (OLP), illustrating their particularities. Malignant transformation probably favored by chronic inflammation present in OLP is considered to arise in a small percentage in late stages (such as atrophic OLP or post-lichen state), but the true prevalence is probably underestimated because these lesions are often considered to be leukoplakia. Clinically malignant transformation will present as multiple lesions (verrucous carcinoma or squamous cell carcinoma), more or less spaced in time and often preceded by OIN (oral intraepithelial neoplasia). [ABSTRACT FROM AUTHOR]

Lichen planus is a chronic inflammatory dysimmune mucocutaneous disease. Oral lichen planus, which progresses in relapses, is a common complaint that can affect the entire oral mucosa. Once it has evolved over a number of years, the mucosa becomes (sclero-) atrophic. The (sclero-) atrophic or post-lichen stage has been associated with a risk of malignant transformation. To understand the process whereby oral lichen planus becomes malignant, it is necessary to be familiar with the different clinical and histopathological characteristics related to its natural history. During the late phase (atrophic lichen planus and post-lichen stage), the modified oral mucosa shows signs of becoming malignant. However, the possibility of it progressing in this way has long been controversial. A review of the literature addressing this topic enabled the various suggested pathogenic hypotheses to be assessed but the determining factor seems to be chronic inflammation. [ABSTRACT FROM AUTHOR]

Verrucous lichen planus (VLP), is a chronic inflammatory dermatosis mainly involving the lower limbs. It rarely affects the perineal area, where it occurs in association with other mucocutaneous lichen lesions. We here report the case of a 51-year old patient with isolated perineal verrucous lichen planus. The patient, who had no significant medical history, presented with painless, verrucous, slightly itchy lesions in the perineal area that had gradually increased in volume over the past 8 years. Clinical examination revealed the presence of multiple firm grayish budding lesions with a rough surface, measuring 1-4 cm in diameter, in the perianal and scrotal area (A). The remainder of the somatic examination was normal. Histology showed verrucous acanthotic epidermis associated with mainly lymphocytic inflammatory infiltrate penetrating the basement membrane and pigmentary incontinence with the formation of apoptotic bodies in the basal layer of epidermis, without signs of viral infection or malignant transformation (B). The diagnosis of verrucous lichen planus was retained. Hepatitis C serology, lipid assessment as well as abdominal ultrasound were normal. A very strong local corticosteroid therapy was prescribed. The patient had a favorable outcome without recidivism at 18-months' follow-up. [ABSTRACT FROM AUTHOR]