1/17. lichen planus pemphigoides with circulating autoantibodies against 200 and 180 kDa epidermal antigens.We describe a case of lichen planus pemphigoides with circulating autoantibodies against 200 and 180 kDa epidermal antigens. A 24-year-old man presented pruritic erythematous patches with occasional central blister formation on the face, neck, and trunk and erythematous hyperkeratotic patches on the elbows and feet for 10 months. Histopathological findings of the neck and plantar lesions were consistent with lichen planus. Direct immunofluorescence studies from both lesions showed a linear deposition of IgG and C3 and cytoid bodies along the basement membrane zone. Indirect immunofluorescence studies demonstrated circulating IgG antibodies deposited on the epidermal side of salt-split skin. Immunoblot analysis using epidermal extract showed that the patient's serum reacted with 180 kDa bullous pemphigoid antigen (BPAG2) and a 200 kDa antigen. The cutaneous lesions almost cleared with a low dose of prednisolone and acitretin.- - - - - - - - - - ranking = 1keywords = lichen (Clic here for more details about this article) |
2/17. Nail dystrophy due to lichen sclerosus?Lichen sclerosus (LS) affects anogenital skin alone in 80% of cases. When extragenital disease occurs, it usually affects the trunk, neck, axillae and wrist flexures. Nail involvement with LS is rare. In contrast, lichen planus (LP) commonly affects extragenital skin. Mucosal lesions occur in 50% of cases, affecting the mouth and genitalia. Nail disease in LP is common, and, if severe, can lead to destruction of the nail bed. LS and LP can coexist. We report two cases of LS with nail involvement. In the Case 1 disease was confined to the nail, and nail biopsy confirmed LS. In the Case 2, the nail changes formed part of the widespread genital and extragenital LS, confirmed histologically. We review existing literature on nail disease in LS and discuss the possible aetiology of the nail changes.- - - - - - - - - - ranking = 12.037202976347keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
3/17. Palmoplantar lichen planus presenting with vesicle-like papules.Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. Although several morphological patterns may be seen, plaques or small papules with compact hyperkeratosis are usually observed. We present a 25-year-old woman with a one-month history of slightly pruritic, red papules on her palms and soles. Dermatologic examination revealed numerous, asymptomatic, unscaly, red papules on her palms and soles, some of them resembling vesicles and white reticulate plaques on both sides of the buccal mucosa. The diagnosis was established by the typical histopathological features of lichen planus. Although resistant to topical corticosteroids, she responded well to systemic corticosteroid therapy, and no recurrence was observed during the follow-up period of one year.- - - - - - - - - - ranking = 3keywords = lichen (Clic here for more details about this article) |
4/17. mycetoma of the foot caused by Cylindrocarpon lichenicola in an immunocompetent traveler.Cylindrocarpon is a cosmopolitan soil fungus, which rarely causes human disease. It has infrequently been reported as causing keratitis, mycetoma, osteomyelitis and peritonitis in chronic peritoneal ambulatory dialysis patients and disseminated infection in leukemic neutropenic hosts. This report describes a case of invasive infection caused by Cylindrocarpon lichenicola, localized in the right foot of an otherwise immunocompetent traveler.- - - - - - - - - - ranking = 2.5keywords = lichen (Clic here for more details about this article) |
5/17. Management of erosive lichen planus with topical tacrolimus and recurrence secondary to metoprolol.metoprolol, a widely prescribed beta-adrenergic receptor blocker, has occasionally been associated with a diversity of cutaneous reactions. We present a 79-year-old male patient with erosive lichen planus (LP) on the feet and hands who was successfully treated with topical tacrolimus. Six months after the lesions had been cured the patient received the beta-receptor blocker metoprolol for the treatment of hypertonus. Within only 2 weeks of metoprolol intake the erosive lesions on the palms and feet recurred. After discontinuation of the drug and repetitive topical treatment with tacrolimus a complete remission of the lesions could be achieved. The recurrence of erosive LP probably secondary to metoprolol and the therapeutic success of topical tacrolimus in the treatment of LP are discussed.- - - - - - - - - - ranking = 2.5keywords = lichen (Clic here for more details about this article) |
6/17. Trachyonychia: case report and review of the literature.Trachyonychia is the term used to describe nail plate roughness, pitting, and ridging that may affect 1 to 20 nails. alopecia areata, psoriasis, lichen planus, atopic dermatitis, ichthyosis vulgaris, as well as other skin conditions have been associated with trachyonychia, but the causal relationship is often challenging to demonstrate histologically. Clinical evidence of these cutaneous disorders in conjunction with a nail matrix biopsy may help elucidate an etiology of trachyonychia, but many cases often remain idiopathic. Nail biopsy findings may match skin histology, but more commonly show spongiotic or nonspecific changes. We present an interesting case of a female with progressive development of trachyonychia in all 20 nails coinciding with a new diagnosis of sarcoidosis.- - - - - - - - - - ranking = 0.5keywords = lichen (Clic here for more details about this article) |
7/17. Ultraviolet A-1 as a treatment for ulcerative lichen planus of the feet.Ulcerative lichen planus of the feet is a rare variant of lichen planus characterized by the constellation of a chronic bullous and ulcerative eruption limited to the feet, atrophy of involved skin and nails, and cicatricial alopecia. Only split-thickness skin grafting has here to been documented to be effective. We here report a case with ulcerative lichen planus of the feet successfully treated with medium-dose ultraviolet A-1.- - - - - - - - - - ranking = 3.5keywords = lichen (Clic here for more details about this article) |
8/17. Bazex syndrome (acrokeratosis paraneoplastica). An analytic review.Bazex syndrome (acrokeratosis paraneoplastica) is characterized by a psoriasiform eruption that favors acral sites and has been associated with an underlying malignancy in all reported cases. Of the 93 patients in this series, 89 were male with a mean age of 60 /- 8.5 years. Squamous cell carcinomas of the head and neck and squamous cell tumors of unknown primary with cervical lymph node metastases were the most commonly associated neoplasms, suggesting that the factor(s) responsible for the development of the syndrome are relatively specific for tumors of the upper aerodigestive tract. The cutaneous lesions were erythematous to violaceous in color and had associated scale; the most frequently observed sites of involvement were the ears, nose, hands, and feet, including the nails. In 63% of the cases, the cutaneous lesions preceded the initial symptoms or diagnosis of the tumor by an average of 11 months (range, 1-72) and, in general, the eruption was resistant to a variety of topical treatments. Occasionally, a reappearance of the papulosquamous lesions signaled the recurrence of the tumor (6 cases) or the appearance of skin lesions coincided with the development of metastatic disease (3 cases). In 91% (64/70) of the patients, the skin eruption either improved significantly following treatment of the underlying malignancy or did not improve in the setting of persistent tumor. However, even when all of the skin lesions cleared, the nail dystrophy often persisted. Fifteen of the patients developed vesicles, bullae, and crusts in addition to papulosquamous lesions. Possible explanations include the formation of an epidermal-dermal split via a bullous lichen planus-like mechanism, or the coexistence of two diseases; i.e., acrokeratosis paraneoplastica plus either porphyria cutanea tarda, bullous pemphigoid, or epidermolysis bullosa acquisita. One possible explanation for the development of the characteristic cutaneous eruption is an immune reaction, humoral or cellular, directed against a common antigen present on the tumor and the normal skin. Alternatively, tumor production of a keratinocyte growth factor such as TGF-alpha may be involved in the induction of the psoriasiform skin lesions.- - - - - - - - - - ranking = 0.5keywords = lichen (Clic here for more details about this article) |
9/17. Treatment of erosive lichen planus with dapsone.A 74-year-old woman with a chronic, severe, erosive lichen planus on the tongue, buccal mucosa and toes was treated successfully with dapsone. Previous therapy had failed, Partly due to side effects.- - - - - - - - - - ranking = 2.5keywords = lichen (Clic here for more details about this article) |
10/17. Palmar-plantar lichen sclerosus et atrophicus.A 57-year-old woman has had lichen sclerosus et atrophicus confined to the palms and soles for the past six years. diagnosis was confirmed by histologic study. Our patient's disease has been resistant to therapy.- - - - - - - - - - ranking = 13.745752237153keywords = lichen sclerosus, sclerosus, lichen (Clic here for more details about this article) |
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