Lichen planus (LP) is a chronic inflammatory and immune-mediated disease that affects the skin, hair, nails and mucous membranes. Although there is a broad clinical spectrum of lichen planus manifestations, the skin and oral cavity remain the major sites of involvement. A group of European dermatologists with a long-standing interest and expertise in lichen planus has sought to define therapeutic guidelines for the management of patients with LP. The clinical features, diagnosis and possible medications that clinicians can use, in order to control the disease, will be reviewed in this manuscript.The revised final version of the lichen planus guideline was passed on to the European Dermatology Forum (EDF) for a final consensus with the European Academy of Dermatology and Venereology (EADV).

We report five cases of delayed hypersensitivity reactions to a TDS containing buprenorphine. Such adverse reactions might be under-reported. A fentanyl-containing TDS is a good alternative in these cases.

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A healthy, 9-year-old boy presented with a 6-week history of an enlarging, nontender, erythematous plaque in the right periorbital region. It had commenced as a small pink papule near the right lateral canthus after a cat scratch. Previous treatment had included topical mupirocin, several courses of systemic antibiotics, and acyclovir without improvement. The patient had continued to feel well without any fevers or chills, changes in activity level, or ophthalmologic symptoms.Physical examination revealed an indurated, erythematous, slightly crusted plaque at the right periorbital region (Fig. 1). Several small, nontender, mobile, subcutaneous nodules were palpated radially along the right cheek.A skin biopsy specimen was obtained for histopathological evaluation (Figs. 2 and 3) and tissue culture.