Annular Atrophic Lichen planus

Mseddi, M.; Bouassida, S.; Marrakchi, S; Khemakhem, M.; Turki, H.; Zahaf, Abdelmajid

doi:10.1159/000071801

Cited by 11 publications

(22 citation statements)

References 3 publications

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“…Annular atrophic LP is a rare variant of LP and characterized by annular, violaceous plaques with central atrophy. Up to date 10 cases have been described [27,28,29,30,31,32,33,34,35]. Erosive LP is a painful variant of LP with eroded or ulcerated lesions mainly in mucocutaneous sites which is often difficult to treat and may lead to scarring [36,37,38].…”

Section: Discussionmentioning

confidence: 99%

Oral, Esophageal and Cutaneous Lichen Ruber Planus Controlled with Alitretinoin: Case Report and Review of the Literature

Kolios¹,

Maggio²,

Gubler

et al. 2013

Dermatology

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Background: Therapy-resistant lichen planus (LP) can be a challenging condition for dermatologists. There are some case reports about successful treatments with alitretinoin of cutaneous and oral, but not of esophageal LP. Objective: We present the unique case of a patient with cutaneous, oral and esophageal LP which was refractory to classical treatment options (topical clobetasol propionate and pimecrolimus, intramuscular triamcinolone acetonide); because of systemic side effects the patient did not tolerate systemic acitretin dosed up to 25 mg daily. Methods: Oral alitretinoin was used at a dose of 30 mg daily. Results: Both oral and skin changes as well as dysphagia completely resolved within 4 weeks without any severe side effects and the drug was used for 6 months. No papules, intraoral striae or dysphagia recurred during the 6 months of treatment. After 4 months the patient relapsed with mucosal patches so that a second cycle was initiated for 6 months where oral LP lesions resolved after 4 weeks also (with sporadic mild headache). Conclusion: Further studies are needed to better understand the impact of alitretinoin in LP. Our observation suggests alitretinoin as a new, well-tolerated treatment option for esophageal LP after failed response to conventional treatments.

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Section: Discussionmentioning

confidence: 99%

Oral, Esophageal and Cutaneous Lichen Ruber Planus Controlled with Alitretinoin: Case Report and Review of the Literature

Kolios¹,

Maggio²,

Gubler

et al. 2013

Dermatology

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“…ALP is seen in about 10% of lichen planus patients and predominantly in those with dark skin, and most cases occur in the genital area [4, 5, 6]. The precise pathomechanism of lichen planus has not yet been clarified.…”

Section: Discussionmentioning

confidence: 99%

Annular Lichen planus: Study of the Cellular Mechanisms of Annularity

Yamanaka

Akiyama²,

Shibaki³

et al. 2004

Dermatology

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Annular lichen planus is a rare, unique subtype of lichen planus. We report a 34-year-old Japanese male who had multiple, dark red to purple, annular macules with slightly raised borders. Histopathological examination of a skin biopsy specimen from the peripheral region of the macule showed the typical features of lichen planus. Immunohistochemical stainings revealed that a number of CD1a-positive, S-100-protein-positive Langerhans cells were present at the border zone of the annular lesion and most of the infiltrating cells were CD4-positive, CD8-negative lymphocytes. Conversely, inside the annular lesion, the number of Langerhans cells was decreased, and an equal number of CD4-positive cells and CD8-positive cells was present in the sparse infiltration. These results suggest that activation of Langerhans cells initiated a lichenoid tissue reaction but a subsequent depletion of Langerhans cells suppressed the lymphocyte infiltration. These sequential events might be involved in the formation of the unique annular structure in this condition.

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“…6 We do not have the exact explanation for this observation besides the above-mentioned biochemical mechanisms or the local irritation and erythema following tazarotene causing depigmentation by Koebnerization. 3 As with other topical retinoids, adverse events with tazarotene are limited to local effects, most frequently being erythema, pruritus, burning/stinging and, rarely, pyogenic granuloma in patients with psoriasis.…”

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confidence: 89%

A case of annular atrophic lichen planus

Kim

Seo

Jang

et al. 2007

Acad Dermatol Venereol

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In psoriasis, tazarotene acts by modulating the three main pathogenic features: abnormal differentiation, hyperproliferation of keratinocytes, and inflammation. 3 As with other topical retinoids, adverse events with tazarotene are limited to local effects, most frequently being erythema, pruritus, burning/stinging and, rarely, pyogenic granuloma in patients with psoriasis. 4 However, retinoids are not known to cause depigmentation. Topical use of retinoic acid (RA) produces improvement in hyperpigmentation by reducing the number of functioning melanocytes and/or in inhibiting their ability to synthesize melanin. 5 Retinoids are potent inhibitors of mammalian GSTs (glutathione-s-transferase) and this makes cells more susceptible to the cytotoxic effects of chemicals. 6 We do not have the exact explanation for this observation besides the above-mentioned biochemical mechanisms or the local irritation and erythema following tazarotene causing depigmentation by Koebnerization. The occurrence of vitiligo within an area treated with tazarotene does not illustrate definite direct cause but probably does indicate the need for vigilance to see whether this association occurs again. Clinicians should be aware of potential pigmentary changes, particularly when using tazarotene on areas of skin that are readily visible or in patients of vitiligo for treatment of other dermatoses. We suggest that this rare but important observation should be considered as a potential side-effect of tazarotene. Mays S. The pathogenesis of psoriasis and the mechanism of action of tazarotene. J Am Acad Dermatol 1998; 39: S129-S133. 4 Weinstein GD, Krueger GG, Lowe NJ et al. Tazarotene gel, a new retinoid, for topical therapy of psoriasis. vehicle-controlled study of safety, efficacy, and duration of therapeutic effect. J Am Acad Dermatol 1997; 37: 85-92. 5 Kligman AM, Willis I. A new formula for depigmenting human skin. Arch Dermatol 1975; 111: 40-48. 6 Kasraee B, Handjani F, Aslani FS. Enhancement of the depigmenting effect of hydroquinone and 4-hydroxyanisole by all-trans-retinoic acid (tretinoin): the impairment of glutathione-dependent cytoprotection? Dermatology 2003; 206: 289-291.

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Annular Atrophic Lichen planus

Cited by 11 publications

References 3 publications

Oral, Esophageal and Cutaneous Lichen Ruber Planus Controlled with Alitretinoin: Case Report and Review of the Literature

Oral, Esophageal and Cutaneous Lichen Ruber Planus Controlled with Alitretinoin: Case Report and Review of the Literature

Annular Lichen planus: Study of the Cellular Mechanisms of Annularity

A case of annular atrophic lichen planus

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