Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

Gorouhi, Farzam; Davari, Parastoo; Fazel, Nasim

doi:10.1155/2014/742826

Cited by 383 publications

(482 citation statements)

References 236 publications

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“…Ocular rosacea 3,137 Some scarring is common Dermatitis herpetiformis 128 Rarely causes scarring Lichen planus 138,139 Rarely causes scarring Systemic lupus and discoid lupus 140 Rarely causes scarring…”

Section: Dermal Diseases With Variable Ocular Involvementmentioning

confidence: 99%

The 2016 Bowman Lecture Conjunctival curses: scarring conjunctivitis 30 years on

Dart

2017

Eye

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This review is in two sections. The first section summarises 35 conditions, both common and infrequent, causing cicatrising conjunctivitis. Guidelines for making a diagnosis are given together with the use of diagnostic tests, including direct and indirect immunofluorescence, and their interpretation. The second section evaluates our knowledge of ocular mucous membrane pemphigoid, which is the commonest cause of cicatrizing conjunctivitis in most developed countries. The clinical characteristics, demographics, and clinical signs of the disease are described. This is followed by a review and re-evaluation of the pathogenesis of conjunctival inflammation in mucous membrane pemphigoid (MMP), resulting in a revised hypothesis of the autoimmune mechanisms causing inflammation in ocular MMP. The relationship between inflammation and scarring in MMP conjunctiva is described. Recent research, describing the role of aldehyde dehydrogenase (ALDH) and retinoic acid (RA) in both the initiation and perpetuation of profibrotic activity in MMP conjunctival fibroblasts is summarised and the potential for antifibrotic therapy, using ALDH inhibition, is discussed. The importance of the management of the ocular surface in MMP is briefly summarised. This is followed with the rationale for the use of systemic immunomodulatory therapy, currently the standard of care for patients with active ocular MMP. The evidence for the use of these drugs is summarised and guidelines given for their use. Finally, the areas for research and innovation in the next decade are reviewed including the need for better diagnostics, markers of disease activity, and the potential for biological and topical therapies for both inflammation and scarring.

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Section: Dermal Diseases With Variable Ocular Involvementmentioning

confidence: 99%

The 2016 Bowman Lecture Conjunctival curses: scarring conjunctivitis 30 years on

Dart

2017

Eye

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“…He explained it to be an inflammatory disorder involving stratified squamous epithelium of unknown etiology. 2 Initially the condintion was named "lichen ruberplanus" and "lichen psoriasis". In 1895, Weyl demonstrated Wickham Striae (reticulate white lines) on the surface of lichen planus lesions.…”

Section: Introductionmentioning

confidence: 99%

A prospective case control study on metabolic syndrome in lichen planus in a tertiary care centre

2017

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Background: Lichen planus is an autoimmune, inflammatory papulosquamous disease affecting skin and mucous membrane with a possible association with the parameters of metabolic syndrome.Methods: We carried out a hospital based case control study among patients attending DVL OPD during a period of 1.5 years (January 2015 - May 2016). Study population included 40 cases of LP and 80 age and sex matched controls. Relevant history, clinical examination and blood investigations were done. Diagnosis of MS was made based on IDF criteria.Results: There was no significant association between metabolic syndrome and lichen planus (p=0.292). Although there was higher prevalence of hypertension (47.5% vs. 27.5%, p=0.029), triglyceride level (25% vs. 10%, p=0.030) and low HDLC levels (65% vs. 45%, p=0.039). We could not establish significant association between FBS and waist circumference with LP.Conclusions: Though metabolic syndrome was not significantly associated with LP, its components such as hypertension, triglycerides and low HDLC levels were significantly associated with LP as per the study. Therefore patients with LP need to be screened to rule out each of these parameters to avoid later complications.

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“…Cytotoxic T-cell infiltration into the epithelium results in apoptotic basal keratinocytes. Theoretically, it may be induced by CXCR3 and CCR5 mediated signaling pathways initiated by both, T-cells and keratinocytes [9,10]. There have been no previously reported HLA studies in this variant of LP.…”

Section: Etiologymentioning

confidence: 88%

“…The symptoms may range from discomfort to severe, painful episodes. Involvement of the dorsum of the tongue might cause dysgeusia [9].…”

Section: Reticular Lpmentioning

confidence: 99%

A Review of Vulvovaginal-Gingival Syndrome. Case Report

Grau¹,

Roig²,

Juncadella³

et al. 2017

UCMS

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Abstract:Vulvovaginal-gingival syndrome (VVGS) is a chronic mucocutaneous disease of unknown etiology, which consists of a triad of symptoms: vulvar, vaginal and gingival of lichen planus (LP) lesions. The evidence suggests an autoimmune response, a genetic and probably hormonal component. Associated factors observed in LP include stress/anxiety, hepatitis C virus (HCV) and autoimmune diseases, among others. The most serious complication of oral and possibly also vulvar Lichen Planus is the development of squamous cell carcinoma. Corticosteroids are the mainstay treatment for LP in order to control inflammatory activity. In case of failure, immunosuppressive agents can be used (Tacrolimus and Cyclosporine). We present an illustrated case of VVGS who over the years developed tongue cancer and, 10 years later, a vulvar cancer. Oral Lichen Planus (OLP) should be referred to the appropriate specialists to rule out involvement of other mucous membranes and track it early to diagnose a possible malignant transformation. The efficient management of VVGS involves a multidisciplinary approach involving gynecologists, dermatologists and stomatologists.

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Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

Cited by 383 publications

References 236 publications

The 2016 Bowman Lecture Conjunctival curses: scarring conjunctivitis 30 years on

The 2016 Bowman Lecture Conjunctival curses: scarring conjunctivitis 30 years on

A prospective case control study on metabolic syndrome in lichen planus in a tertiary care centre

A Review of Vulvovaginal-Gingival Syndrome. Case Report

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