Detection of Varicella-Zoster Virus Antigens in Lesional Skin of Zosteriform Lichen Planus but Not in That of Linear Lichen Planus

Abstract

Background: Distinctions between ‘linear lichen planus’ (LP) and ‘zosteriform LP’ are difficult to determine solely based on clinical findings. Objective: The aim of this study is to determine whether the presence of the varicella-zoster virus (VZV) antigens could be used to differentiate the zosteriform LP from the linear LP. Methods: We immunohistochemically investigated the presence of in vivo localization of VZV antigens in 8 LP lesions (zosteriform LP: n = 5, linear LP: n = 3). Results: We describe 2 cases of zosteriform LP without apparent prior episodes of herpes zoster, in whom VZV antigens were detected in the eccrine epithelium. Further analysis showed that VZV antigens were exclusively detected in the eccrine epithelium in the zosteriform LP lesions, but not in the linear LP lesions. Conclusion: Etiological differences exist between zosteriform LP and linear LP. The presence of VZV antigens in lesional skin of the former indicates a possible triggering role of this virus in the pathogenesis of this variant.

Lichen planus and lichenoid reactions as a systemic disease

“…Patients with true zosteriform LP-like lesions are and the pattern may at best be explained by a Koebner phenomenon induced by a preceding herpes zoster infection with secondary trauma or mechanical manipulation of the lesions(45). Negative PCR results in the LP lesions supported the view that there is no direct association between varicella-zoster virus infection and the development of LP(46,47).…”

Varicella Zoster Virus and Internal Root Resorption: A Case Report

“…The generalized oral involvement was in the form of severe mucous and labial ulcers, and no improvements were observed in the oral and labial status after recovery from the disease, which might be explained by the capacity of the VZV to remain dormant, indicating a viral etiology for the oral manifestations. Mizukawa et al (26) carried out a study to evaluate the presence of VZV antigens in zosteriform lichen planus compared with those in linear lichen planus and reported the presence of these antigens only in the epithelial sweat glands in the zosteriform lichen planus, with no signs of these antigens in the linear lichen planus, which might indicate differences in the etiology between these 2 lichen planus forms and superimposition of oral lesions resulting from this virus in the acute phase of the linear lichen planus and exacerbation of oral lesions, resulting in erosive lichen planus. The presence of VZV antigens in skin lesions of the former might indicate the role of this virus in the pathogenesis of this variant.…”

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

“…Linear LP can follow a ‘blaschkoid' distribution in adults but is also described in a case report of a child [12,13,14,15]. Zosteriform LP follows dermatomal lines and is thought to be an isotopic response to herpes zoster or at least showing antigens against varicella zoster virus in lesional skin [16,17,18]. Lichen planus pigmentosus-inversus is suggested to be a rare variant of LP limited to intertriginous regions and seems to have a short inflammatory phase with fast transformation into a long noninflammatory regressive phase with brown, nonpruritic, small inflammatory macules; scaling is limited [19,20,21,22,23,24,25].…”