Líquen escleroso e atrófico: relato de dois casos de apresentação atípica

Abstract

O líquen escleroso e atrófico é doença crônica da pele que se apresenta clinicamente de forma variada. Pode acometer mulheres e, menos freqüentemente, homens e crianças, sendo a área mais afetada a região anogenital. Há forte associação com doenças auto-imunes, e estudos imunogenéticos têm revelado associação com o HLA DQ7. Raramente acomete áreas extragenitais; entretanto, os autores relatam dois casos da doença, com localizações atípicas (extragenitais) e fazem uma abordagem terapêutica distinta. O uso tópico de corticoterapia de alta potência é relatado, porém, com riscos; enquanto agentes imunomoduladores tópicos são descritos com boa resposta clínica e com menor risco de atrofia.

Lichen Sclerosus Atrophicus [LSA] in the Areolae: A Case Report

“…Typical findings are white opalescent papules that may cluster and progressively result in parchment-like skin [1, 3]. Lichen sclerosus (LS) encompasses the disorders known as LSetA, Balanitis xerotica obliterans (LS of male genitalia glans and prepuce), and kraurosis vulvae (LS of labia majora, labia minora, perineum, and perianal region [4]).…”

Líquen escleroso e atrófico acral: relato de caso

“…It is more prevalent in females (ratio of 6-10 women to one man). 1,2 Higher incidence has been observed in white women aged around 40. The etiology is unknown but it is thought that genetic susceptibility plays a role in the disease.…”

“…7 It occurs predominantly in the genital area (in 83-98% of all cases), with extragenital lesions occurring in between 8% to 20% of cases. 1,2,3,8 The genital form of the disease in women is called craurose vulvar. This manifests as extremely puriginous lesions forming painful erosions, vulvar atrophy with progressive narrowing of the vaginal opening and dispaurenia.…”

“…Lichen sclerosus et atrophicus (LEA) is an uncommon chronic inflammatory disease which particularly affects the genital area of adult women. 1,2,3 Extragenital forms of the disease are rare, mainly affecting the thoracic region. 2 We describe a rare case of extragenital LEA which appeared initially in the palmoplantar region.…”

Scanning electron microscopy of lichen sclerosus

“…1,4-6 In this area collagen bundles are no longer observed, the dermal tissue looks homogeneous and less eosinophilic. Moreover epidermal atrophy, hydropic degeneration of the basal layer and dermal lymphocytic infiltrate are also seen.…”