Oral lichen planus pemphigoides: a series of four cases

Lichen Planus Pemphigoides: From Lichenoid Inflammation to Autoantibody-Mediated Blistering

“…In LPP, two discrete primary skin lesions occur: lichenoid papules/plaques and tense blisters. Cases of LPP exclusively restricted to mucous membranes have also been reported (48, 49). The nail apparatus may also be affected by LPP, resulting in nail atrophy or even loss of the nail plate (50).…”

“…The lichenoid eruption consists of pruritic violaceous polygonal papules and plaques with a shiny surface (Figures 1A,B). On the mucosa, patterned white streaks may be found, most prominently on the buccal and the outer genital mucosa (48, 51). Blisters and erosions typically appear after the development of the lichenoid skin changes and classically on previously unaffected skin.…”

Pembrolizumab‐induced lichen planus pemphigoides in a patient with metastatic melanoma

“…Die Hemmung des Immun-Checkpoints könnte eine sowohl gegen den Tumor als auch gegen das Hautorgan gerichtete Autoimmunität Differenzialdiagnosen des Lichen planus pemphigoides. Klinische, histologische und immunologische Differenzierung von bullösem Lichen planus, Lichen planus pemphigoides und bullösem Pemphigoid[ 8,13,14 ] .Abk. : DEJ, dermoepidermale Junktionszone; DIF, direkte Immunfluoreszenz.Hautverbesserung herbeiführen.…”

Comments regarding “Four cases of mucous membrane pemphigoid with clinical features of oral lichen planus” and on the utility of immunofluorescence

“…Thus, given the often innocuous clinical appearance of oral LPP that resembles oral LP, as noted in our own clinical experiences as well as that of Fukuda et al , we would like to emphasize the importance of immunofluorescence studies to establish a diagnosis of LPP to ensure a prompt referral to the appropriate specialists to prevent debilitating sequelae secondary to mucosal scarring.…”

“…Contributing to its lack of recognition, oral LPP is likely frequently underdiagnosed due to the lack of prescribed immunofluorescence studies in cases that may appear similar to oral LP. Including the recently published findings of Fukuda and colleagues, there are now 35 reported cases of LPP with well‐characterized oral involvement that have undergone confirmatory testing with direct immunofluorescence, 31 (89%) of which presented clinically with classic reticular or erosive LP with an absence of intraoral bullae . While we recognize that oral lesions of both diseases are treated in a similar manner, the utility of immunofluorescence studies in establishing the diagnosis of oral LPP is of importance, as LPP is considered a systemic autoimmune disease within the pemphigoid family that may present with a scarring phenotype affecting the conjunctivae, larynx, and/or esophagus, which carries a risk of progression to complications such as blindness, respiratory distress, and dysphagia, respectively …”