ABSTRACT
The term "Wolf's isotopic response" describes the occurrence of a new skin disorder at the site of another unrelated and already healed skin disease. In most cases, herpes zoster is the inicial disease. Different disorders may develop on the same site, most commonly granulomatous and lichenoid reactions, infiltration of hematologic diseases, skin tumors and infections. There are few related cases of lichen planus presenting as isotopic response. We report a case of a 74 year-old woman, with multiple itchy, rose-colored and shiny papules that developed at site of previously healed herpes zoster, on the right arm and shoulder. The pathogenesis of this phenomenon is still unknown and further studies are needed.
.Subject(s)
Aged , Female , Humans , Herpes Zoster/pathology , Lichen Planus/pathology , Skin Diseases, Viral/pathology , Biopsy , Herpes Zoster/complications , Lichen Planus/etiology , Skin Diseases, Viral/complications , Skin/pathologyABSTRACT
Lichen planus is an uncommon disease in children, and only 2 to 3% of affected patients are under twenty years of age. This dermatosis may appear in several clinical forms, which vary according to the morphology and distribution of lesions. In less than 0.2% of all lichen planus cases, the lesions are distributed along the lines of Blaschko, and is a variant called linear lichen planus. This is a case report of a patient aged two years and eight months, who presented keratotic violaceous papules, affecting the abdomen, buttocks and right thigh, distributed along the lines of Blaschko. Histopathological examination confirmed a diagnosis of linear lichen planus.
O líquen plano é uma enfermidade pouco frequente na infância, apenas 2 a 3% dos pacientes acometidos se encontram abaixo dos vinte anos de idade. Essa dermatose pode se apresentar sob várias formas clínicas, as quais variam de acordo com a morfologia e distribuição das lesões. Em menos de 0,2% dos casos de líquen plano, as lesões se distribuem ao longo das linhas de Blaschko, variante denominada de líquen plano linear. Relata-se o caso de uma paciente de dois anos e oito meses de idade apresentando pápulas violáceas de superfície ceratósica acomentendo a região abdominal, região glútea e coxa direita, distribuídas ao longo das linhas de Blaschko, cujo exame histopatológico confirmou o diagnóstico de líquen plano linear.
Subject(s)
Child, Preschool , Female , Humans , Lichen Planus/pathology , Diagnosis, Differential , Lichen Planus/etiology , Skin/pathologyABSTRACT
El liquen plano (LP) es una dermatosis inflamatoria crónica que afecta a la piel, membranas mucosas, pelo y uñas; de etiología desconocida, en cuya patogenia existe un daño autoinmunitario mediado por linfocitos T frente a los queratinocitos basales que expresan autoantígenos alterados en su superficie. Se presenta con diferentes patrones clínicos, como LP oral, LP anular, LP lineal, LP atrófico, LP hipertrófico, LP ampollar, LP pigmentoso, LP actínico. Su presentación clásica se caracteriza por pápulas poligonales o placas, pruriginosas, de coloración violácea, superficie brillante, surcada por estrias blanquecinas, característicamente distribuidas en forma simétrica sobre todo en las superficies flexoras de la muñeca, tobillos y muslos. Evoluciona por brotes y su curso es autolimitado, se resuelve en un periodo de meses a años, pero puede persistir indefinidamente. Existen múltiples opciones de tratamiento que incluyen corticoides tópicos, intralesionales y sistémicos, retinoides, fototerapia, inmunomoduladores tópicos y en casos graves o resistentes al tratamiento, la ciclosporina, metotrexato y fotoféresis extracorpórea.
Lichen planus (LP) is a chronic inflammatory dermatosis that affectsthe skin, mucous membranes, hair and nails; of unknown aetiology, whose pathogenesis is autoimmune damage mediated by T cells against basal keratinocytes that express autoantigens altered on its surface. It comes with different clinical patterns, such as oralLP, LP annularis, LP linearis, LP, LP verrucosus, bullosa LP, LP pigmentosus, LP actinicus. Classical presentation is characterized bypolygonal papules or plaques, pruritic, violet colour, glossy surface, drained by whitish stretch marks, characteristically distributed in symmetrical form especially in surface flexors of the wrist, ankles and thighs. It evolves by outbreaks and its course is self-limited, resolving in a period of months to years, but may persist indefinitely. There are multiple treatment options including steroids topics, miscellaneous and systemic, retinoids, phototherapy, immunomodulators topical and in cases of severe or resistant to treatment, ciclosporin, methotrexate and photoferesis extracorporea.
Subject(s)
Humans , Male , Female , Medical Illustration , Lichen Planus/diagnosis , Lichen Planus/etiology , Lichen Planus/history , Lichen Planus/pathology , Lichen Planus/therapy , Education, Medical, ContinuingABSTRACT
El liquen plano lineal unilateral es una rara variante de liquen plano, más común en niños.Existen dos formas de presentación: aquella de distribución metamérica (llamada también zosteriforme) y la que sigue las líneas embrionarias de Blaschko ( liquen plano blaschkoide). Clínicamente se observan lesiones papulosas eritemato-violáceas brillantes, de superficie plana y pruriginosas, de trayecto lineal por lo general unilateral. La histología corresponde a los hallazgos propios del liquen plano. Responde parcialmente al tratamiento con corticoides tópicos, emolientes y antihistamínicos orales, persistiendo hiperpigmentación residual y tendencia a la recurrencia. Presentamos el caso de un varón de 24 años con lesiones de liquen plano lineal distribuidas en la región paraesternal y miembro superior derecho que siguen las líneas dee Blaschko, las cuáles aparecieron 15 días posteriores a un traumatismo de clavícula homolateral (fractura).
Subject(s)
Humans , Male , Adult , Lichen Planus/diagnosis , Lichen Planus/classification , Lichen Planus/etiology , Lichen Planus/pathologyABSTRACT
Las Dermatosis Liquenoides son un grupo de enfermedades frecuentes en Dermatología. La palabra liquen produce confusión a los dermatólogos, pues es utilizada indistintamente para definir un patrón histopatológico de infiltrado linfocítico en banda en la membrana basal, así como también un patrón clínico de pápulas violáceas aplanadas y brillantes. Considerando su frecuencia, es conveniente que los dermatólogos se encuentren bien familiarizados con estos conceptos en orden a realizar diagnósticos precisos y así otorgar tratamientos adecuados a estos pacientes.
Lichenoid dermatoses are a group of diseases frequently seen in dermatology. The word lichen tends to confuse dermatologists because this term describes a histopathological pattern characterized by a band-like lymphocytic infiltrate in the basal membrane, as well as a clinical pattern of flat, violet, shiny papules. Given the high number of patients suffering from this disorder, it is advisable for dermatologists to be well familiarized with these concepts in order to give an accurate diagnosis and suitable treatment.
Subject(s)
Lichen Planus/diagnosis , Lichen Planus/therapy , Clinical Evolution , Diagnosis, Differential , Lichen Planus/epidemiology , Lichen Planus/etiology , Lichen Planus/physiopathologyABSTRACT
BACKGROUND: The epidemiological association of lichen planus (LP) with hepatitis C virus (HCV) infection has been recorded from some countries and HCV RNA3 has been isolated from lesional skin in patients with LP and chronic HCV infection. The observed geographical differences regarding HCV infection and LP could be immuno-genetically related. AIM: To determine whether HCV has a causal relationship with LP. METHODS: Histopathologically proved cases of LP were subjected to antibody to HCV test by the Third Generation Enzyme Immunoassay Kit for the detection of antibody to HCV (Anti-HCV) in human serum or plasma. They were routinely screened in the virology department by the reagent kit, HIVASE 1 + 2, adopting the "direct sandwich principle" for the assay to detect antibodies to HIV-1 and/or HIV-2. There were 150 age and sex matched controls (not suffering from LP) and HIV-I and II negative, and negative for HCV. RESULTS: Of the 104 patients studied only 2 patients (1.92%) of generalized LP with disease duration of more than 3 months were found to be positive for antibodies to HCV. This was not a significant finding and no statistical methods, e.g. Chi square test etc. could be applied. CONCLUSION: Hepatitis C virus is not significant to the causation of LP in India.
Subject(s)
Adolescent , Adult , Aged , Case-Control Studies , Child , Child, Preschool , Female , Hepacivirus/pathogenicity , Hepatitis C/complications , Humans , Infant , Infant, Newborn , Lichen Planus/etiology , Male , Middle AgedSubject(s)
Humans , Male , Female , Lichen Planus/etiology , Lichen Planus/psychology , Lichen Planus/therapyABSTRACT
Objetivo: Realizar una revisión bibliografíca del virus de la hepatitis C (VHC) y de las manifestaciones dermatológicas que pueden desencadenarse en los pacientes afectados por este virus. Observaciones: El VHC es actualmente reconocido como uno de los principales agentes causales de enfermedad hepática crónica. La infección viral suele acompañarse de manifestaciones dermatológicas en un gran número de casos. La patogénesis de estos cuadros cutáneos puede estar asociada directamente a la presencia viral, tal como ocurre en el eritema necrolítico acral, considerado actualmente como una patología específica del VHC. Otros cuadros, como la crioglobulimenia mixta, el liquen plano, la sialoadenitis, la urticaria crónica, la enfermedad de Behcet, el eritema polimorfo y nodoso (entre otras patologías), responden a mecanismos inmunológicos. Un segundo grupo, representado por la porfiria cutánea tarda y prurito, responde a mecanismos no inmunológicos. Tambien debemos incluir como manifestaciones dermatológicas del VHC a las farmacodermias generadas por la terapia antiviral con interferón, que desencadena patologías como psoriasis, liquen plano, síndrome de Sjögren, y la asociación del interferón con ribavirina, responsables de reacciones fotoalérgicas. Presentamos una nueva clasificación de la manifestaciones cutáneas del VHC, que facilita la compresión de las mismas desde el punto de vista etiopatogénico, a partir de la revisión bibliográfica realizada
Subject(s)
Humans , Carcinoma, Hepatocellular/etiology , Liver Cirrhosis/etiology , Skin Diseases, Viral/etiology , Hepacivirus/isolation & purification , Hepatitis C, Chronic/epidemiology , Hepatitis C/complications , Hepatitis C/drug therapy , Disease Progression , Ribavirin/adverse effects , Cryoglobulinemia/virology , Erythema Multiforme/etiology , Lichen Planus/etiology , Porphyria Cutanea Tarda/etiology , Pruritus/etiology , Psoriasis/etiology , Risk Factors , Urticaria/etiologySubject(s)
Humans , AIDS-Related Opportunistic Infections , Dermatology/classification , Drug Hypersensitivity/complications , Drug Hypersensitivity/etiology , Hepatitis C, Chronic/complications , Hepatitis C , Hepatitis C/complications , Lipodystrophy/etiology , Lymphoma, AIDS-Related , Acquired Immunodeficiency Syndrome/complications , Cryoglobulinemia/complications , Cryoglobulinemia/etiology , Lichen Planus/complications , Lichen Planus/etiology , Porphyria Cutanea Tarda/complications , Porphyria Cutanea Tarda/etiology , Ribavirin/adverse effects , Ribavirin/therapeutic use , Sialadenitis/complications , Sialadenitis/etiologySubject(s)
Mouth Neoplasms/classification , Mouth Neoplasms/diagnosis , Mouth Neoplasms/etiology , Mouth Neoplasms/physiopathology , Erythroplasia/diagnosis , Erythroplasia/etiology , Leukoplakia, Oral/diagnosis , Leukoplakia, Oral/etiology , Leukoplakia/etiology , Leukoplakia/physiopathology , Lichen Planus/diagnosis , Lichen Planus/etiology , Lichen Planus, Oral/diagnosis , Lichen Planus, Oral/etiologyABSTRACT
Presentamos dos pacientes con carcinoma espinocelular ubicado sobre lesiones de liquen plano oral de larga evolución. Se discute la posibilidad de transformación maligna del liquen plano oral
Subject(s)
Humans , Male , Female , Adult , Aged , Carcinoma/complications , Lichen Planus/etiology , Mouth Neoplasms/diagnosis , Tongue/pathologySubject(s)
Humans , Male , Child , Epidermis/ultrastructure , Lichen Planus/etiology , Microscopy, Fluorescence , Lichen Planus/diagnosisABSTRACT
Com o objetivo de estudar o comportamento clínico-epidemiológico e comparar os resultados obtidos com a literatura médica mundial, foi realizada uma análise retrospectiva de 160 casos de líquen plano, selecionado entre 201.723 pacientes portadores de dermatoses diversas, atendidos no ambulatório de Dermatologia do Hospital Universitário Antônio Pedro (HUAP). Niterói, Rio de Janeiro, entre 1973 e 1988 (16 anos). A amostra foi representada por 46 pacientes do sexo masculino (28,75//) e 114 do sexo feminino (71,25//), sendo 86 brancos(53,75//), 27 negros (16,87//) e 47 pardos (29,35//), com idades variando de quatro meses a 83 anos