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目的:比较经典扁平苔藓与色素性扁平苔藓常见皮肤镜的特征。方法:选取13例经典扁平苔藓和6例色素性扁平苔藓患者共99处皮损进行皮肤镜检查并对其特征进行比较。结果:经典扁平苔藓常见的皮肤镜特征有Wickham纹,以片状模式为主的黄棕色色素结构和点状、线状及球状等血管;色素性扁平苔藓常见的皮肤镜特征有以点状、球状模式为主的蓝灰色、黄棕色色素结构和毛囊角栓。结论:皮肤镜可用于经典扁平苔癣和色素性扁平苔藓的辅助诊断。 相似文献
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Belfiore P Di Fede O Cabibi D Campisi G Amarù GS De Cantis S Maresi E 《The British journal of dermatology》2006,155(5):994-998
BACKGROUND: Lichen planus (LP) is a mucocutaneous inflammatory dermatosis that frequently involves the oral and genital mucosae. Patients with LP affecting these sites are often seen by oral medicine specialists or gynaecologists who work in isolation and depend heavily on histopathologists to help them in confirming the diagnosis. There are few studies in the literature combining the experiences of these specialists who share the care of patients with both oral and genital LP. OBJECTIVES: To estimate the prevalence of vulval LP (VLP) in a cohort of patients with histologically confirmed oral LP (OLP). METHODS: The study group consisted of 42 women histologically diagnosed with OLP. The mean age was 60.5 years (range 27-81). They underwent genital examination, colposcopy and vulvoscopy. For the histological confirmation of clinical VLP biopsies were performed whenever a clinical lesion was found. Oral and genital biopsy specimens were processed through histological and immunohistochemical staining. Histological diagnoses of LP were made according to the modified World Health Organization histopathological criteria proposed by van der Meij and van der Waal for the diagnosis of OLP, and extended to VLP. Patients with clinical evidence, but without the histological confirmation of OLP and VLP, were excluded from the study group. RESULTS: Thirty-two vulval and one vaginal biopsy specimens were obtained. Histological diagnoses were confirmed in 24 of 32 (75%) patients who underwent a vulval biopsy: these represent 57% (24 of 42) of the study group. Of the 12 patients free of symptoms such as itching, burning and dyspareunia, but with clinical vulval lesions, 11 (92%) had histological confirmation of VLP. Vulval lichen sclerosus was ascertained in five of 32 (16%) cases. CONCLUSIONS: This study showed a 57% prevalence of VLP in selected patients with OLP. The high prevalence of VLP of 92% in the women who were free of vulval symptoms confirmed the usefulness of this careful integrated approach. 相似文献
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目的:研究IL-22在扁平苔藓皮损中的表达,探讨其在扁平苔藓疾病中的作用。方法:免疫组化检测IL-22在30例扁平苔藓皮损和10例正常皮肤组织中的表达。结果:在扁平苔藓皮损中IL-22主要表达于表皮全层的角质形成细胞和真皮浅层浸润的淋巴细胞胞质,在正常皮肤中IL-22主要表达于基底层附近的角质形成细胞,IL-22在扁平苔藓皮损的表达水平明显高于正常皮肤(P<0.01)。结论:IL-22在扁平苔藓发病中可能起一定作用。 相似文献
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Perforin expression in peripheral blood lymphocytes and skin-infiltrating cells in patients with lichen planus 总被引:2,自引:0,他引:2
Prpić Massari L Kastelan M Gruber F Laskarin G Sotosek Tokmadzić V Strbo N Zamolo G Zauhar G Rukavina D 《The British journal of dermatology》2004,151(2):433-439
BACKGROUND: Current evidence suggests that lichen planus is a T-cell-mediated autoimmune disease in which cytotoxic mechanisms have been poorly investigated. OBJECTIVES: We investigated the expression of perforin in subpopulations of peripheral blood lymphocytes (PBL) in exacerbation and remission phases of the disease as well as in skin lesions. METHODS: We performed a simultaneous detection of perforin (intracellular molecule) and cell surface antigens on PBL by flow cytometry, and skin lesions were investigated by immunohistochemistry. RESULTS: The most interesting finding was a significant increase of perforin expression in cytotoxic T lymphocytes (CD3+ perforin+ cells) in the exacerbation phase of disease (P < 0.05), which was mostly located in the CD8+ subpopulation (CD8+ perforin+) (P < 0.01). Using immunohistochemistry we confirmed the infiltration of T lymphocytes in skin lesions, especially of CD4+ and CD8+ phenotypes, compared with uninvolved (P < 0.05) and healthy skin (P < 0.01). The expression of perforin was also significantly higher in lesional skin compared with nonlesional and healthy skin (P < 0.05). CONCLUSIONS: Our results clearly show the upregulation of perforin expression in peripheral blood as well as in lesions of patients with lichen planus and therefore suggest an important role for perforin in this autoimmune disease. 相似文献
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Lichen sclerosus (LS) and lichen planus (LP) are both immunologically mediated diseases with a preference for the genitalia. The basic principles of management of vulval LS and vulvovaginal LP are the same and involve explanation of the disease, emphasizing the chronic nature of the condition and outlining treatment options. The main difference between the two conditions is that LP has a propensity to involve the mucous membranes including the mouth and vagina which are rarely affected in LS. First‐line treatment for LS is a super‐potent topical corticosteroid ointment which has a high response rate. Erosive vulvovaginal LP is more challenging to treat. Second‐line therapies include topical calcineurin inhibitors and systemic agents. There is limited evidence for systemic treatments for both conditions. The risk of vulval squamous cell carcinoma (SCC) is increased in both LP and LS, and it is not known how treatment affects this risk. We recommend teaching self‐examination and longitudinal evaluation. 相似文献
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Lichen planus is a common inflammatory disease but its perforating variety is not so common and it has been described in small number of text and articles. Here we reported a case of plantar lichen planus where there was a history of discharge of dark grains from the sole of foot and diagnosing the disease as eumycetoma of dark grains repeated antifungal therapy could not resolve the lesions and histopathologically it showed the classical pictures of lichen planus. Collaborating the clinical and histological features we have diagnosed the case as perforating lichen planus but Verhoeff-Van Gieson stain could not elucidate the perforating channel which ot difficult to delineate and often missed. So, we have put the diagnosis of plantar lichen planus and treated with intramuscular triamcinolone and the lesions resolved. 相似文献
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Vulvo-vaginal lichen planus is a condition which imposes a significant burden of symptoms and sequale. There is a paucity of knowledge and evidenced-based management with significant diagnostic delay prior to appropriate treatment being common. There remains great variability in clinician practice in the context of limited knowledge. This clinical review presents current evidence on the clinicopathological features, practical assessment and management options. Learning points include characterization of this chronic, burdensome clinical entity that has no standardized diagnostic or management protocols. We provide practical clinical conclusions based on current knowledge and identify areas for future research to improve patient outcomes. 相似文献
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We herein report a case of a rare variety of the acute eruptive form of lichen planus. The patient was a 51-year-old male who developed an intensely pruritic eruption on the lower legs which spread rapidly to all four extremities and trunk within a few months. The papulosquamous lesions were more than ten thousand in number. Topical steroid, cyclosporine, and systemic griseofulvin treatments were ineffective. However, there was a dramatic response to oral etretinate. 相似文献
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Lichen planus (LP) is an incompletely understood T‐cell mediated auto‐immune dermatosis. When LP involves the genitalia it may present as painful, pruritic erosions that can be exquisitely tender, causing distress and genitourinary and sexual dysfunction. Management of erosive genital LP is often suboptimal. Despite higher order evidence demonstrating the efficacy of oral acitretin in the management of cutaneous and oral LP, it still features below other immunosuppressive and immunomodulatory therapies in many clinicians’ therapeutic ladder. We present a case of severe erosive penile LP, successfully treated with oral acitretin after topical and oral corticosteroids failed to induce remission. 相似文献
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Francesca Spirito DDS Vito Carlo Alberto Caponio DDS PhD Eleonora Lo Muzio DDS Giuseppina Campisi DDS Andrea Santarelli DDS Lucio Lo Russo DDS PhD Corrado Rubini MD Gianfranco Favia MD Luisa Limongelli DDS Noemi Coppola DDS PhD Lorenzo Lo Muzio MD PhD Stefania Leuci DDS PhD 《Pediatric dermatology》2023,40(3):489-493
Oral lichen planus usually occurs in adults; there are no clear data regarding the incidence and the clinical features of oral lichen planus in children. This paper reports clinical findings, treatments, and outcomes of 13 Italian patients with oral lichen planus in childhood diagnosed between 2001 and 2021. The most common finding was keratotic lesions with reticular or papular/plaque-like patterns, confined to the tongue in seven patients. Although oral lichen planus in childhood is rare and the malignant transformation index is unknown, specialists must be aware of its characteristics and oral mucosal lesions must be correctly diagnosed and managed. 相似文献
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目的:分析36例扁平苔藓(LP)的临床、组织病理(HP)、免疫病理(IF)、免疫印迹特点。方法:回顾分析36例LP的临床资料,HPI、F、免疫印迹检查结果。结果:36例LP中男18例,女18例,年龄12~63岁,病程1周至20年。HP诊断LP的敏感性是72.5%,一些特殊类型如色素性LP、光化性LP、肥厚性LP、毛发LP、大疱性LP、LE/LP重叠综合征等各有其特点。IF诊断LP的敏感性是75%,在IF中,Ig、C3各有11例和10例在基底膜带(BMZ)沉积,其中2例血清中检测出抗BMZ抗体。免疫印迹检查中,在表皮提取的抗原上4例类天疱疮样扁平苔藓(LPP)均出现阳性反应条带,其中2例240 kDa,2例200 kDa,3例180 kDa。结论:LP并非少见,其临床类型很多,HP和IF检查是确诊LP的主要依据。泼尼松、氨苯砜、反应停联合治疗LP有肯定效果。 相似文献
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Wolf's isotopic response: a case of zosteriform lichen planus 总被引:1,自引:0,他引:1
Lichen planus is a lichenoid disorder characterized by shiny, flat papules. In addition to the classical appearance, there are several variants. Zonal or zosteriform lesions have been described. A 25-year-old male with a complaint of increasing numbers of erythematous swellings on his left groin for twenty days was admitted to our out-patient clinic. He had a history of herpes zoster in the same localization which had been treated with topical acyclovir two weeks prior to his admission. Dermatological examination revealed multiple, shiny, erythematous, umblicated papules localized to the left inguinal region in a linear pattern. A biopsy was taken from the lesions. According to the clinical and pathological findings the diagnosis was zosteriform lichen planus. Zosteriform lichen planus is a rare variant of lichen planus; its differentiation from zona zoster and other linear dermatoses is difficult. We presented our case because of its rarity as a variant of lichen planus and its appearance in the area of healed herpes zoster as an isotopic response. 相似文献
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A 28-year-old male with histologically proven psoriasis vulgaris was administered oral 8-methoxypsoralen UVA therapy (PUVA). The plaques of psoriasis gradually responded to treatment, however numerous pruritic, violaceous papules over the right forearm and left thigh developed 5 months after starting PUVA (45 sittings with a cumulative dose of 156 J/cm(2)). Histopathologic examination of these lesions was compatible with the diagnosis of lichen planus (LP). On stopping PUVA therapy, the lesions subsided in one month. This case emphasizes the hypothesis that cell injury caused by PUVA therapy could expose some sequestered antigens to autoreactive lymphocytes and induce lichen planus. 相似文献
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Ramírez P Feito M Sendagorta E González-Beato M De Lucas R 《The Australasian journal of dermatology》2012,53(1):e10-e13
Actinic lichen planus (ALP) is a photosensitive variant of lichen planus, affecting mainly young adults of Middle Eastern descent. We report a case of ALP in a 9-year-old Colombian girl with an excellent response to hydroxychloroquine and photoprotection. 相似文献