误诊为白癜风的颈部硬化萎缩性苔藓一例

患者女,20岁,因颈部局限性硬化性斑块7个月、水疱6个月就诊。患者于7个月前发现右侧颈部出现一蚕豆大小浅褐色斑块,表面褶皱,局部皮肤变硬,无瘙痒、疼痛感,未予重视……     

桥本甲状腺炎合并白癜风、硬化萎缩性苔藓一例

患者女,22岁。1年前于右侧额部头皮及右侧面颊部出现片状白斑,同时伴有右侧额部白发。就诊前4个月出现右面部、颈部、躯干、上肢、下肢萎缩性斑片,伴有色素脱失和色素沉着,不伴疼痛和瘙痒,皮疹逐步扩大,局部变硬。近来左腹部及左膝上方出现类似硬化萎缩性皮损。家族中无类似病史。体检：神清,营养中等,双侧甲状腺I度肿大,质韧,无明显压痛,左侧甲状腺可触及结节。其他各系统检查无异常。皮肤科情况：右侧额部头皮及右侧面颊部片状白斑,右侧额部白斑局部毛发呈白色。右侧面颈部、右侧躯干、右侧上肢及下肢、左腹部、左膝上方大腿部沿皮纹走向可见多个大小不一的萎缩性斑片,表面微皱,羊皮纸样萎缩,触之质硬（图1）……     

硬化性苔藓1例

临床资料患者,男,36岁。主因左腰腹部出现淡白色斑伴瘙痒1年,于2009年9月1日来我院就诊。患者1年前左腰腹部出现淡红色斑片,偶有瘙痒,逐渐     

硬化性苔藓发病机制的研究进展

 硬化性苔藓(LS)是一种发病机制复杂且尚未明了的疾病,目前往往采取对症治疗的方式,但效果不理想。国内外已从不同方面对LS的机制开展研究,其中在免疫、遗传方面研究较丰富,主要涉及T淋巴细胞、炎症及纤维化相关细胞因子、人类白细胞抗原等;此外,也有研究表明LS的发生与代谢因素及微生物因素存在关联。本文综述近年来有关LS发病机制的研究,为今后治疗上的突破提供新思路。     

足底部硬化萎缩性苔藓一例

患者女,59岁,外阴萎缩性白斑5年及足部萎缩性硬化性浅色斑块2年于2017年8月23日就诊。5年前无明显诱因外阴出现淡白色萎缩性斑片,未诊治。2年前足背、足底出现瓷白色萎缩性斑片,足底部皮疹逐渐增多、增大,偶有疼痛感,走路时加重……     

Extragenital bullous lichen sclerosus: A case report and literature review

Lichen sclerosus (LS) is a chronic dermatosis characterized by atrophic white papules or plaques, most commonly occurring on the anogenital skin. Blisters have been rarely described developing in the background of extragenital LS. A 74-year-old woman with a 4-year history of sclerotic patches on the trunk showed a flaccid bulla on the lower back for 3 months. The histopathological finding of the skin biopsy was consistent with the diagnosis of bullous LS. In this paper, we present this uncommon case, review the literature on extragenital bullous LS, discuss the pathogenesis, and provide some treatment options for the case.     

Oxidative stress is implicated in the pathogenesis of lichen sclerosus

BACKGROUND: Lichen sclerosus (LS) is a chronic inflammatory skin disease of unknown aetiology which can be associated with secondary malignancies. Recent evidence supports an autoimmune basis for this disorder, as demonstrated by autoantibodies to extracellular matrix protein 1 (ECM-1). The pathophysiological mechanisms leading to autoimmunity and carcinogenesis are poorly understood. OBJECTIVES: We hypothesized that oxidative stress, which has been demonstrated to be involved in the pathogenesis of several autoimmune and malignant disorders, contributes to these processes in LS. METHODS: Skin biopsies from 16 patients with untreated, histologically confirmed vulval LS were examined immunohistochemically using antibodies against the lipid peroxidation products malondialdehyde and 4-hydroxynonenale and against the oxidative DNA damage marker 8-hydroxy-2'-deoxyguanosine. Protein carbonyls as markers of protein oxidation were visualized using the dinitrophenylhydrazone method. Expression of antioxidant enzymes was investigated. Normal vulval tissue from 16 subjects served as control. RESULTS: In vulval LS tissue a significant increase of lipid peroxidation products was found particularly within the basal cell layers of the epidermis, thus colocalizing with ECM-1. Oxidative DNA damage was detected throughout LS biopsies. Intriguingly, protein oxidation was significantly increased within the dermis of LS lesions, indicating oxidative protein damage in the areas of sclerosis and inflammation. The enzymatic antioxidant defence in LS was found to be significantly disturbed. CONCLUSIONS: This is the first study to demonstrate oxidative damage to lipids, DNA and proteins in LS, revealing a novel pathophysiological mechanism which may contribute to sclerosis, autoimmunity and carcinogenesis. Therapeutic strategies using antioxidants might be a useful new approach in the treatment of LS and could also help to prevent secondary malignancies.     

外阴硬化性苔藓合并汗管瘤1例

患者女，50岁，因外阴白色斑块伴瘙痒2年，加重1个月于2019年7月19日来我科就诊。患者2年前阴蒂部位皮肤出现色素减退，伴剧烈瘙痒，就诊于当地医院，考虑为阴道炎，给予口服药物治疗（具体不详）2周，瘙痒稍有减轻，但时有反复，未行进一步诊治……     

儿童线状硬化萎缩性苔藓一例

患儿女,4岁。因右颈肩部皮肤硬化萎缩2年就诊于首都儿科研究所附属儿童医院皮肤科。患儿2年前无明显诱因下右颈肩部出现散在米粒大小红色丘疹,自觉瘙痒,后皮疹逐渐增多,融合成斑块,局部变硬变薄,出现羊皮纸样皱缩,表面脱屑,无吞咽困难、呼吸困难等不适……     

肛门生殖器外硬化萎缩性苔藓一例

患者男,56岁。因躯干及四肢群集性白色皮疹半年余就诊于我院皮肤科门诊。患者于半年前右肩部出现群集性白色皮疹,表面有光泽及均匀分布的黑头粉刺样角质栓,密集而不融合,坚硬,四周绕以紫红色晕,躯干、双前臂屈侧及胫前逐渐出现类似皮损。随着时间推移,皮损表面出现轻度萎缩,部分融合成较大斑块,触之硬度较前减轻,并逐渐消退,到我院就诊时右肩部原有皮损已消退,不遗留任何痕迹……     

An interesting case of colocalization of segmental lichen planus and vitiligo in a 14-year-old boy

A 14‐year‐old boy had segmental vitiligo (L_3?4) on the right thigh and leg for 4 years, and was advised to apply topical clobetasol propionate, 0.05%, in the night, with daily sun exposure for 10 min, as he refused to comply with topical psoralens. As there was no response to therapy even after 3 months, the patient stopped the steroid cream but continued with the sun exposure. Subsequently, the patient noticed gradual‐onset, itchy, violaceous, pigmented, raised lesions superimposed on the vitiligo macules. Cutaneous examination revealed violaceous, polygonal papules, 0.5 × 0.5 cm in size, some of which coalesced to form discrete violaceous plaques, confined to areas of vitiligo, with a clear‐cut demarcation from normal skin ( Fig. 1 ). The scalp, palms, soles, nails, and mucosa were normal. Histopathology of the polygonal papules revealed hyperkeratosis, wedge‐shaped hypergranulosis, irregular acanthosis with saw toothing of the rete ridges, basal cell liquefaction, and a band‐like lymphocytic infiltrate ( Fig. 2 ), consistent with lichen planus. The patient was subsequently prescribed fluticasone propionate (0.05%) ointment once daily for the lesions of lichen planus. There was a marked improvement in the lesions of lichen planus after 1 month.

Figure 1 Open in figure viewer PowerPoint Violaceous papules of lichen planus colocalized on vitiligo macules with associated leukotrichia seen on the right leg     

硬化萎缩性苔藓合并局限性硬皮病一例

患者男,44岁.躯干、四肢皮肤泛发硬化萎缩斑片进行性加重8年,自觉瘙痒.检查见皮损有色素沉着和色素减退,触之有皮革样硬度.口腔黏膜、肛门、外生殖器未见皮损,不伴系统损害,常规实验室检查无异常发现.组织病理显示,表皮角化过度,萎缩变薄,基底细胞液化变性,真皮乳头层见纯一化变性带.真皮中下层胶原纤维增生、致密、红染,轻度玻璃样变.诊断为硬化萎缩性苔藓合并局限性硬皮病.     

大疱性硬化萎缩性苔藓一例

<正>硬化萎缩性苔藓(lichen sclerosus)又称为白色苔藓、白点病、硬斑病性扁平苔藓,是一种病因不明的炎症性皮肤疾病,皮损多表现为境界清楚的瓷白色硬化性丘疹和斑块[1],晚期形成白色硬化萎缩性斑块,少数患者白斑基础上出现张力性水疱、大疱、血疱[2]。本文将对1例大疱性硬化萎缩性苔藓的发病机制、临床表现、病理、鉴别及治疗等方面进行国内外文献的复习及总结。临床资料患者,男,25岁。左肋缘下发现硬化     

外阴硬化性苔藓并发颗粒细胞瘤1例

患者女，65岁，因外阴皮疹伴瘙痒6年余，加重3个月就诊。患者6年前无明显诱因下外阴皮肤瘙痒，局部皮肤变白，反复搔抓，皮肤肥厚皲裂，曾外用多种药膏（具体不详），病情未见好转。近3个月病情加重，左侧大阴唇局部可触及皮下结节，遂就诊。既往健康，无相关疾病家族史。系统检查未见异常……     

Case of sequentially occurring lesions of facial lichen sclerosus following the lines of Blaschko

Extragenital lichen sclerosus (LS) is usually asymptomatic and appears as ivory- or porcelain-white macules, papules and plaques. It is most common on the neck, shoulders and upper portion of the trunk. To date, the linear form of extragenital LS corresponding to the lines of Blaschko on the trunk or limbs has been rarely reported. We describe a 25-year-old Korean woman with sequentially occurring lesions of extragenital LS confined to the face following the lines of Blaschko.