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We present a case of vesicular linear lichen planus in a 62-year-old woman. This unusual presentation of lichen planus and other conditions in the differential diagnosis are discussed.
Although reports in the literature are sparse, a definite relationship exists between nail anomalies and lichen planus. Ungual lichen planus may occur without any mucocutaneous signs, as has been documented by histologic studies. It may be the initial and most important clinical manifestation of the disease process, and permanent anonychia may result unless corticosteroid therapy is initiated promptly. Increased awareness of nail involvement will result in a more frequent diagnosis and better understanding of the disorder.
We describe a 67 year old woman who suffers from lichen sclerosus et atrophicus. The clinical and histologic findings are mixed with those of lichen planus or respectively the alterations of both diseases.
A 51-year-old man was treated for histologically proven chronic hepatitis C with 3 MU of recombinant interferon-alpha-2a three times a week. Before interferon therapy, a mild lichen planus (hypertrophic variant) had been diagnosed, which exacerbated within 6 weeks of treatment to a severe erosive oral form. Then interferon therapy was stopped because local measures did not improve oral lesions. However, the patient tolerated interferon therapy well, and the initially four-fold elevated aminotransferase levels returned to normal. Nine weeks after discontinuation of interferon therapy, nearly all the buccal mucous membrane lesions had disappeared. But 8 weeks after withdrawal of interferon, aminotransferase levels rose again to six times the normal range. Treating physicians should know that a pre-existing lichen planus would potentially exacerbate, as a side effect of interferon-alpha-2a therapy of chronic hepatitis. However, further observations are needed to decide its clinical relevance.
The results of a biomonitoring study carried out in the Municipality of Colle di Val d'Elsa (central Italy), using the diversity of epiphytic lichens and the accumulation of selected elements in thalli of the lichen Evernia prunastri transplanted in two urban sites are reported. The results indicate that the survey area suffers from different types of pollution. The main air pollutants are NO( X ) and Pb. Vehicular traffic and domestic heating are the main sources of the former, and traffic and a crystal factory of the latter. Furthermore, most study area is eutrophicated due to diffuse agricultural activities and the presence of pig and sheep stockfarms.
Lectins are used to study four cases of keratosis pilaris, four of lichen spinulosus, 11 of porokeratosis, 8 of striated lichen and one case of pityriasis rubra pilaris, with the aim of providing data to improve knowledge of the histogenesis of these processes.
Clinical, histological and ultrastructural features in five cases of lichen aureus are descirbed. This rare condition with ages ranging here from 6 to 31 consists of a pigmented papular and purpuric eruption. Unilaterally, trunk or limb may be involved, in a possible systematized distribution. The microscopic picture is characterized by a dense histiocytic and lymphocytic infiltration in the upper part of the dermis; extravasation of erythrocytes and iron pigment in the histiocytes are often noticed. In fine structure most cells of the dermal infiltrate are histiocytes (or macrophages) with numerous worm-like structures and even typical Langerhans granules in three cases; histiocytic cells; histiocytes are frequently seen in apposition to lymphocytes. In all these cases, no sign of histiocytosis X is found. Classification of lichen aureus in the group of idiopathic pigmented purpuric eruption is proposed.
Although cases of lichen planus (LP) associated with hepatitis C virus (HCV) infection have been described, the association between the two diseases has not been established because the geographic origin of patients could be an important factor in HCV prevalence in patients with LP. The serum samples of 78 consecutive patients with cutaneous and/or mucous LP and 82 control patients were analysed for the presence of antibodies to HCV by enzyme-immunoassay and for the presence of antigens of HCV by two-stage polymerase chain reaction (PCR). The clinical features of patients with LP associated with HCV infection were compared with patients with LP without HCV infection. Sixteen of the 78 (20%) patients had anti-HCV antibodies. In 13 of these 16 cases (81%), HCV-RNA was detected by PCR in serum samples. In the 82 control patients, anti-HCV antibodies was observed in two (2.4%) patients. We have found a statistically significant association (P < 0.05) between erosive LP and HCV infection. We conclude that the high prevalence of HCV-RNA in patients with LP provides some evidence for the role of HCV in the pathogenesis of LP. Our results suggest an association between erosive LP and HCV infection.
Eight compounds isolated from an extract of Central Asian lichens comprised new glucosides having murolic, protoconstipatic and allo-murolic acids as the aglycones and a saccharide moiety linked at C-18 made up of four glucoses. The structures were elucidated using extensive spectroscopic analysis (1D and 2D NMR, MS, IR, UV and CD) and by chemical methods.
The compounds isolated from the extract of Central Asian lichen (Acarospora gobiensis H. Magn.) comprised three new glycosides having 18-hydroxy-dihydroalloprotolichesterinic, 18-hydroxy-neodihydroprotolichesterinic and 18-hydroxy-dihydroprotolichesterinic acids as aglycones and a di- or trisaccharide moiety linked at C-18 and at the carboxylic group. These compounds, called gobienines A-C, were found to be di- or trisacharides forming a macrolactone with the aglycone. The structures were elucidated by using extensive spectroscopic analysis (1D and 2D NMR, MS, IR and ORD) and chemical and enzymatic methods.
In order to evaluate if oral lichen planus (OLP) may be regarded as a marker of even unknown liver disease, 96 incident OLP cases were screened through anamnestic, laboratory, instrumental investigations and gastroenterology consultation. The frequency of hepatopathies was 23/96 (24%): 7 had cirrhosis, 3 had chronic active hepatitis, 2 had chronic persistent hepatitis, 10 steatosis and 1 had undetermined liver disease. Eleven of these 23 patients (48%) had unknown hepatopathies, although five of them had severe liver disorders (cirrhosis, chronic hepatitis). Forty-four of 73 patients without definite liver disorders (60%) had at least one abnormal liver parameter. This results confirm frequent association of OLP with hepatic damage and moreover it shown that OLP may be an important clinical sign of symptomless hepatopathies.
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BACKGROUND: The cause of lichen sclerosus et atrophicus (LSA) is unknown, but on the penis it is associated with chronic occlusion, that is, phimosis. Microscopic changes of LSA were seen unexpectedly in two acrochordons. OBJECTIVE: Our purpose was to further characterize this phenomenon. METHODS: A total of 449 acrochordons examined in our histopathologic laboratory in the past 2 years were studied for changes of LSA, and clinical data were collected. RESULTS: Eight additional cases were found. All of the acrochordons exceeded 0.5 cm, and three were 1 cm or larger. At least six were under chronic occlusion or pressure. The dermal changes of LSA predominated over the epidermal changes. All showed collagenous homogenization, sclerosis, and inflammation. Elastic fibers were characteristically decreased. CONCLUSION: These observations strengthen the evidence that LSA in flaccid skin may be caused by chronic occlusion.
A 14-year old boy developed lesions, which clinically and histopathologically corresponded to the rare condition known under the term of lichen purpuricus seu aureus. The disease can be classified close to purpura pigmentosa progressiva.
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