RESUMO
Introducción: El liquen plano (LP) es una enfermedad inflamatoria crónica, de etiología desconocida, que puede afectar la piel, los anexos y las mucosas. Objetivo: Describir las características epidemiológicas y clínicas y el tratamiento realizado en los pacientes con diagnóstico clínico e histopatológico de LP, valorados en el Servicio de Dermatología del Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" en los últimos 33 años. Diseño:Estudio descriptivo, retrospectivo y transversal. Materiales y métodos: Se revisaron las historias clínicas de los pacientes con diagnóstico histopatológico de LP atendidos en el Hospital desde agosto de 1987 hasta febrero de 2020 y se analizaron las variables epidemiológicas, clínicas y de tratamiento. Resultados: Se incluyeron datos de 26 pacientes, 18 de los cuales eran varones (69,3%). La media de edad en el momento del diagnóstico fue de 9,6 años. Presentaron la variedad de LP clásico 24 pacienes (93%). El compromiso ungueal y de la mucosa bucal se observó en 2 pacientes (7,7%). Ninguno tuvo asociación a fármacos ni a infecciones. En cuanto al tratamiento recibido, 4 pacientes (15,4%) tuvieron pérdida del seguimiento; 13 (50%) realizaron tratamiento tópico; 6 (23%), tratamiento sistémico y 3 (11,5%), tratamiento combinado. El promedio de seguimiento fue de 6 meses y se obtuvo una respuesta favorable en el 68% de los pacientes. Conclusiones: El LP es una patología de baja frecuencia en la infancia. No se encontró asociación a medicamentos ni a enfermedades infecciosas como se describe en la población adulta. Su curso es crónico y, en los pacientes que tuvieron un adecuado seguimiento, se obtuvo una buena respuesta al tratamiento indicado.
Introduction: Lichen planus (LP) is a chronic, inflammatory disease of unknown etiology, which can affect skin, adnexal tissues and mucosa. Objective: to describe the clinical, epidemiological characteristics and the treatment received by patients with clinical and histopathological diagnosis of LP, seen at the Dermatology Service of Pediatric Hospital "Prof. Dr. Juan P. Garrahan" in the last 33 years. Design: Descriptive, retrospective and cross-sectional study. Materials y methods: We reviewed the clinical history of patients with histopathological diagnosis of LP that were treated at our hospital from August 1987 to February 2020 and analysed the epidemiological, clinical and treatment variables. Results: Data of 26 patients were included in this study 18 of which are males (69.3%). The mean age of diagnosis was 9.6 years. 24 patients (93%) presented the classical type of LP. Ungual and mucosal compromise were observed in 2 patients (7.7%) and none had associations with infections or drugs. Regarding treatment, 4 patients (15.4%) did not continue follow-ups, 13 patients (50%) had topical treatment, 6 (23%) had systemic treatment and 3 patients (11.5%) received combined treatment. The average follow-up time was 6 months and 68% of patients had favorable outcome. Conclusions: LP is an uncommon pathology in children. During this study we did not find any etiologic relations with use of drugs or infectious diseases as is described in de adult population. Its course is chronic and in the patients that had a proper follow-up a good response to the indicated treatment was obtained.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Líquen Plano/epidemiologia , Fototerapia , Argentina/epidemiologia , Estudos Transversais , Estudos Retrospectivos , Corticosteroides/uso terapêutico , Líquen Plano/diagnóstico , Líquen Plano/patologia , Líquen Plano/terapiaRESUMO
Introducción: La Medicina Natural y Tradicional constituye hoy en día una necesidad, no como opción terapéutica, sino por su valor intrínseco, al tratar al paciente de forma holística, además de su inocuidad y bajo costo. Objetivo: Evaluar la evolución clínica en pacientes tratados con Esencias florales de Bach y costo del tratamiento. Métodos: Se realizó un estudio de evaluación de la evolución de pacientes con diagnóstico clínico de Psoriasis, Vitíligo y Liquen plano, los cuales fueron tratados con Esencias florales de Bach en el período de marzo del 2016 a marzo del 2018, en Consulta Multidisciplinaria Dermatología- Medicina Natural Tradicional- Psicología, del Policlínico Docente Héroes del Moncada; del municipio de Cárdenas, Matanzas. Los datos fueron recopilados y procesados en el software Excel, atendiendo a variables demográficas, se tuvieron en cuenta los criterios de inclusión, exclusión y consentimiento informado de pacientes vírgenes de tratamiento convencional. Las esencias florales utilizadas fueron: Crab Apple, Willow, Verbain, Impatiems, Walnut, Cherry Plum, Sweet Chestnut, Chicory, Clematis, Beech, Star of Bethlehem, While Chestnut y Larch de forma oral y tópica. Resultados: En el sexo femenino predominó el Vitíligo y Psoriasis. La ansiedad estuvo presente en 17 pacientes, en cuanto a la evolución, 14 pacientes asintomáticos y 14 mejorados. El costo de las Esencias florales oral fue gratuito y el tópico muy bajo. Conclusiones: La evolución clínica fue favorable y el costo del tratamiento muy bajo, lo cual demostró la efectividad de la terapia floral en la muestra(AU)
Introduction: Natural and traditional medicine is nowadays a necessity, not as a therapeutic option, but because of its intrinsic value, since it allows to treat the patient holistically, in addition to its innocuousness and low cost. Objective: To assess the clinical evolution and cost of treatment in patients treated with Bach flower essences. Methods: A study was carried out to assess the evolution of patients with a clinical diagnosis of psoriasis, vitiligo and lichen planus, who were treated with Bach flower essences in the period from March 2016 to March 2018, at a multidisciplinary consultation of dermatology, traditional natural medicine and psychology from Héroes del Moncada Teaching Polyclinic in Cárdenas Municipality, Matanzas Province. The data were collected and processed in the EXCEL software, taking into account demographic variables, together with inclusion and exclusion criteria, as well as informed consent of patients who had not received any conventional treatment. The flower essences used, orally and topically, were crab apple, willow, verbain, impatiens, walnut, cherry plum, sweet chestnut, chicory, clematis, beech, star of Bethlehem, white chestnut and larch. Results: The female sex predominated in cases of vitiligo and psoriasis. Anxiety was present in seventeen patients. Regarding evolution, fourteen patients were asymptomatic and the same amount achieved improvement. The cost of the oral flower essences was free and that of the topical ones was very low. Conclusions: Clinical evolution was favorable and the cost of treatment was very low, which demonstrated the effectiveness of flower therapy in the sample studied(AU)
Assuntos
Humanos , Masculino , Feminino , Psoríase/terapia , Vitiligo/terapia , Evolução Clínica/tendências , Essências Florais/uso terapêutico , Líquen Plano/terapiaRESUMO
This is a case report of lichen planus (LP) with multiple system involvement. A 35-year-old female patient was admitted in November 2014 with a 5-year history of painful/difficult sexual intercourse and loss of oral mucosa, and an 8-year history of focal hair loss. Earlier, the patient had been unable to adhere to corticosteroid therapy because of severe adverse side effects. In September 2014, labia minora mucosa defects and stricture of the urethral orifice (with dysuria), vaginal orifice, and vagina were identified. Biopsy was performed and a diagnosis of erosive LP was made. The patient was treated with an oral immunosuppressant (cyclosporine A) and urethral/vaginal dilatation. Urine flow rate and sex life were improved after 6 months and she discontinued medication. Four years later, the patient reported a good overall treatment efficacy. LP can involve multiple systems and should be considered in patients with dyspareunia. Immunosuppressive agents can achieve a satisfactory effect in patients with contraindication to corticosteroid.
Assuntos
Humanos , Feminino , Adulto , Dermatoses do Couro Cabeludo/diagnóstico , Doenças Uretrais/diagnóstico , Doenças Vaginais/diagnóstico , Líquen Plano/diagnóstico , Dermatoses do Couro Cabeludo/patologia , Dermatoses do Couro Cabeludo/terapia , Doenças Uretrais/patologia , Doenças Uretrais/terapia , Doenças Vaginais/patologia , Doenças Vaginais/terapia , Líquen Plano/patologia , Líquen Plano/terapiaRESUMO
O objetivo do presente estudo foi a importância da homeopatia para o tratamento das patologias crônicas que não encontram boa resolução quando abordadas apenas de forma tradicional. Através de estudo de caso foram acompanhados e revisitados 2 casos clínicos com diagnóstico de líquen comprovados por biópsia que foram abordados inicialmente de modo convencional e que após tratamento sem sucesso, buscaram uma alternativa na homeopatia. Houve remissão dos processos crônicos em ambos os casos com bons resultados. Houve restabelecimento rápido duradouro e sem grandes efeitos indesejáveis no longo prazo em ambos os casos relatados, como preconizam os princípios da homeopatia em que "cura é o restabelecimento rápido, suave e duradouro da saúde". A homeopatia pode atuar de forma interdisciplinar junto ao tratamento convencional de doenças crônicas dermatológicas do tipo líquen, melhorando seus resultados. (AU)
The aim of the present study was to establish the relevance of homeopathy for treatment of chronic diseases when conventional treatment does not lead to satisfactory outcomes. We describe 2 cases of lichen confirmed on biopsy initially given conventional treatment. Due to therapeutic failure, the patients sought homeopathic treatment, which induced regression of disease. In both cases, cure occurred rapidly, was long-lasting action and without undesirable side effects, as established in homeopathy principles: "the highest ideal of cure is rapid, gentle and permanent restoration of health." Homeopathy might be considered for interdisciplinary treatment of chronic skin problems, such as lichen, together with conventional approaches to improve therapeutic outcomes.
Assuntos
Humanos , Masculino , Feminino , Criança , Pessoa de Meia-Idade , Arsenicum Album/uso terapêutico , Aurum Metallicum/uso terapêutico , Homeopatia , Líquen Plano/terapiaRESUMO
O líquen plano pilar é desordem rara da ordem das alopecias cicatriciais primárias. Descreve- se um caso de paciente do sexo feminino, portadora de placas eritêmato-descamativas e plugues foliculares em região frontoparietal bilateralmente, associados a teste de tração positivo. Após biópsia compatível com líquen plano pilar, a paciente foi tratada com prednisona associada a clobetasol, apresentando repilação da área acometida. O tratamento dessa patologia é um desafio devido à escassez de dados sobre eficácia das terapêuticas e constante recidiva. Trata-se de quadro irreversível se não for tratado precocemente. É descrito um caso clássico de líquen plano pilar com boa resposta terapêutica, destacando- -se a importância do diagnóstico precoce, já que em fase inicial a maioria das alopecias cicatriciais é não cicatricial, devendo, por esse motivo, ser manejada como emergência em tricologia.
Lichen planopilaris is a rare disorder that belongs to the primary scarring alopecia type. The present study describes the case of a female patient bearing desquamative erythematous plaques and follicular plugs bilaterally in the frontoparietal region, associated with positive pull test. The biopsy's result was consistent with lichen planopilaris and the patient was treated with prednisone associated with clobetasol, with regrowth of the hair in the affected area. The treatment of this pathology is a challenge due to the lack of data on efficacy of therapies and constant recurrence. The picture is irreversible if not treated early. This paper describes a classic case of a case of lichen planopilaris with good therapeutic response, highlighting the importance of early diagnosis, due to the fact that most cicatricial alopecias do not produce scarring in their initial stage and should for this reason be managed as an emergency in trichology.
Assuntos
Humanos , Feminino , Adulto , Líquen Plano/terapia , Líquen Plano/diagnóstico por imagem , Diagnóstico Precoce , Alopecia/diagnóstico por imagemRESUMO
OBJECTIVE: This study aimed to determine a possible correlation between oral mucosal disease and salivary concentrations of the antimicrobial peptides human beta-defensin-1 (hβD-1) and human betadefensin- 2 (hβD-2). METHOD: The present work focussed on the establishment of a reversed phase-high performance liquid chromatography (RP-HPLC) procedure to quantify human beta-defensins (hβD-1 and hβD-2) in saliva samples of patients with oral diseases such as lichen planus (n = 10), Behçet (n = 10) and recurrent apthous stomatitis (n = 10). RESULTS: Linear calibration range for hβD-1 and hβD-2 defensins was 1.67−200 µg mL-1 and 3.13− 100 µg mL-1 with R2 values of 0.9998 and 0.996, correspondingly. The concentration of beta-defensins in saliva was determined by comparing the peak areas of eluted hβD-1 and hβD-2 with that of their standards. The variation of the amount of beta-defensins was evaluated by comparisons of the results obtained from the patients with oral mucosal diseases before and after treatments and the control subjects. The limit of detection (LOD) and limit of quantification (LOQ) were found to be 1.62 µg mL- 1 and 5.39 µg mL-1 for hβD-1 and 0.94 µg mL-1 and 3.13 µg mL-1 for hβD-2, respectively. CONCLUSION: The salivary beta-defensin concentration was significantly higher in patients with oral mucosal diseases than in healthy volunteers; furthermore, in patients with oral mucosal diseases, the concentration was significantly higher before treatment than after treatment.
OBJETIVO: Este estudio tuvo por objeto determinar una posible correlación entre la enfermedad de la mucosa oral y las concentraciones salivales de la beta-defensina humana 1 (hβD-1) y la beta-defensina humana 2 (hβD-2) de los péptidos antimicrobianos. MÉTODO: El presente trabajo estuvo encaminado al establecimiento de un procedimiento de cromatografía líquida de alta eficacia de fase reversa (RP-HPLC) para cuantificar las beta-defensinas humanas (hβD-1 y hβD-2) en muestras de saliva de pacientes con enfermedades orales como el liquen plano (n = 10), Behçet (n = 10), y la estomatitis aftosa recurrente (n = 10). RESULTADOS: El rango de calibración lineal de las defensinas hβD-1 y hβD-2 fue 1.67-200 µg mL-1 y 3.13-100 µg mL-1 con valores R2 de 0.9998 y 996, respectivamente. La concentración de beta-defensinas en la saliva se determinó utilizando el área de sus estándares. La variación de la cantidad de beta defensinas fue evaluada por comparaciones de los resultados obtenidos de los pacientes con enfermedades de la mucosa oral, antes y después de los tratamientos y los sujetos de control. Se halló que el límite de detección (LDD) y el límite de cuantificación (LDC) fueron 1.62 µg mL-1 y 5.39 µg mL- 1 para hβD-1 y 0.94 µg mL-1 y 3.13 µg mL-1 hβD-2, respectivamente. CONCLUSIÓN: La concentración de beta-defensina salival fue significativamente mayor en los pacientes con enfermedades de la mucosa oral que en los voluntarios sanos. Además, en pacientes con enfermedades de la mucosa oral, la concentración fue significativamente mayor antes del tratamiento que después del tratamiento.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Saliva/química , Estomatite Aftosa/metabolismo , Síndrome de Behçet/metabolismo , beta-Defensinas/metabolismo , Líquen Plano/metabolismo , Estomatite Aftosa/terapia , Biomarcadores/metabolismo , Estudos de Casos e Controles , Síndrome de Behçet/terapia , Cromatografia Líquida de Alta Pressão , Líquen Plano/terapia , Mucosa BucalRESUMO
El liquen plano (LP) es una dermatosis inflamatoria crónica que afecta la piel y las mucosas, de etiología desconocida y patogenia autoinmunitaria, mediada por linfocitos T frente a los queratinocitos basales que expresan autoanticuerpos alterados en su superficie. El LP se presenta en diferentes patrones clínicos, como LP anular, LP lineal, LP que sigue las líneas de Blaschko y LP zosteriforme. La distribución zosteriforme es una variedad poco frecuente, que sigue un dermatoma. Se presenta un paciente con LP zosteriforme, de sexo masculino, de 45 años de edad, raza mestiza, con un tiempo de enfermedad de cuatro meses; con erupciones lineales zosteriformes, que afectan la región dorsal, axilar, brazo y cara lateral izquierda del tronco, sin sobrepasar la línea media, correspondiendo a los dermatomas 4, 5, 6, 7, 8. La biopsia efectuada confirmó el diagnóstico de LPzosteriforme. Se revisan los aspectos clínicos y terapéuticos de este caso.
Lichen planus (LP) is a chronic inflammatory dermatosis that affects the skin and the mucous membranes of unknown aetiology and pathogenesis of autoimmune mediated by T cells against basal keratinocytes that express autoantibodies altered its surface. It occurs in different clinical patterns, such as LP annularis, LPlinearis, LP following the lines of Blaschko and LP zosteriforme.The zosteriforme distribution is a rare variety, which follows adermatome. Is a patient of male, 45 years old, mixed race, with a timeof 4 months disease; with linear eruptions zosteriformes, affecting the dorsal, axillary region, arm and left side face of the trunk, without exceeding the median line, corresponding to the dermatomes 4, 5, 6,7, 8. The effected biopsy confirmed the diagnosis of LP zosteriforme. Reviewing the clinical and therapeutic aspects of this case.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ilustração Médica , Linfócitos T , Líquen Plano/patologia , Líquen Plano/terapia , Relatos de CasosRESUMO
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.
Assuntos
Humanos , Masculino , Feminino , Ilustração Médica , Líquen Plano/diagnóstico , Líquen Plano/etiologia , Líquen Plano/história , Líquen Plano/patologia , Líquen Plano/terapia , Educação Médica ContinuadaRESUMO
El liquen plano hipertrófico generalizado es una dermatosis subaguda o crónica e inflamatoria, autolimitada de etiología desconocida, que afecta a la piel, mucosas y anexos cutáneos (uñas y pelo). Es una enfermedad relativamente frecuente en adultos, pero extremadamente rara en niños y se presenta en la población general con una prevalencia menor al 1%. La forma infantil es clínicamente similar a la del adulto, aunque la afectación mucosa es excepcional. Se comunica el caso de un niño de 8 años de edad, con lesiones cutáneas generalizadas de liquen plano, con buena evolución y respuesta a tratamiento con corticoides tópicos.
Generalized hypertrophic lichen planus is asubacute or chronic dermatoses, self-limited, inflammatory of unknown etiology that affects the skin, mucous membranes and skin appendages (nails and hair). It is a relatively common disease in adults, but extremely rare in children and occurs in the general population with a prevalence below 1%. The infantile form is clinically similar to adult, although the mucosal involvement is exceptional. We report the case of a child of 08 years of age, with generalized skin lesions of lichen planus, with good outcome and response to treatment with topical corticosteroids.
Assuntos
Humanos , Masculino , Criança , Líquen Plano , Líquen Plano/patologia , Líquen Plano/terapia , Relatos de CasosRESUMO
Paciente de sexo femenino, de 35 años de edad, raza blanca, con un tiempo de evolución de 5 meses; presenta una erupción lineal zosteriforme, que abarca la región lateral izquierda del troncoa la altura submamaria y se extiende unilateralmente por esta región en la parte anterior del tronco, prolongándose por la linea blanca hasta cerca del ombligo, teniendo una configuración típicamente lineal- zosteriforme y corresponde a los dermatomas 4, 5, 6, 7, 8, y 9. La biopsia efectuada, confirmó el diagnóstico de liquen plano zosteriforme. El liquen plano, es una dermatosis frecuente, que afecta piel y mucosas, pero la distribución lineal zosteriforme, es una variedad poco frecuente. El propósito de este artículo, es para aumentar la casuística de esta variedad, analizar sus aspectos característicos y su tratamiento.
Patient of feminine sex, of 35 years of age, white race, with a time of evolution of 5 months; there presents a linear eruption zosteriforme, which includes the lateral left region of the trunk to the submammary height and spreads unilaterally over this region in the previous part of the trunk, extending for the white line up to near the navel, with typically linear configuration - zosteriforme. Correspondent to the dermatomas 4, 5, 6, 7, 8, and 9.The biopsy, confirmed the diagnosis of flatlichen zosteriforme. The flat lichen, it is afrequent dermatosis, which affects skin and mucous, but the linear distribution zosteriforme, is a slightly frequent variety. The intention of this article, is to increase the casuistry of this variety, to analyze typical aspects and treatment.
Assuntos
Humanos , Adulto , Feminino , Líquen Plano , Líquen Plano/terapia , Relatos de CasosRESUMO
Introdução: Líquen plano é uma doença inflamatória e pruriginosa que afeta pele, mucosas e anexos, podendo apresentar achados clínicos incomuns. Possui etiologia desconhecida e pico de incidência na vida adulta, pouco comum em crianças. Por estas razões, os autores relatam um caso raro, de difícil diagnóstico, no qual uma criança apresentava manifestações cutâneas semelhantes a molusco contagioso. Descrição do caso: VCN, cinco anos, feminina, com lesões pruriginosas pelo corpo, há um ano. Negava história familiar, antecedentes de atopia ou uso de drogas prévias à erupção. Já havia recebido inúmeras medicações, sem melhora. Foi encaminhada ao serviço de Dermatologia da Faculdade de Medicina do ABC onde, ao exame dermatológico, apresentava pápulas violáceas, brilhantes e umbilicadas, disseminadas pelo tegumento, incluindo palmas e plantas, com a presença de fenômeno de Koebner, poupando couro cabeludo. Na mucosa jugal, placa esbranquiçada semelhante à leucoplasia, ligeiramente arboriforme. Apresentou exames laboratoriais inalterados e achados da biópsia compatíveis com líquen plano. Iniciou-se tratamento com corticoide e anti-histamínico oral e emoliente tópico levando à melhora progressiva, evoluindo com máculas hipercrômicas residuais após quatro meses de tratamento. Discussão: Há evidências de que ocorram modificações nos ceratinócitos basais, desencadeando resposta imune com recrutamento e ativação de linfócitos T. As lesões caracterizam-se por pápulas poligonais, violáceas, descamativas, achatadas, com distribuição bilateral e simétrica acometendo faces flexoras. O objetivo deste relato é descrever um caso atípico de líquen plano extenso numa criança, com algumas lesões simulando quadro clínico de molusco contagioso. Diagnóstico correto e precoce e tratamento adequado diminuem riscos de complicações e melhoram a qualidade de vida.
Introduction: Lichen planus is a pruriginous and inflammatory disease that affects skin, mucous membrane and annex and may present unusual clinical findings. Its etiology is unknown and its peak incidence is in adult life, being uncommon in childhood. For these reasons, the authors report a rarecase of difficult diagnosis, in which a child presented cutaneous manifestations similar to molluscum contagiosum. Case report: VCN, five years old, female, complaining of disseminated cutaneous ichthing lesions for one year. There was no previous family history, atopyc precedents or use of drugs previous to the eruption. She had already received several drugs, without any improvement. She was sent to the Service of Dermatology of Faculdade de Medicina do ABC in which, at dermatological examination, presented violaceae, brilliant and umbilicated papules, throughout the tegument including palms and soles, with presence of Koebner phenomenon, saving scalp. In buccal mucous membrane, there was whitish plaque resembling leukoplakia, slightly tree-shaped. She presented normal laboratory exams and biopsy findings compatible to lichen planus. The treatment was initiated with oral corticosteroids and antihistaminics and topical emollient, leading to progressive improvement, evolving with residual hyperchromic macules after four months of treatment. Discussion: There are evidences that basal keratinocytes damage involves the cellular immune response with CD4+ lymphocytes recruitment and activation. The lesions are characterized by polygonal, violaceae, scaling, flattened papules, with bilateral and symmetric distribution affecting flexor surfaces. The objective of this report is to describe an atypical case of generalized lichen planus in a child, simulating an extensive molluscum contagiosum. Correct and early diagnosis and adequate treatment decrease complication risks and improve quality of life.
Assuntos
Humanos , Feminino , Criança , Líquen Plano/diagnóstico , Líquen Plano/terapia , Molusco Contagioso/diagnósticoRESUMO
Since there are not specific pathogens for most of the intraoral lesions and there is not unique protocol for their therapies and also some of these drugs are not accessible in Iran, we decided to introduce the drugs most available and appropriate in our country. This study has been done by review discussion procedures. The articles were extracted from native, foreign and international journals, medline, books and theses. Whole part of therapies were considered in these articles. The following lesions were discussed in this study: 1- Primary and secondary herpetic gingivostomatitis, 2- Recurrent Aphthus stomatitis, 3- Lichen planus, 4-Candidiasis, 5- Burning sensation in oral cavity, 6- Xerostomia and 7- taste disorder. As we know there are several kinds of medications for each lesion, although most of them have side effects, and some of them can not be found in our country, we have tried to do our best to suggest appropriate drugs for each intraoral disorders
Assuntos
Gerenciamento Clínico , Estomatite Herpética/terapia , Estomatite Aftosa/terapia , Líquen Plano/terapia , Candidíase/terapia , Síndrome da Ardência Bucal/terapia , Xerostomia/terapia , Distúrbios do Paladar/terapiaRESUMO
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.