Adult-onset lichen striatus versus adult blaschkitis: a clinicopathological review of 40 cases of acquired blaschkolinear inflammatory dermatosis.

BACKGROUND: Since the first description of adult blaschkitis (AB), the existence of this entity has been a matter of great debate. OBJECTIVES: To compare clinicopathological features of lichen striatus (LS) and AB cases. MATERIALS AND METHODS: We retrospectively reviewed the clinicopathological features of patients who clinically showed linear inflammatory dermatosis along Blaschko's lines based on a skin biopsy registry. RESULTS: Through a process of clinicopathological differential diagnosis, 27 cases of LS, three of AB, eight of linear lichen planus, and two of linear psoriasis were identified. Clinicopathological differences between LS and AB were mostly insignificant except for age at onset and multiple site involvement. In these cases, females were affected more frequently than males. The mean age at onset was 31.6 years, and the most common involved site was the leg. The lesions lasted approximately 8.3 months with few relapses. The most common histopathological finding was perivascular infiltration followed by peri-appendageal infiltration. CONCLUSION: Distinction between LS and AB appears to be unnecessary given their overlapping features.

Unusual photodermatosis with lichenoid eruption and apoptosis in a 33-year-old female.

We describe the clinical and dermoscopic features and histopathological findings in a case of a 33-year-old female patient with an adult-onset photodermatosis. This eruption was not typical of well-established photodermatoses due to its apoptotic keratinocytes. To our knowledge, this is the first report of these combined clinical and pathologic features.

Allelic loss in amalgam-associated oral lichenoid lesions compared to oral lichen planus and mucosa.

BACKGROUND: The amalgam-associated oral lichenoid lesion (AAOLL) shows clinical and histopathological features similar to oral lichen planus (OLP). Molecular researches to improve knowledge of pathogenesis and clinical behavior of AAOLL are still scarce. OBJECTIVE: We investigated for the first time the use of loss of heterozygosity (LOH) as a molecular approach for genetic characterization of AAOLL in comparison with OLP and evaluated the cell proliferation index. MATERIALS AND METHODS: The sample comprised nine AAOLLs, 10 OLPs, and eight NOMs matched by patients' gender and age. LOH was assessed using polymorphic microsatellite markers at chromosomes 9p (D9S157, D9S162, D9S171), 11q (D11S1369), and 17p (TP53, AFM238WF2). Cell proliferation was assessed by immunohistochemical expression of Ki-67 (MIB-1). The association between LOH and Ki-67 was investigated. RESULTS: Loss of heterozygosity occurred in 5/9 AAOLLs and in 2/10 OLPs in at least one marker each, while NOM showed no LOH. Cell proliferation index in AAOLL ranged from 2 to 23%. There was no association between cell proliferation and LOH, independent of the marker. CONCLUSION: Our study shows that the profile of molecular changes in AAOLL and OLP, evaluated by LOH and Ki-67 expression, is similar. Additional studies including larger samples should be performed to confirm or to refute our findings.

Sweat as an Efficient Natural Moisturizer.

Although recent research on the pathogenesis of allergic skin diseases such as atopic dermatitis has focused on defects in skin genes important for maintaining skin barrier function, the fact that excreted sweat has an overwhelmingly great capacity to increase skin surface hydration and contains moisturizing factors has long been ignored: the increase in water loss induced by these gene defects could theoretically be compensated fully by a significant increase in sweating. In this review, the dogma postulating the detrimental role of sweat in these diseases has been challenged on the basis of recent findings on the physiological functions of sweat, newly recognized sweat gland-/duct-related skin diseases, and therapeutic approaches to the management of these diseases. We are now beginning to appreciate that sweat glands/ducts are a sophisticated regulatory system. Furthermore, depending on their anatomical location and the degree of the impairment, this system might have a different function: sweating responses in sweat glands/ducts located at the folds in hairy skin such as on the trunk and extremities could function as natural regulators that maintain skin hydration under quiescent basal conditions, in addition to the better-studied thermoregulatory functions, which can be mainly mediated by those at the ridges. The normal functioning of sweat could be disturbed in various inflammatory skin diseases. Thus, we should recognize sweating disturbance as an etiologic factor in the development of these diseases.

Skin Signs of Rheumatoid Arthritis and its Therapy-Induced Cutaneous Side Effects.

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that primarily affects the joints, but may exhibit extra-articular, including cutaneous, manifestations such as rheumatoid nodules, rheumatoid vasculitis, granulomatous skin disorders, and neutrophilic dermatoses. A large burden of cutaneous disease may be an indication of RA disease activity and the need for more aggressive treatment. Many of the therapeutic agents used to treat RA can also result in cutaneous adverse effects, which pose their own diagnostic and therapeutic challenges. Anti-TNFα agents, in particular, have a wide variety of adverse effects including psoraisiform eruptions, granulomatous conditions, and cutaneous connective tissue disorders. Herein we provide an update on the clinical presentations and management of RA-associated cutaneous findings as well as drug-induced cutaneous effects, with particular attention to the adverse effects of biologic disease-modifying agents.

Evaluation of the Effects of Dental Implants on Oral Lesions.

OBJECTIVE: To determine whether dental implants impress oral lesions, and to evaluate the nature of their effect on the lesions. MATERIALS AND METHODS: A comprehensive search was done via Google and PubMed for articles (including case reports and literature reviews) containing the keywords 'oral squamous cell carcinoma' (OSCC), 'oral lichen planus' (OLP), 'lichenoid contact reaction' (LCR), 'osseointegrated implants', and 'dental implants' , in the last 10 years (2002-2012). RESULTS: The study included 24 articles involving patients with dental implants, and some oral lesions (e.g. oral lichen planus and oral squamous cell carcinoma) or with a history of lesions. In these publications, there is evidence suggesting the possibility of emergence, exacerbation, recurrence, or even malignant transformation of the oral lesions after implant placement in some cases. CONCLUSION: Based on our review of the literature, implant treatment does not seem to be completely safe under any circumstances, but may have some complications in subjects with certain diseases (e.g. oral lesions, autoimmune diseases, malignancies, allergic reactions, etc.). Therefore prior to treatment, patients should be fully informed of the risks. CLINICAL SIGNIFICANCE: Implant treatment is best done with caution in patients with cancer or mucocutaneous disorders.

Lichenoid drug eruption after human papillomavirus vaccination.

Lichenoid drug reactions have been linked to a long and growing list of medications, most of which are used mainly in adults, making these reactions exceedingly rare in children. To the best of our knowledge, this case report is the first of a lichenoid drug eruption in a child after human papillomavirus vaccination.

Reação liquenoide oral de contato por hipersensibilidade ao amálgama: relato de 5 casos / Orallichenoid contact reaction by hypersensitivity to amolgam: report of 5 cases

Reações liquenoides orais de contato (RLC) resultam predominantemente por mecanismo de hipersensibilidade da mucosa oral a componentes presentes nas restaurações de amálgama, cujas lesões apresentam características clínicas e histopatológicas seme¬lhantes às do líquen plano oral (LPO) idiopático. A diferenciação entre RLC e LPO idiopá¬tico se faz, essencialmente, pela observação da melhora clínica ou desaparecimento das lesões RLC após a substituição das restaurações de amálgama por materiais restauradores não-metálicos. No presente artigo, 5 casos clínicos de RLC são relatados, enfatizando-se o processo de diagnóstico e tratamento.

Lichenoid contact reactions (LCR) occu r mostly as hypersensitivity reactions of the oral mucosa to components of amalgam restorations, with clinical and histopathologic charac¬teristics similar to those of idiopathic orallichen pia nus (OLP). The differentiation betweenl LCR and idiopathic OLP is made mainly by observation of clinical improvement or disappea¬rance of LCR lesions after replacement of amalgam resolutions by non-metallic restorativel materiais. The present article report 5 cases of LCR, in which the diagnostic approach anol treatment are emphasized.

Lichenoid tissue reaction/interface dermatitis: clinical and histological perspectives.

A number of uncommon, clinically diverse and poorly understood inflammatory skin diseases are linked by the presence of a set of histopathological elements that have traditionally been referred to as the "lichenoid tissue reaction/interface dermatitis" (LTR/IFD). The prototypic skin disease in this category is lichen planus. However, the LTR/IFD can also be seen in skin disorders associated with systemic illnesses (lupus erythematosus, dermatomyositis), and the skin changes of potentially fatal disorders such as graft-versus-host disease, Stevens-Johnson syndrome, and toxic epidermal necrolysis. It has been traditionally felt that cytotoxic T-lymphocytes represent the final effector cell type for the epidermal basal cell layer injury pattern that is common to LTR/IFD disorders. Recent work has suggested that a number of different LTR/IFD skin disorders share a common inflammatory signaling pathway involving the actions of plasmacytoid dendritic cell-derived IFN-alpha. This signaling pathway appears to amplify cytotoxic T cell injury to the epidermal basal cell compartment. This review will summarize the work implicating this pathway as well as the other cellular and molecular mechanisms that are thought to be responsible for the prototypic LTR/IFD disorder, lichen planus. It is hoped that a better understanding of the immunological commonalities shared by various LTR/IFD disorders will lead to more effective safer treatment options for these illnesses.

"Pediatric blaschkitis": expanding the spectrum of childhood acquired Blaschko-linear dermatoses.

We describe two young children who developed relapsing, pruritic, papulovesicular eruptions in multiple bands along Blaschko lines on the neck, trunk, and extremities. Skin specimens in both revealed spongiotic dermatitis. This represents the first report of "blaschkitis" in children, providing further evidence that lichen striatus and blaschkitis are related acquired Blaschko-linear dermatoses that exist on a spectrum rather than as the childhood and adult form of a single disease entity. We highlight the features that differentiate blaschkitis from lichen striatus, review the potential roles of cutaneous mosaicism, environmental triggers, and background immunologic state in their pathogenesis, and discuss the spectrum of inflammatory dermatoses that can follow Blaschko lines.

Líquen plano: breve revisão de suas características clínicas, etiológicas, laboratoriais e terapêuticas / Lichen planus: brief revision of clinicals, etiologicals, laboratorials and therapeuticals characteristics

Interessados pela importante dermatose denominada líquen plano, os autores fazem uma breve revisão da literatura abordando algumas características da doença, tais como clínica, etiologia, epidemiologia, diagnóstico e possíveis terapêuticas atuais, visando uma modesta contribuição ao estudo da mesma

Liquen «nitidus» / Lichen nitidus

El liquen nitidus es una erupción liquenoide que se manifiesta en forma de pápulas brillantes de pequeño tamaño, del color de la piel normal, con carácter asintomático, de forma localizada o generalizada. La confirmación se realiza mediante estudio histopatológico, que presenta un infiltrado linfohistiocitario en dermis superficial con crestas interpapilares elongadas en los bordes abarcando dicho infiltrado. Por su tendencia a la resolución espontánea y la ausencia de síntomas, generalmente no precisa tratamiento

Lichen nitidus is a lichenoid eruption characterized by small, shiny, skin-colored papules. It is asymptomatic and can be localized or generalized. The diagnosis is confirmed by means of histopathological study, which reveals the presence of a lymphohistiocytic infiltrate in the superficial dermis, with elongated interpapillary crests on the borders encircling the infiltrate. Given that it tends to resolve spontaneously and the absence of symptoms, it generally does not require treatment

Inflamacao liquenóide / Lichenoid inflamation

O liquen plano e outros vários quadros clínicos dermatológicos com morfología macroscópica semelhante, e por isso recebndo a designaþao de liquenóide ou somente apresentando o quadro histopatológico do líquen plano, que assim recebe o batismo de inflamaþao liquenóide, constituem o tema abordado neste estudo. O ceratinícito da camada basal é o alvo da agressao e o palco dos aconttecimentos patológicos, sobretudo de base molecular, que comeþam a ser conhecidos, embora ainda incompletamente. A base da inflamaþao liquenóide é uma reaþao imunológica de hipersensibilidade retardada, que aos poucos vem sendo esclarecida. A intensidade da inflamaþao liquenóide é variável, indo desde a destriþao da camada basal, com grande infiltraþao linfocitária da mesma e da derme papilar subjacente, até ao encontro fortuito de apenas focos inflamatórios liquenóides em variadas doenþas cutÔneas, como ceratoses, actínticas, ceratoses seborréicas, carcinomas, nevos melanocíticos e outras doenþas cutÔneas (AU)

Inflamacao liquenóide / Lichenoid inflamation

O liquen plano e outros vários quadros clínicos dermatológicos com morfología macroscópica semelhante, e por isso recebndo a designaçao de liquenóide ou somente apresentando o quadro histopatológico do líquen plano, que assim recebe o batismo de inflamaçao liquenóide, constituem o tema abordado neste estudo. O ceratinícito da camada basal é o alvo da agressao e o palco dos aconttecimentos patológicos, sobretudo de base molecular, que começam a ser conhecidos, embora ainda incompletamente. A base da inflamaçao liquenóide é uma reaçao imunológica de hipersensibilidade retardada, que aos poucos vem sendo esclarecida. A intensidade da inflamaçao liquenóide é variável, indo desde a destriçao da camada basal, com grande infiltraçao linfocitária da mesma e da derme papilar subjacente, até ao encontro fortuito de apenas focos inflamatórios liquenóides em variadas doenças cutâneas, como ceratoses, actínticas, ceratoses seborréicas, carcinomas, nevos melanocíticos e outras doenças cutâneas