Detection of T lymphocytes and T lymphocyte subsets in lichen planus: in situ and in peripheral blood.

BACKGROUND: Abnormal immune mechanisms are thought to be important in the pathogenesis of lichen planus (LP). This is a study to clarify the changes that occur in T lymphocytes and T lymphocyte subsets, both in situ and in peripheral blood. METHODS: A group of 100 patients with LP were included in this study. T lymphocytes and T lymphocyte subsets were detected in lesional skin by immunoperoxidase cell surface staining using monoclonal antibodies. Peripheral T lymphocytes and T lymphocyte subsets were also detected by indirect immunofluorescence using monoclonal antibodies. A group of 10 normal healthy subjects were used as controls. RESULTS: The study of the lesional T lymphocytes and T lymphocyte subsets demonstrated that helper T cells was the predominant subset in LP lesions in most of the patients. This predominance was evident irrespective of the duration of the disease and was more evident in late than in early lesions. The percentage of both total T lymphocytes and helper T cells in peripheral blood was decreased significantly in patients compared with controls. A significant decrease in helper T cells and the helper/cytotoxic T cell ratio was detected in patients with a longer duration of the disease. CONCLUSION: Activation of helper T lymphocytes that were found to be the predominant subsets in LP lesions may be responsible for epidermotropic cellular infiltrates leading to damage and destruction of epidermal cells.

HLA antigens in Arabs with lichen planus.

We have HLA typed 50 Arab patients with cutaneous lichen planus who were resident in Kuwait and then compared the antigen incidence with 100 normal controls. There were no significant differences in the antigens of the HLA-ABC loci but there was a significant increase in HLA-DR1 (P = 0.0018, RR = 3.68) and HLA-DR10 (P. corr. = 0.00096, RR = 8.27) and a significant decrease in HLA DR5 (P. corr. = 0.0396, RR = 0.18). The relevance of these findings to earlier reports on lichen planus in which HLA-DR1 (but not DR10) is increased is discussed. This is the first report of HLA antigen frequency in Arab patients with lichen planus, and would support the fact that HLA DR1 is universally associated with the disease, although the more significant association appears to be with HLA-DR10.

Cutaneous leishmaniasis in Kuwait. Clinical experience with itraconazole.

Twenty-four patients suffering from single or multiple lesions of cutaneous leishmaniasis were included in this study. Most of the lesions were on the extremities. The patients were randomly divided into two groups. Most of the patients in the first group who were given oral itraconazole for a period of 6-8 weeks showed excellent clinical response. On the other hand, only one patient in the second control group who was given placebo showed good clinical improvement. Systemically administered itraconazole may prove to be a valuable modality for the treatment of cutaneous leishmaniasis.