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1.
Mayo Clin Proc ; 95(8): 1684-1695, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32753140

RESUMO

OBJECTIVE: To characterize the clinicopathologic findings, comorbidities, and treatment outcomes of women with lichen planopilaris (LPP). METHOD: In this retrospective review of women with LPP at Mayo Clinic from 1992 to 2016, we searched for scarring alopecia in all female patients aged 1 to 100 years from January 1, 1992, through December 31, 2016. Men were excluded from this study to more accurately determine the association of hormonal factors in LPP pathogenesis. Two hundred thirty-two patients were included as they met diagnostic criteria for LPP based on clinicopathologic correlation, with 217 having confirmatory biopsies. RESULTS: We identified 232 women with LPP (mean age, 59.8 years). Of those, 92.7% (215) presented with hair loss; 23.7% (55) had preceding inflammation; 30.6% (71) had thyroid disease, including hypothyroidism (23.2%; 54); and 9.4% (22) had vitamin D deficiency. Incidence of depression and anxiety was 45.7% (106) and 41.8% (97), respectively. History of total abdominal hysterectomy/bilateral salpingo-oophorectomies and hormone replacement therapy was found in 16.8% (39) and 16.4% (38), respectively. Lichen planus at other body sites occurred in 16.4% (38) of patients; and 53.2% (123) had slowing of disease progression or disease stabilization, often requiring combination therapies. In those who achieved slowing or stabilization of disease, mean time to recurrence was 1.8 year. The mean time to remission was 1.1 year. CONCLUSION: The typical LPP patient is a 60-year-old female with vertex scarring alopecia who presents with burning, erythema, inflammation, and scale. Almost half of patients will have comorbid autoimmunity. As previously reported, LPP is associated with thyroid disease. We also found higher rates of depression, anxiety, nutritional deficiencies, and skin cancer than reported in the general population.


Assuntos
Líquen Plano/patologia , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Alopecia/patologia , Fármacos Dermatológicos/uso terapêutico , Feminino , Humanos , Líquen Plano/tratamento farmacológico , Pessoa de Meia-Idade , Estudos Retrospectivos , Pele/patologia , Adulto Jovem
2.
PLoS One ; 15(8): e0238005, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822406

RESUMO

BACKGROUND: Studies have investigated whether patients with lichen planus are at a high risk of metabolic syndrome; however, currently, no conclusive data are available in this regard. OBJECTIVE: This meta-analysis was performed to analyze the published literature investigating the association between metabolic syndrome and lichen planus. METHOD: Two reviewers independently searched 4 databases (PubMed, Embase, the Cochrane Library and Web of Science) for observational studies assessing the prevalence of metabolic syndrome in patients with lichen planus. Review Manager 5.3 software was used to statistically analyze the data. RESULTS: 200 relevant articles were searched. After a further reading, 12 studies with 1422 participants (715 with LP and 707 controls) fulfilled the eligibility criteria. Overall, the pooled odds ratio based on random effects analysis was 2.81 (95% confidence interval: 1.79-4.41, P<0.00001). This meta-analysis shows that compared with the general population, patients with lichen planus are more likely to develop metabolic syndrome. Subgroup analysis of prevalence of metabolic syndrome showed higher odds ratio in studies using International Diabetes Federation diagnostic criteria (odds ratio 4.65) and the Harmonized criteria (odds ratio 26.62) than studies using National Cholesterol Education Program Adult Treatment Panel III criteria (odds ratio 1.75), and thus might be more appropriate for diagnosing metabolic syndrome. CONCLUSIONS: This meta-analysis shows that compared with the general population, patients with lichen planus are more likely to develop metabolic syndrome. Therefore, early diagnosis and prompt initiation of first-line therapy for metabolic disorders are important in patients with lichen planus.


Assuntos
Líquen Plano/patologia , Síndrome Metabólica/diagnóstico , Bases de Dados Factuais , Humanos , Líquen Plano/complicações , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Razão de Chances , Prevalência , Fatores de Risco
3.
An Bras Dermatol ; 95(3): 307-313, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32299739

RESUMO

BACKGROUND: Clinical and histological features may overlap between lichen planopilaris-associated and discoid lupus erythematosus-associated scarring alopecia. OBJECTIVES: The aim of this study was to demonstrate the cutaneous infiltration of plasmacytoid dendritic cells and to compare their distribution pattern in discoid lupus erythematosus and lichen planopilaris. METHODS: Twenty-four cases of discoid lupus erythematosus and 30 cases of lichen planopilaris were examined for immunostaining of the CD123 marker. The percentage and distribution pattern of plasmacytoid dendritic cells and the presence of the plasmacytoid dendritic cells clusters were evaluted in the samples. RESULTS: The number of plasmacytoid dendritic cells was higher in the discoid lupus erythematosus specimens. Aggregations of 10 cells or more (large cluster) were observed in half of the discoid lupus erythematosus specimens and only 2 lichen planopilaris, with 50% sensitivity and 93% specificity for differentiating discoid lupus erythematosus from lichen planopilaris. STUDY LIMITATIONS: Incidence and prevalence of discoid lupus erythematosus-associated scarring alopecia in the scalp are low, so the samples size of our study was small. CONCLUSIONS: We suggest that a plasmacytoid dendritic cells cluster of 10 cells or more is highly specific for distinguishing discoid lupus erythematosus from lichen planopilaris. It also appears that CD123 immunolabeling is valuable in both active and late stages of the disease.


Assuntos
Células Dendríticas/patologia , Subunidade alfa de Receptor de Interleucina-3/imunologia , Líquen Plano/patologia , Lúpus Eritematoso Discoide/patologia , Adulto , Alopecia/patologia , Biomarcadores , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Coloração e Rotulagem
4.
Clin Exp Dermatol ; 45(6): 727-731, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32311113

RESUMO

Lichen planus pemphigoides (LPP) is a rare autoimmune subepidermal blistering disease characterized by the coexistence of both lichen planus and either bullous pemphigoid or mucous membrane pemphigoid (MMP) features. Frontal fibrosing alopecia (FFA) is a scarring alopecia, generally considered a form of lichen planopilaris. We report two patients with concomitant FFA and MPP. Patient 1 was a 73-year-old woman with the clinical and histological diagnosis of oral lichen planus. In addition, she presented alopecic plaques in the parietal area with blisters, immunohistologically compatible with Brunsting-Perry pemphigoid, a variant of MMP. During follow-up, the patient also developed FFA. Patient 2 was a 70-year-old woman with a history of ocular inflammation and desquamative gingivitis, who was diagnosed with MMP based on a conjunctival biopsy. She also had clinical features of FFA. ELISA and frontal biopsy confirmed the diagnoses of MMP and FFA. In conclusion, we report two patients with MMP associated with FFA, and discuss whether this association is a new variant of LPP or an incidental finding.


Assuntos
Alopecia/complicações , Líquen Plano/complicações , Doenças da Boca/patologia , Mucosa Bucal/patologia , Penfigoide Mucomembranoso Benigno/complicações , Idoso , Alopecia/patologia , Feminino , Gengivite/complicações , Humanos , Líquen Plano/patologia , Penfigoide Mucomembranoso Benigno/patologia , Couro Cabeludo/patologia
10.
Ann Thorac Surg ; 109(2): e83-e85, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31323214

RESUMO

Cancer arising in lichen planus of the esophagus (LPE) is extremely rare. We report 2 elderly female patients with LPE who developed squamous cell carcinoma. Both underwent laparoscopic ischemic gastric preconditioning followed 2 weeks later by 3-field esophagectomy. Final pathological stages were carcinoma in situ and pT3N2, respectively. No adjuvant therapy was given. The patient with in situ cancer has no evidence of recurrence at 24 months. The second patient opted to follow up locally and died 8 months later. LPE should be closely monitored for malignant degeneration. Esophagectomy should be considered when malignancy is detected.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Esofagectomia/métodos , Esôfago/patologia , Líquen Plano/patologia , Idoso , Biópsia , Carcinoma de Células Escamosas/cirurgia , Transformação Celular Neoplásica , Diagnóstico Diferencial , Neoplasias Esofágicas/cirurgia , Esofagoscopia , Esôfago/cirurgia , Feminino , Humanos , Laparoscopia
11.
Int J Dermatol ; 59(2): 137-142, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31630401

RESUMO

BACKGROUND: The pathogenesis of lichen planus (LP) is mostly autoimmune, while psychological and infectious factors are recognized to trigger or aggravate the disease. An association with diabetes is reported. Our objective was to determine the epidemio-clinical characteristics of LP and its associated factors. METHODS: This multicentric, prospective study was conducted over a 6-month period. The histopathology was only performed for atypical forms. Patients with a notion of drug intake before the rash were excluded. Anti-hepatitis C Virus (HCV) antibodies screening was systematical in case of mucosal damage. The data were analyzed using the SPSS IBM 20 software. RESULTS: The average age was 38 years. Women represented 84.6% (n = 66) of the studied population. The patients were married in 61.5%. Obesity or overweight status was noted in 41%. A marital or relational conflict was found in 25.6%. History of LP was reported in 24.4% (n = 19). Pruritus was found in 96.2%. The locations were as follows: skin (97.4%), mucous membranes (15.4%), and hair and nails (5.1%). Lesions were diffuse in 56.4%. The clinical forms were as follows: typical (52.6%), erythematosquamous (17%), warty (14.5%), pigmented (14.5%), and blaschkolinear (one case). Histopathology confirmed the diagnosis of LP in 91.4%. Blood sugar level was high in one case. Hepatitis B surface antigen (HBsAg) was positive in 3.03%. Anti-HIV and anti-HCV antibodies were negative. CONCLUSION: Lichen planus is a relatively rare disease in sub-Saharan Africa and is seen more in adults. The clinical manifestations are polymorphic, but the mucosal damage is rarely isolated.


Assuntos
Líquen Plano/epidemiologia , Líquen Plano/patologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Antígenos de Superfície da Hepatite B/sangue , Humanos , Relações Interpessoais , Líquen Plano/complicações , Líquen Plano/psicologia , Masculino , Estado Civil , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estresse Ocupacional/epidemiologia , Estudos Prospectivos , Prurido/etiologia , Senegal/epidemiologia , Pigmentação da Pele , Adulto Jovem
12.
J Cutan Pathol ; 47(2): 128-134, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31605498

RESUMO

BACKGROUND: The purpose of the study was to compare the histopathologic and immunophenotypic features of central centrifugal cicatricial alopecia (CCCA) and lichen planopilaris (LPP) to better characterize and differentiate these two clinical entities. CCCA remains an ill-defined and still-unsettled histologic entity and many hair loss experts regard CCCA to be histologically indistinguishable from LPP. Given the overlapping histologic features of these two lymphocyte-predominant cicatricial alopecias, and the lack of consensus regarding the significance of proposed distinctions, dermatopathologists face difficulty in providing clinicians and patients certainty with a definitive diagnosis of CCCA vs LPP. METHODS: We performed a retrospective review of 51 scalp biopsies of patients with either the clinical diagnosis of CCCA (27 cases) or LPP (24 cases). Clinical information, histologic features of hematoxylin-eosin-stained sections, and a panel of immunohistochemical markers were evaluated on scalp biopsies. Tested parameters were quantified, and statistical analysis was performed. RESULTS: Our study found no differences on either histologic assessment or immunophenotypic characterization between cases of classic LPP and CCCA. CONCLUSION: The conclusion of this study is that the inflammatory infiltrates in CCCA and LPP are not only histologically similar but also immunophenotypically indistinguishable.


Assuntos
Alopecia , Líquen Plano , Adulto , Idoso , Idoso de 80 Anos ou mais , Alopecia/imunologia , Alopecia/patologia , Feminino , Humanos , Líquen Plano/imunologia , Líquen Plano/patologia , Masculino , Pessoa de Meia-Idade
13.
J Cutan Pathol ; 47(3): 275-279, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31589773

RESUMO

Pembrolizumab, an anti-programmed cell death-1 (PD-1) antibody preparation, has been shown to induce various dermatologic adverse events which may present with delayed onset or even after discontinuation of therapy. We report a 78-year-old female patient with a stage II lung adenocarcinoma treated with pembrolizumab, who developed lichenoid eruptions and multiple cutaneous plaque/nodular eruptions as pseudoepitheliomatous hyperplasia, during and up to 2 months after discontinuation of pembrolizumab therapy. Multiple skin biopsies revealed epidermal hyperplasia with hyperkeratosis, hypergranulosis, diffuse to patchy lichenoid lymphocyte infiltrate with scattered eosinophils and neutrophils, confluent to scant dyskeratosis of the lower epidermis, minimal to overt invagination, and cystic proliferation of squamous epithelium to papillomatosis with hypergranulosis and keratosis. Overall, multiple patterns were present with similarities to lichenoid drug eruption, lichen planus, early invasive squamous cell carcinoma, early keratoacanthoma, and verruca. However, the findings ultimately supported a diagnosis of hypertrophic lichen planus. All the lesions resolved with oral prednisone, hydroxychloroquine, and topical triamcinolone acetonide ointment 0.1%. In summary, our case shows that pembrolizumab can induce lichenoid eruption with pseudoepitheliomatous hyperplasia, and these lesions can clinically and pathologically mimic early invasive squamous cell carcinomas or keratoacanthomas.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos Imunológicos/efeitos adversos , Erupção por Droga/patologia , Líquen Plano/induzido quimicamente , Adenocarcinoma de Pulmão/tratamento farmacológico , Idoso , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Erupção por Droga/diagnóstico , Feminino , Humanos , Líquen Plano/patologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia
14.
Int J Dermatol ; 59(2): 245-252, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31231800

RESUMO

BACKGROUND: Lichen planus pigmentosus (LPP) is an acquired disorder of hyperpigmentation affecting certain racial and ethnic groups. OBJECTIVE: To retrospectively analyze the demographic and clinical characteristics of LPP. METHODS: Clinical and demographic records of all LPP patients attending our pigmentary clinic from January 2011 to June 2018 were reviewed. RESULTS: Data of 344 LPP patients (229 females) were analyzed. Affected females had significantly higher age at onset (P < 0.002) but lesser disease duration at presentation (P < 0.001) as compared to males. Significant positive correlation between body surface area involvement and disease duration was observed (r = 0.72). Personal history of atopy and accompanying autoimmune diseases were observed in 49 (14.24%) and 45 (13.08%) patients, respectively. Observed morphological patterns of LPP included diffuse (n = 193, 56.1%); reticular (n = 45, 13.1%); blotchy (n = 41, 11.9%); and follicular (n = 28, 8.1%). All the patients had a chronic and indolent course of disease with approximately half (49.2%) reporting satisfactory improvement with treatment. CONCLUSION: This is the largest clinico-demographic study till date on LPP. A longer disease duration was associated with more widespread disease. Although the disease improved over time as per patient and physician global assessment, a complete clearance was rarely attained.


Assuntos
Líquen Plano/complicações , Líquen Plano/patologia , Adolescente , Adulto , Idade de Início , Idoso , Doenças Autoimunes/complicações , Superfície Corporal , Criança , Dermatite Atópica/complicações , Fármacos Dermatológicos/uso terapêutico , Feminino , Humanos , Hiperpigmentação/complicações , Hipersensibilidade/complicações , Índia , Líquen Plano/tratamento farmacológico , Líquen Plano/genética , Líquen Plano Bucal/complicações , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rinite Alérgica/complicações , Fatores Sexuais , Luz Solar/efeitos adversos , Centros de Atenção Terciária , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
15.
Am J Dermatopathol ; 42(3): 173-177, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31855586

RESUMO

BACKGROUND: Folliculitis decalvans (FD) and lichen planopilaris (LPP) are classified as neutrophilic and lymphocytic cicatricial alopecias according to the North American Hair Research Society. Recently, a clinical phenotype combining concomitant or sequential features for both was described as a FD LPP phenotypic spectrum (FDLPPPS). OBJECTIVES: To review the most common phenotypic presentation of FDLPPPS with a main focus on histopathology. METHODS: We reviewed retrospectively series of 7 patients with a similar phenotypic presentation with special focus on the histologic pattern. All patients presented with concomitant features for FD and LPP and recalcitrant course unresponsive to topical and systemic immunomodulatory/anti-inflammatory agents. RESULTS: The most common clinical phenotype was that of hairless patches on the vertex with lost follicular ostia and perifollicular scale and the following diagnostic findings: (1) polytrichia; (2) positive bacterial culture for Staphylococcus in over 50% of the samples isolated from pustules and hemorrhagic crusts; (3) "mixed" histologic features for primary cicatricial alopecia including multicompound follicular structures of average 2-5 follicles (follicular packs), atrophy of the follicular epithelium, lymphohistiocytic infiltrate with granulomas, and prominent plasma cells, but absence of neutrophilic infiltrate in all cases except scarce neutrophils in one; and (4) clinical improvement with adjuvant systemic antimicrobials. CONCLUSIONS: The FDLPPPS may be underreported and should be considered in all cases of LPP recalcitrant to treatment. Dermatologists and dermatopathologists should recognize this phenotypic spectrum to guide optimal clinical management consisting of immunomodulatory and anti-inflammatory agents along with systemic antimicrobials.


Assuntos
Alopecia/patologia , Foliculite/patologia , Líquen Plano/patologia , Adulto , Alopecia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Estudos Retrospectivos
16.
Clin Exp Dermatol ; 45(1): 63-72, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31017678

RESUMO

We present a series of 13 patients with clinical and histological features of both folliculitis decalvans (FD) and lichen planopilaris (LPP), either concomitantly, or sequentially as the clinical phenotype changed over time. This biphasic presentation of FD-LPP is not as uncommon as would be expected from the lack of description in the literature. We discuss current theories about the pathogenesis of both LPP and FD, and speculate how abnormal immune responses may either predispose to secondary bacterial infection or be influenced by dysbiosis of the skin/hair follicle microbiome, resulting in inflammation and permanent hair follicle damage.


Assuntos
Foliculite/complicações , Folículo Piloso/patologia , Líquen Plano/complicações , Adulto , Idoso , Feminino , Foliculite/patologia , Humanos , Líquen Plano/patologia , Masculino , Pessoa de Meia-Idade , Fenótipo
17.
Biomed Res Int ; 2019: 5829185, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781623

RESUMO

Background: Ashy dermatosis (AD) and lichen planus pigmentosus (LPP) are both acquired macular pigmentation of uncertain aetiology. Despite the controversy surrounding their entities, recent global consensus has concluded that they are 2 different diseases with distinct clinical presentations. Nevertheless, there are limited data on their histopathological comparisons. Objective: To evaluate the differences in histopathological findings between AD and LPP. Methods: Electronic records and photographs of patients with the diagnosis of AD or LPP from January 2008 to December 2018 were retrospectively reviewed by a dermatologist. Patients were then classified into groups with AD and LPP, based on the clinical descriptions from the recent consensus. Those with history/clinical presentations suggestive of other causes of macular pigmentation were excluded. The histopathological diagnosis of AD and LPP was then reevaluated by a blinded dermatopathologist. Results: One hundred and twenty-four patients with acquired macular pigmentation were identified; 24 were excluded due to clinical history or photographs being inconsistent with AD or LPP. Of the remaining 100 patients, 71 had clinical findings consistent with LPP while 29 had AD. The prevalence of epidermal hyperkeratosis was significantly higher in LPP when compared to AD (33.8% vs. 0%, p < 0.001), as well as epidermal hypergranulosis (35.2% vs. 0%, p < 0.001), lichenoid dermatitis (49.3% vs. 7.1%, p < 0.001), perifollicular infiltration (47.9% vs.10.3%, p < 0.001), and perifollicular fibrosis (35.2% vs. 10.3%, p=0.01). In addition, the degree of pigmentary incontinence was more severe in LPP (21.1% vs. 3.5%, p=0.015). For AD, vacuolization of the epidermal basal cell layer was more common (96.4% vs. 77.5%, p=0.02). Conclusions: Although most cases of AD and LPP can be diagnosed clinically, in doubtful cases, histopathological findings of lichenoid dermatitis, epidermal hyperkeratosis/hypergranulosis, and moderate to severe pigmentary incontinence can help distinguish LPP from AD.


Assuntos
Líquen Plano/diagnóstico , Líquen Plano/patologia , Dermatopatias/diagnóstico , Dermatopatias/patologia , Adulto , Consenso , Diagnóstico Diferencial , Epiderme/patologia , Feminino , Humanos , Hiperpigmentação/diagnóstico , Hiperpigmentação/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tailândia , Resultado do Tratamento
19.
Braz J Med Biol Res ; 52(10): e8823, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618369

RESUMO

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
Líquen Plano/diagnóstico , Dermatoses do Couro Cabeludo/diagnóstico , Doenças Uretrais/diagnóstico , Doenças Vaginais/diagnóstico , Adulto , Feminino , Humanos , Líquen Plano/patologia , Líquen Plano/terapia , Dermatoses do Couro Cabeludo/patologia , Dermatoses do Couro Cabeludo/terapia , Doenças Uretrais/patologia , Doenças Uretrais/terapia , Doenças Vaginais/patologia , Doenças Vaginais/terapia
20.
Scand J Gastroenterol ; 54(10): 1189-1198, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31608788

RESUMO

Background: Although lichen planus (LP) is a common skin disorder, the prevalence of esophageal involvement (ELP) and its clinical manifestations are poorly defined. We aimed to establish diagnostic criteria and characterize disease outcomes of ELP.Methods: Clinical, endoscopic, histological, and immunofluorescence data from consecutive patients with known LP between 2013 and 2018 were analyzed. We established endoscopic (denudation and tearing of the mucosa, hyperkeratosis and trachealization) and histological criteria (mucosal detachment, T-lymphocytic infiltrate, intraepithelial apoptosis, dyskeratosis, and fibrinogen deposits along the basement membrane) to grade disease severity. Endoscopic findings were correlated with clinical symptoms. Response to medical therapy was monitored.Results: Fifty-two consecutive patients (median age 59.5 years) were analyzed. According to our grading system, 16 patients were considered as severe and 18 as mild ELP. Dysphagia was the only symptom which differentiated patients with severe (14/16) or mild ELP (8/18) from patients without ELP (1/18). Concomitant oral and genital involvement of LP was associated with the presence of ELP, while oral involvement alone was not. Follow-up of 14/16 patients with severe EPL for at least one year revealed that most of these patients responded to topical corticosteroids (budesonide: n = 9/10 or fluticasone n = 2/2). Three budesonide patients experienced a resolution of symptomatic esophageal stenosis.Conclusions: Esophageal involvement of LP is frequent, but may be asymptomatic. ELP can be diagnosed using the diagnostic criteria proposed here. Dysphagia and combined oral and genital manifestation are associated with ELP. Therapy with topical corticosteroids appears to be a prudent therapeutic approach for ELP.


Assuntos
Doenças do Esôfago/diagnóstico , Líquen Plano/diagnóstico , Corticosteroides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios/uso terapêutico , Doenças do Esôfago/tratamento farmacológico , Doenças do Esôfago/patologia , Esofagoscopia , Feminino , Seguimentos , Humanos , Imunossupressores/uso terapêutico , Líquen Plano/tratamento farmacológico , Líquen Plano/patologia , Masculino , Pessoa de Meia-Idade , Diagnóstico Ausente/prevenção & controle , Índice de Gravidade de Doença , Resultado do Tratamento
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