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Tekin B, Xie F, Lehman JS. Lichen Planus: What is New in Diagnosis and Treatment? Am J Clin Dermatol 2024; 25:735-764. [PMID: 38982032 DOI: 10.1007/s40257-024-00878-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/11/2024]
Abstract
Lichen planus (LP), an idiopathic, multifaceted chronic inflammatory disease with a heterogeneous clinical presentation, affects approximately 0.5-1% of the population. The various clinical manifestations of LP fall into three broad categories, namely cutaneous, appendageal, and mucosal, with further subclassification depending on the morphology and distribution patterns of individual lesions. There is mounting evidence that LP has systemic associations, including autoimmune conditions, glucose intolerance, dyslipidemia, and cardiovascular disorders. Cutaneous hypertrophic and mucosal forms of LP are at a heightened risk for malignant transformation. Familiarity with these potential associations in conjunction with long-term follow-up and regular screening could lead to a timely diagnosis and management of concomitant conditions. In addition, the frequent quality of life (QoL) impairment in LP underscores the need for a comprehensive approach including psychological evaluation and support. Several treatment strategies have been attempted, though most of them have not been adopted in clinical practice because of suboptimal benefit-to-risk ratios or lack of evidence. More recent studies toward pathogenesis-driven treatments have identified Janus kinase inhibitors such as tofacitinib, phosphodiesterase-4 inhibitors such as apremilast, and biologics targeting the interleukin-23/interleukin-17 pathway as novel therapeutic options, resulting in a dramatic change of the treatment landscape of LP. This contemporary review focuses on the diagnosis and management of LP, and places emphasis on more recently described targeted treatment options.
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Affiliation(s)
- Burak Tekin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Julia S Lehman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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Santos-Coelho M, Alves Barbosa J, Cabete J, Brasileiro A. Pytiriasis Lichenoide Chronica Following Influenza Vaccination, and Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T513-T514. [PMID: 38423505 DOI: 10.1016/j.ad.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/22/2022] [Accepted: 10/31/2022] [Indexed: 03/02/2024] Open
Affiliation(s)
- M Santos-Coelho
- Departamento de Dermatología y Venereología, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.
| | - J Alves Barbosa
- Departamento de Dermatología y Venereología, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - J Cabete
- Departamento de Dermatología y Venereología, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - A Brasileiro
- Departamento de Dermatología y Venereología, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
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3
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Santos-Coelho M, Alves Barbosa J, Cabete J, Brasileiro A. Pytiriasis Lichenoide Chronica Following Influenza Vaccination, and Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:513-514. [PMID: 37271190 DOI: 10.1016/j.ad.2022.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/22/2022] [Accepted: 10/31/2022] [Indexed: 06/06/2023] Open
Affiliation(s)
- M Santos-Coelho
- Dermatology and Venereology Department, Centro Hospitalar Universitário de Lisboa Central, E.P.E., Lisboa, Portugal.
| | - J Alves Barbosa
- Dermatology and Venereology Department, Centro Hospitalar Universitário de Lisboa Central, E.P.E., Lisboa, Portugal
| | - J Cabete
- Dermatology and Venereology Department, Centro Hospitalar Universitário de Lisboa Central, E.P.E., Lisboa, Portugal
| | - A Brasileiro
- Dermatology and Venereology Department, Centro Hospitalar Universitário de Lisboa Central, E.P.E., Lisboa, Portugal
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Vičić M, Hlača N, Kaštelan M, Brajac I, Sotošek V, Prpić Massari L. Comprehensive Insight into Lichen Planus Immunopathogenesis. Int J Mol Sci 2023; 24:ijms24033038. [PMID: 36769361 PMCID: PMC9918135 DOI: 10.3390/ijms24033038] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
Lichen planus is a chronic disease affecting the skin, appendages, and mucous membranes. A cutaneous lichen planus is a rare disease occurring in less than 1% of the general population, while oral illness is up to five times more prevalent; still, both forms equally impair the patient's quality of life. The etiology of lichen planus is not entirely understood. Yet, immune-mediated mechanisms have been recognized since environmental factors such as hepatitis virus infection, mechanical trauma, psychological stress, or microbiome changes can trigger the disease in genetically susceptible individuals. According to current understanding, lichen planus immunopathogenesis is caused by cell-mediated cytotoxicity, particularly cytotoxic T lymphocytes, whose activity is further influenced by Th1 and IL-23/Th-17 axis. However, other immunocytes and inflammatory pathways complement these mechanisms. This paper presents a comprehensive insight into the actual knowledge about lichen planus, with the causal genetic and environmental factors being discussed, the immunopathogenesis described, and the principal effectors of its inflammatory circuits identified.
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Affiliation(s)
- Marijana Vičić
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Nika Hlača
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Marija Kaštelan
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Ines Brajac
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Vlatka Sotošek
- Department of Anesthesiology, Reanimation and Intensive Care, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Tome Strižića 3, 51000 Rijeka, Croatia
| | - Larisa Prpić Massari
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Correspondence:
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5
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Rovira-López R, Pujol RM. Blaschkolinear acquired inflammatory skin eruption (blaschkitis) following COVID-19 vaccination. JAAD Case Rep 2022; 26:35-37. [PMID: 35789676 PMCID: PMC9242886 DOI: 10.1016/j.jdcr.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Roger Rovira-López
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
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Raccampo L, Sembronio S, Tel A, Cacitti V, Robiony M. Oral Lichen Planus arising after BNT162b2 mRNA COVID-19 Vaccine: report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:e54-e57. [PMID: 35851250 PMCID: PMC8995197 DOI: 10.1016/j.oooo.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Luca Raccampo
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Salvatore Sembronio
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Tel
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Veronica Cacitti
- Department of Pathology, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Massimo Robiony
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy.
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