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Shao Y, Sun K, Yang M, Chang J. Vulvar-vaginal-gingival-otic syndrome. Exp Dermatol 2024; 33:e14912. [PMID: 37612855 DOI: 10.1111/exd.14912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/23/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023]
Abstract
In order to retrospectively analyse the multi-site involvement pattern of erosive lichen planus patients, we retrospectively reported the clinical and medical data of three patients with erosive lichen planus which involving their vulva, vagina, gingiva, and ear canal. We confirmed the existence of otic lichen planus, and found that it is more common in patients with vulvovaginal-gingival syndrome of erosive lichen planus. Therefore, we propose 'vulvovaginal-gingival-otic syndrome' to further describe this rare compound pattern of lichen planus.
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Affiliation(s)
- Yakun Shao
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Kailv Sun
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Min Yang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianmin Chang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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2
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Sasikumar S, Maneesh SG, Chandran S, Raghavendra KS, Hasan S, Umerali IP, Michael MM, Yadu Krishnan KG, Raveendran C, Malavika S. A Rare Case of Post Inflammatory Lateral Stenosis of External Auditory Canal and It's Management with Review of Literature. Indian J Otolaryngol Head Neck Surg 2022; 74:437-441. [PMID: 36032897 PMCID: PMC9411352 DOI: 10.1007/s12070-020-02203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/05/2020] [Indexed: 11/30/2022] Open
Abstract
Acquired external auditory canal stenosis is a challenging condition to treat and can affect any age group. Post inflammatory lateral canal atresia is uncommon. This article focuses on a 2 year old child who presented with hearing loss with history of otitis externa. The lateral part of Auditory Canal was completely stenosed. He underwent debrider assisted endoscopic ear surgery and stenting, and a patent External Auditory Canal with normal hearing was achieved.
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Affiliation(s)
| | - S. G. Maneesh
- Department of ENT, Narayana Hrudayalaya, Bangalore, India
| | | | | | - Suhel Hasan
- Department of ENT, Narayana Hrudayalaya, Bangalore, India
| | - I. P Umerali
- Department of ENT, Narayana Hrudayalaya, Bangalore, India
| | | | | | | | - S. Malavika
- Department of ENT, Narayana Hrudayalaya, Bangalore, India
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Mantsopoulos K, Thimsen V, Müller SK, Sievert M, Goncalves M, Iro H, Agaimy A, Hornung J. Postinflammatory Medial Meatal Fibrosis: Histopathologic Features and Outcomes of Surgical Management. EAR, NOSE & THROAT JOURNAL 2021; 102:391-396. [PMID: 33813900 DOI: 10.1177/01455613211001134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aims of our study were to investigate the clinical and audiometric outcome of the surgical treatment of postinflammatory medial meatal fibrosis (PIMMF) and to review the histopathologic changes in the specimens of the fibrotic plug, in order to try to shed light on the pathogenesis of the disease. MATERIALS AND METHODS The clinical records and the histopathologic specimens of all patients who underwent tympanomeatoplasty for PIMMF at the ENT Clinic of the University of Erlangen between 2006 and 2020 were evaluated retrospectively. RESULTS Thirty-four patients (41 primary surgical procedures) made up our study cohort. Of this, 28 cases were managed by means of meatoplasty and 13 cases with tympanomeatoplasty. The mean preoperative air-bone gap (ABG) was 27.8 dB (10-44 dB). Postoperative ABG was significantly improved compared to preoperative values at both short- and long-term follow-ups (P < .001 for both). No significant difference was noted between short-term and long-term ABG (P = .240). An ABG ≤20 dB was achieved in 65.8% of patients (short term) and 50% (long term). The overall rate of revision surgery for restenosis was 29.3% (12/41). Histopathologic reevaluation of the fibrotic plugs revealed a mosaic of patterns with frequent occurrence of secondary cholesteatoma-like lesions and keloid-like tissue changes. Lichenoid submucosal inflammation and increased ectopic ceruminous gland lobules were seen less frequently. DISCUSSION The moderate long-term outcome of surgical management and the identification of histologic changes with therapeutic implications might pave the way for alternative nonsurgical treatment options.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Vivian Thimsen
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sarina Katrin Müller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matti Sievert
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Miguel Goncalves
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Joachim Hornung
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Guo LN, Shin JJ, Schulte S, Merola JF. Severe recalcitrant otic lichen planus treated with mycophenolate mofetil. JAAD Case Rep 2020; 8:1-3. [PMID: 33457480 PMCID: PMC7797928 DOI: 10.1016/j.jdcr.2020.11.023] [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: 10/31/2022] Open
Affiliation(s)
- Lisa N Guo
- Harvard Medical School, Boston, Massachusetts.,Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jennifer J Shin
- Harvard Medical School, Boston, Massachusetts.,Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Stephanie Schulte
- Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Joseph F Merola
- Harvard Medical School, Boston, Massachusetts.,Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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5
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Altunisik N, Koc A, Toplu Y, Sener S, Turkmen D, Sarac G, Durmaz I. Evaluation of hearing function in patients with lichen planus. Med Hypotheses 2020; 143:109867. [DOI: 10.1016/j.mehy.2020.109867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/07/2020] [Accepted: 05/21/2020] [Indexed: 10/24/2022]
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6
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Lazzerini F, Bruschini L, Berrettini S, De Vito A, Forli F. Lichen planus of the external auditory canal: Treatment options and review of literature. Clin Case Rep 2020; 8:2017-2020. [PMID: 33088542 PMCID: PMC7562884 DOI: 10.1002/ccr3.3049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 11/19/2022] Open
Abstract
Medical topic therapies can relieve symptoms associated with lichen planus of external auditory canal. Further, bone‐anchored hearing devices represent an optimal solution for hearing restoration in otic lichen planus.
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Affiliation(s)
| | - Luca Bruschini
- ENT Audiology and Phoniatric Unit University Hospital of Pisa Pisa Italy
| | - Stefano Berrettini
- ENT Audiology and Phoniatric Unit University Hospital of Pisa Pisa Italy.,Division of ENT Diseases Karolinska Institute Stockholm Sweden
| | - Andrea De Vito
- ENT Audiology and Phoniatric Unit University Hospital of Pisa Pisa Italy
| | - Francesca Forli
- ENT Audiology and Phoniatric Unit University Hospital of Pisa Pisa Italy
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Kmeid M, Nehme J. Post-inflammatory acquired atresia of the external auditory canal. J Otol 2019; 14:149-154. [PMID: 32742275 PMCID: PMC7387840 DOI: 10.1016/j.joto.2019.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/17/2019] [Accepted: 07/26/2019] [Indexed: 12/15/2022] Open
Abstract
Acquired atresia of the external auditory canal (EAC) is a rare cause of conductive hearing loss. It has been traditionally classified into 4 categories: traumatic, post-operative, neoplastic and inflammatory. Post-inflammatory acquired auditory canal atresia is thought to be the result of chronic and repetitive infectious bouts affecting the auditory canal. Nevertheless, the underlying pathophysiology of this disorder is yet to be fully elucidated. Current data fail to clearly state the impact that certain underlying systemic disorders may have on the EAC. The possible association to metabolic disturbances such as iron deficiency is also emphasized. In the light of these findings, this analysis can be used to improve the classification of this entity thereby standardizing the assessment of therapeutic approaches.
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Affiliation(s)
- Michel Kmeid
- School of Medicine, Lebanese University, Beirut, Lebanon
| | - Jade Nehme
- Lebanese University, Department of Otolaryngology, Head and Neck Surgery, Beirut, Lebanon
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Košec A, Kostić M, Ajduk J, Ries M. Hypertrophic recurring lichen planus of the external auditory canal. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 136:123-126. [PMID: 30606652 DOI: 10.1016/j.anorl.2017.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 01/19/2023]
Abstract
INTRODUCTION We report a case of unilateral progressive primary hypertrophic lichen planus of the external auditory canal requiring several surgical interventions to deal with constant pruritus, otorrhoea, stenosis and conductive hearing loss. CASE SUMMARY A 58-year-old woman was initially treated with meatoplasty for suspected chronic obliterating otitis externa. She remained symptom-free for 5 years, before the disease recurred, affecting other body surfaces as well. Otorrhoea, conductive hearing loss and pruritus worsened, and a canal wall down tympanomastoidectomy was performed, removing the skin of the external auditory canal and the tympanic membrane completely. Lichen planus was confirmed histopathologically. DISCUSSION Very few surgical results have been published on stenosis of the external auditory canal caused by lichen planus. Complete medial external auditory canal skin elevation and removal with postoperative split-skin grafting is advised for initial treatment. We discuss treatment options and surgical outcome after initial surgical failure.
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Affiliation(s)
- A Košec
- Department of Otorhinolaryngology and Head and Neck Surgery, Clinical University Hospital Center Sestre milosrdnice, 29, Vinogradska cesta, 1000 Zagreb, Croatia.
| | - M Kostić
- School of Medicine, University of Zagreb, Šalata 3b, Zagreb, Croatia; Croatian Institute for Health Insurance, Zagreb, Croatia
| | - J Ajduk
- School of Medicine, University of Zagreb, Šalata 3b, Zagreb, Croatia
| | - M Ries
- School of Medicine, University of Zagreb, Šalata 3b, Zagreb, Croatia
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Henry A, Biddlestone J, McCaul J. 'Nasal flossing': A case report of nasopharyngeal stenosis due to severe erosive lichen planus and a novel therapeutic intervention. Int J Surg Case Rep 2018; 54:99-102. [PMID: 30611058 PMCID: PMC6317303 DOI: 10.1016/j.ijscr.2018.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/17/2018] [Accepted: 11/05/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION We describe a case of severe erosive oral lichen planus that led to nasopharyngeal stenosis. This is a rare clinical presentation that was ultimately, successfully treated by surgery combined with post-operative 'nasal flossing': a novel therapeutic intervention. PRESENTATION OF CASE A 76-year-old male suffering from a rare case of severe oral lichen planus that was resistant to conservative measures is described. Initial surgery was complicated by recurrence of nasopharyngeal stenosis. Definitive surgery required revision of nasopharyngeal stenosis release combined with a course of post- operative 'nasal flossing'. The technique for 'nasal flossing' is described and demonstrated in photographs. The patient remained asymptomatic at 3 years using this combined approach, with restoration of olfaction, taste perception and voice quality, significantly enhancing quality of life. DISCUSSION Erosive oral lichen planus is a rare but important presentation in oral medicine. We found 'nasal flossing' to be a successful treatment to maintain nasopharyngeal patency following surgical repair of this uncommon condition. We are not aware that this combined approach has previously been described in the published literature. CONCLUSIONS Severe erosive oral lichen planus can lead to nasopharyngeal stenosis. Nasopharyngeal stenosis in these patients may be refractive to conventional surgical approaches. 'Nasal flossing' is demonstrated to be both practical and acceptable as a surgical adjunct in these difficult to treat cases of recurrent nasopharyngeal stenosis. This report has relevance for all those practicing oral and maxillofacial surgery, ear nose and throat surgery and oral medicine.
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Affiliation(s)
| | - John Biddlestone
- University of Glasgow, Speciality Registrar, Scottish Deanery, United Kingdom.
| | - James McCaul
- NHS GGC, Professor of Maxillofacial Surgery, University of Bradford, United Kingdom
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Mohebbi M, Mirghorbani M, Banafshe Afshan A, Towfighi M. Lichen Planus in Ocular Surface: Major Presentations and Treatments. Ocul Immunol Inflamm 2018; 27:987-994. [DOI: 10.1080/09273948.2018.1485955] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Masoomeh Mohebbi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Mirghorbani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Banafshe Afshan
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Towfighi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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11
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Ectopic Apocrine Glands as a Predisposing Factor for Postinflammatory Medial Meatal Fibrosis. Otol Neurotol 2015; 36:191-7. [DOI: 10.1097/mao.0000000000000368] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Erosive vulval lichen planus—a diagnosis not to be missed: a clinical review. Eur J Obstet Gynecol Reprod Biol 2013; 171:214-9. [DOI: 10.1016/j.ejogrb.2013.09.038] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 08/31/2013] [Accepted: 09/28/2013] [Indexed: 01/03/2023]
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13
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Banihashemi M, Yazdanpanah MJ, Ayati S. Hewitt-Pelisse syndrome with stenosis of the vagina: a case report. Int J Dermatol 2009; 48:1003-5. [PMID: 19702991 DOI: 10.1111/j.1365-4632.2009.04086.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Mahnaz Banihashemi
- Department of Dermatology and Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran.
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14
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Young O, Murphy M, Fitzgibbon J, O'Sullivan P. Koebner phenomenon of the ear canal skin. Auris Nasus Larynx 2008; 36:82-4. [PMID: 18499373 DOI: 10.1016/j.anl.2008.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Revised: 03/13/2008] [Accepted: 03/17/2008] [Indexed: 10/22/2022]
Abstract
The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.
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Affiliation(s)
- O Young
- Department of Otolaryngology, South Infirmary/Victoria Hospital, Old Blackrock Road, Cork, Ireland.
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Hopsu E, Pitkäranta A. Idiopathic, inflammatory, medial meatal, fibrotising otitis presenting with lichen planus. The Journal of Laryngology & Otology 2007; 121:796-9. [PMID: 17349098 DOI: 10.1017/s0022215107006652] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/15/2006] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Background: Of the acquired ear canal atresias, idiopathic, inflammatory, medial meatal, fibrotising otitis has been suggested as a distinct disease entity, for reasons of aetiology.Objective:To report three more cases of idiopathic, inflammatory, medial meatal, fibrotising otitis and to further consider the possible relationship between this condition and lichen planus.Patients:Three adult patients with idiopathic, inflammatory, medial meatal, fibrotising otitis, two with bilateral aural symptoms, treated and followed up at the department of otorhinolaryngology of Helsinki University Hospital.Results:We found idiopathic, inflammatory, medial meatal, fibrotising otitis, affecting solely the glabrous skin of the osseous part of the external ear canals, in three patients who also suffered from severe oral lichen planus.Conclusions:The aetiopathology or pathophysiology of idiopathic, inflammatory, medial meatal, fibrotising otitis may be linked with lichen planus. Early, active treatment of idiopathic, inflammatory, medial meatal, fibrotising otitis with local corticosteroids may prevent total medial meatal atresia.
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Affiliation(s)
- E Hopsu
- Department of Otorhinolaryngology, Kymenlaakso Central Hospital, Kotka, Finland.
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Setterfield JF, Neill S, Shirlaw PJ, Theron J, Vaughan R, Escudier M, Challacombe SJ, Black MM. The vulvovaginal gingival syndrome: A severe subgroup of lichen planus with characteristic clinical features and a novel association with the class II HLA DQB1∗0201 allele. J Am Acad Dermatol 2006; 55:98-113. [PMID: 16781300 DOI: 10.1016/j.jaad.2005.12.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2004] [Revised: 11/30/2005] [Accepted: 12/04/2005] [Indexed: 11/21/2022]
Abstract
BACKGROUND The vulvovaginal gingival syndrome is an uncommon and severe variant of lichen planus characterized by erosions or desquamation of vulval, vaginal, and gingival mucosae with a predilection for scarring and stricture formation. OBJECTIVE We sought to define the clinical, immunopathologic, and human leukocyte antigen findings in a large cohort of patients. METHODS The clinical presentation and outcome during long-term follow-up were documented in 40 patients. In addition, human leukocyte antigen typing for class II by polymerase chain reaction and sequence-specific primers was performed. RESULTS During a mean follow-up period of 8.7 (SD +/- 6.8) years, long-term sequelae included strictures of the esophagus, lachrymal ducts, and external auditory canal; loss of vulval architecture; vaginal stenosis; and buccal mucosal fibrosis. The DQB1( *)0201 allele was present in 80% of patients versus 41.8% of control subjects (P <or= .0042; relative risk 3.71). CONCLUSION Early diagnosis of this distinct subgroup of lichen planus, combined with appropriate therapeutic measures, may help to minimize the significant physical and psychologic morbidity associated with this scarring disorder.
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Affiliation(s)
- Jane F Setterfield
- St John's Institute of Dermatology, St Thomas' Hospital, London SE1 7EH, UK
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Zaraa I, Mokni M, Letaief H, Cherif F, Eleuch D, Azaiez MI, Tabbane K, Hachicha S, Ben Osman Dhahri A. Sténose complète des conduits auditifs externes. Ann Dermatol Venereol 2004; 131:595-6. [PMID: 15318148 DOI: 10.1016/s0151-9638(04)93677-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- I Zaraa
- Service de Dermatologie, Hôpital La Rabta, Tunis, Tunisie.
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