1
|
Reddy BSK, Ghewade B, Jadhav U, Wagh P. Scleroderma Associated With Organising Pneumonia and Polyarthritis: A Report of a Rare Case. Cureus 2024; 16:e52886. [PMID: 38406027 PMCID: PMC10891365 DOI: 10.7759/cureus.52886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Cryptogenic organising pneumonia (COP) is a form of idiopathic diffuse interstitial lung disease (ILD) that develops in response to a variety of unknown irritants. An essential component of the development of organising pneumonia (OP) is damage to type II pneumocytes and the alveolar basement membrane. An autoimmune illness called systemic sclerosis (SSc) has a significant death rate from cardiopulmonary involvement such as pulmonary hypertension and ILD. Arthritis is an autoimmune disorder, in which the patients experience extra-articular symptoms such as ILD during the course of their disease, and COP frequently coexists with these conditions. It is exceedingly uncommon for OP to occur as the initial sign of arthritis, and its clinical characteristics are still unclear. Scleroderma and inflammatory polyarthritis related to COP are presented in this report.
Collapse
Affiliation(s)
- Bingu Shiv Kiran Reddy
- Pulmonary and Critical Care Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Babaji Ghewade
- Pulmonary and Critical Care Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ulhas Jadhav
- Pulmonary and Critical Care Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pankaj Wagh
- Pulmonary and Critical Care Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
2
|
Swarnkar B, Gupta S, Bhari N, Kumar Arava S. Saxophone Penis Secondary to Lichen Simplex Chronicus Responding to Low Dose of Methotrexate and Doxycycline. Dermatol Pract Concept 2023; 13:e2023123. [PMID: 37557147 PMCID: PMC10412011 DOI: 10.5826/dpc.1303a123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 08/11/2023] Open
Affiliation(s)
- Bhavya Swarnkar
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Sudheer Kumar Arava
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
3
|
Day T, Scurry J, Haqshenas G, Murray G, Tran H, Dennerstein G, Garland SM. The Clinicopathologic Challenge of Nonneoplastic Vulvar Acanthosis. J Low Genit Tract Dis 2022; 26:265-270. [PMID: 35543596 PMCID: PMC9232284 DOI: 10.1097/lgt.0000000000000681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate clinicopathologic features of cases demonstrating an acanthotic tissue reaction not clearly consistent with psoriasis, lichen simplex chronicus, mycosis, or condyloma. MATERIALS AND METHODS This is a retrospective pathologic case series of biopsies reported as "benign acanthotic lesion" and "acanthotic tissue reaction" that lacked a clear diagnosis on expert review. Cases with nuclear atypia were excluded. Clinical and histopathologic data were collected, immunohistochemistry for p16 and p53 were obtained, and molecular testing for 28 common anogenital human papillomavirus (HPV) genotypes was undertaken. RESULTS There were 17 cases with a median age of 47 years. Unilaterality and medial location were clinical reasons for diagnostic difficulty. Histopathologic uncertainty often related to lack of papillary dermal fibrosis to support lichen simplex chronicus or psoriasiform lesions without parakeratosis, subcorneal pustules, and/or mycotic elements. Firm pathologic diagnoses were not possible, but 3 groups emerged: favoring chronic dermatitis, favoring psoriasis, and unusual morphologies. p16 results were negative or nonblock positive while p53 was normal or basal overexpressed. Human papillomavirus testing was negative in 12, low positive for HPV 16 in 1, unassessable in 3, and not requested in 1. CONCLUSIONS There is a group of acanthotic tissue reactions that cannot be classified with standard histopathologic assessment. Further clinicopathologic research into unilateral acanthotic lesions may provide insight into separation of psoriasis and mycosis when organisms are absent. Once nuclear atypia is excluded, immunohistochemistry for p16 and p53 and HPV molecular testing do not assist in diagnostic identification.
Collapse
Affiliation(s)
- Tania Day
- Maternity and Gynaecology, John Hunter Hospital, Lambton Heights, Australia
- Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - James Scurry
- Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
- NSW Health Pathology North, John Hunter Hospital, New Lambton Heights, Australia
| | - Gholamreza Haqshenas
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
- Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia
- Centre for Women's Infectious Diseases, Royal Women's Hospital, Melbourne, Australia
| | - Gerald Murray
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
- Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia
- Centre for Women's Infectious Diseases, Royal Women's Hospital, Melbourne, Australia
| | - Hong Tran
- Vulvar Disorders and Dermatology Clinic, Royal Women's Hospital, Melbourne, Australia
| | | | - Suzanne M. Garland
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
- Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia
- Centre for Women's Infectious Diseases, Royal Women's Hospital, Melbourne, Australia
| |
Collapse
|
4
|
Brożyna AA, Żmijewski MA, Linowiecka K, Kim TK, Slominski RM, Slominski AT. Disturbed expression of vitamin D and retinoic acid-related orphan receptors α and γ and of megalin in inflammatory skin diseases. Exp Dermatol 2022; 31:781-788. [PMID: 34995387 PMCID: PMC9064941 DOI: 10.1111/exd.14521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 02/06/2023]
Abstract
The pathogenesis of inflammatory skin diseases is associated with the abnormal activity of keratinocytes and immune cells infiltrate. Vitamin D3 deficiency can correlate with the increased incidence, severity and duration of inflammatory skin disorders. The exact mechanism on how vitamin D3 influences inflammatory skin diseases still requires clarification. However, it can be associated with the disturbances in transmembrane glycoprotein-LRP2/megalin, which is implicated in vitamin D3 transport to the cell, and defects in vitamin D-signalling through the nuclear receptors. Therefore, by using immunohistochemistry, we analysed the expression of LRP2/megalin, VDR, RORα and RORγ in allergic contact dermatitis, lichen simplex chronicus, sarcoidosis and psoriasis in comparison with the normal skin. We observed decreased expression of LRP2/megalin in all inflammatory lesions in comparison with the normal skin. Significant differences were also noticed in VDR, RORα and RORγ levels between inflammatory lesions and normal skin. Our research indicates disturbed expression of LRP2/megalin, VDR, RORα and RORγ in inflammatory skin lesions in comparison with normal skin. Therefore, we suggest that changes in the activity of these proteins may play role in pathogenesis of inflammatory skin disorders. Furthermore, we suggest that LRP2/megalin, VDR, RORα and RORy may serve as targets in therapy of these diseases.
Collapse
Affiliation(s)
- Anna A Brożyna
- Department of Human Biology, Institute of Biology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, Toruń, Poland
| | - Michał A Żmijewski
- Faculty of Medicine, Department of Histology, Medical University of Gdańsk, Gdańsk, Poland
| | - Kinga Linowiecka
- Department of Human Biology, Institute of Biology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, Toruń, Poland
| | - Tae-Kang Kim
- Departments of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Radomir M Slominski
- Departments of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Graduate Biomedical Sciences Program, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrzej T Slominski
- Departments of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Laboratory Service, VA Medical Center at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
5
|
Abstract
Lichen simplex chronicus (LSC) of the vulva is an acquired, persistent, severely itchy dermatosis usually located in easily reachable areas of the body like the extremities, nape of the neck, and genitalia. It also has a strong association with atopy and is said to be initiated and perpetuated by the itch–scratch–itch cycle. Two cases of rugose labia as the sole presentation of LSC of vulva are being presented.
Collapse
|
6
|
Aquino TM, Calvarido MG, North JP. Interleukin 36 expression in psoriasis variants and other dermatologic diseases with psoriasis-like histopathologic features. J Cutan Pathol 2021; 49:123-132. [PMID: 34346097 DOI: 10.1111/cup.14115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/30/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Elevated epidermal interleukin (IL)-36 expression distinguishes psoriasis from eczematous dermatitis, but other psoriasiform dermatitides (PDs) have not been thoroughly investigated for IL-36 expression. In this study, we assess the IL-36 staining pattern (IL36-SP) in psoriasis variants and other PDs including lichen simplex chronicus (LSC), prurigo nodularis (PN), lichen planus (LP), tinea, pityriasis rubra pilaris (PRP), mycosis fungoides (MF), pemphigus foliaceus (PF), acute generalized exanthematous pustulosis (AGEP), impetigo (IMP), and syphilis (SY). METHODS IL-36 immunostaining was performed on 307 cases of psoriasis and various PDs. IL36-SP in the upper epidermis was graded on a scale of 0-4. RESULTS High IL36-SP occurred in all variants of psoriasis, as well as in AGEP, PRP, PN, tinea, IMP, and LP (P > 0.05). SY, PF, LSC, and MF showed a lower IL36-SP (P ≤ 0.05) compared with psoriasis. CONCLUSION All variants of psoriasis exhibit high IL36-SP. IL-36 staining can assist in differentiating MF, PF, SY, and LSC from psoriasis, particularly MF and LSC, which have consistent low IL-36 expression. AGEP, PRP, tinea, IMP, PN, and LP exhibit high IL-36 expression similar to psoriasis, indicating Th17 activation in these diseases.
Collapse
|
7
|
Gharib K, Mostafa A, Elsayed A. Evaluation of Botulinum Toxin Type A Injection in the Treatment of Localized Chronic Pruritus. J Clin Aesthet Dermatol 2020; 13:12-17. [PMID: 33488912 PMCID: PMC7819596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND: Botulinum toxin is a neurotoxin produced by the bacterium Clostridium botulinum that causes a flaccid muscle paralysis. It is currently used for aesthetic procedures and to treat focal hyperhidrosis. The botulinum toxin has also been used experimentally in many other dermatological conditions with positive results. OBJECTIVE: We sought to evaluate the efficacy and safety of intradermal injection of botulinum toxin A in the treatment of localized recalcitrant chronic pruritus in lichen simplex, inverse psoriasis, post-burn itching, lichen planus (hypertrophic), and postherpetic neuralgia. METHODS: This was a clinical trial study of 32 patients (12 with lichen simplex chronicus [LSC], 4 with inverse psoriasis, 4 with post-burning itch, 4 with lichen planus, 4 with hypertrophic lichen planus, and 4 with post-herpetic neuralgia). We used 2 to 3mL of unpreserved saline to dilute each vial (50 units) of botulinum toxin A. This led to a final concentration of 2 to 2.5U/0.1cc; injections were typically made into the dermis. RESULTS: The ages of patients in the group studied ranged from 13 to 85 years, with a mean of 37.38 years, and 59.4 percent were female. There were statistical reductions in visual analog scale in all the studied cases. CONCLUSION: Botulinum toxin A appears to be a safe and effective therapy for the improvement of localized recalcitrant itching in LSC, inverse psoriasis, burns, hypertrophic lichen planus, lichen planus, and symptoms of postherpetic neuralgia.
Collapse
Affiliation(s)
- Khaled Gharib
- Drs. Gharib, Mostafa, and Elsayed are with the Dermatology Department, Faculty of Medicine, at Zagazig University in Ash Sharqia Governorate, Egypt
| | - Asmaa Mostafa
- Drs. Gharib, Mostafa, and Elsayed are with the Dermatology Department, Faculty of Medicine, at Zagazig University in Ash Sharqia Governorate, Egypt
| | - Ayman Elsayed
- Drs. Gharib, Mostafa, and Elsayed are with the Dermatology Department, Faculty of Medicine, at Zagazig University in Ash Sharqia Governorate, Egypt
| |
Collapse
|
8
|
Abstract
Background Lichen sclerosus is an inflammatory dermatosis of unknown etiology which currently has no cure. Most treatment guidelines recommend the use of ultrapotent topical corticosteroids. However, the relapse rate is usually high. Through a retrospective study we evaluated the efficacy and safety of stromal vascular fraction of adipose tissue as therapy for lichen sclerosus. Material and methods For this retrospective review, we obtained data on patients with vulvar lichen sclerosus treated with autologous fat grafting enriched with adipose derived stromal vascular fraction cells. Data collected through a modified vulvo-vaginal symptoms questionnaire were analyzed before treatment, six months and 24 months after treatment. The 19 items questionnaire was subdivided in four categories: symptoms, signs, social functioning and sexual functioning. Global scores and partial scores for each category were analyzed using paired t-test. For all statistical analyses, a value of p ≤ 0.05 was considered statistically significant. All data are presented as mean ± SD. Results Thirty nine patients were included in the study. Thirty seven patients (94.87%) experienced a significant decrease in global score at six months and 24 months after treatment (p < 0.05). Decrease in scores were also statistically significant between pretreatment and 24 months after treatment for each of the four questionnaire categories - symptoms, signs, social functioning and sexual functioning (p < 0.05). Conclusions This retrospective study showed that the use of autologous fat grafting enriched with adipose derived stromal vascular fraction is safe and leads to significant and long lasting improvement in patients with vulvar lichen sclerosus.
Collapse
|
9
|
ICHIKI T, SUGITA K, FURUE M, YAMAMOTO O. An Intimate Relationship Between Intralesional Depigmentation and Peripheral Nervous System in Lichen Simplex Chronicus. Acta Derm Venereol 2020; 100:adv00042. [PMID: 31821517 PMCID: PMC9128931 DOI: 10.2340/00015555-3390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 12/03/2022] Open
Affiliation(s)
- Toshio ICHIKI
- Department of Medicine of Sensory and Motor Organs, Division of Dermatology, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori 683-8504
- Department of Dermatology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan. E-mail:
| | - Kazunari SUGITA
- Department of Medicine of Sensory and Motor Organs, Division of Dermatology, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori 683-8504
| | - Masutaka FURUE
- Department of Dermatology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan. E-mail:
| | - Osamu YAMAMOTO
- Department of Medicine of Sensory and Motor Organs, Division of Dermatology, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori 683-8504
| |
Collapse
|
10
|
Abstract
Background/aim Phototherapy is a safe and effective treatment modality for numerous dermatological conditions. Recently, targeted phototherapy modalities have gained importance due to their advantages over conventional phototherapy. This retrospective study aimed to evaluate the safety and efficacy of targeted narrowband UVB phototherapy in patients with dermatological disorders. Materials and methods This single-center study included 173 patients who were treated with targeted narrowband UVB phototherapy. Demographic features, phototherapy parameters, and adverse effects were evaluated in all patients, and the treatment response was assessed in patients who attended at least one follow-up visit. Results A total of 173 patients (102 females; 71 males) with vitiligo, alopecia areata, lichen simplex chronicus, palmoplantar psoriasis, and psoriasis vulgaris were included in the study. Among 73 patients, with whom the treatment was finalized by physician, an excellent response was obtained in 10%, 52.9%, 53.8%, 28.6%, and 40% of patients with vitiligo, alopecia areata, lichen simplex chronicus, palmoplantar psoriasis, and psoriasis, respectively. The treatment was generally well tolerated and was discontinued in only two patients due to adverse effects. Conclusion This study demonstrates that targeted narrowband UVB therapy is a safe and effective treatment alternative, particularly for alopecia areata, lichen simplex chronicus, and palmoplantar and plaque-type psoriasis.
Collapse
|
11
|
Jung HM, Eun SH, Lee JH, Kim GM, Bae JM. Less painful and effective intralesional injection method for lichen simplex chronicus. J Am Acad Dermatol 2018; 79:e105-e106. [PMID: 30025827 DOI: 10.1016/j.jaad.2018.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/28/2018] [Accepted: 07/06/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Han Mi Jung
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sung Hye Eun
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Ji Hae Lee
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Gyong Moon Kim
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
| |
Collapse
|
12
|
Abstract
Vulvar dermatoses are common, potentially debilitating conditions that can be seen by a variety of medical specialists. Lichenoid vulvar diseases, namely lichen sclerosus (LS), lichen planus (LP), and lichen simplex chronicus (LSC), can all negatively impact patients' quality of life and LS and LP also have an association with squamous cell carcinoma. It is essential that dermatologists are familiar with the unique features of each of these conditions to ensure the appropriate management and follow up. Herein, we provide an update on the epidemiology, clinical presentation, histopathology, and treatment of patients with vulvar LS, LP, and LSC.
Collapse
Affiliation(s)
- R Fruchter
- The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY
| | - L Melnick
- The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY
| | - M K Pomeranz
- The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY.,Department of Dermatology, NYC Health and Hospital/Bellevue, New York, NY
| |
Collapse
|
13
|
Chan MP, Zimarowski MJ. Vulvar dermatoses: a histopathologic review and classification of 183 cases. J Cutan Pathol 2015; 42:510-8. [PMID: 25996085 DOI: 10.1111/cup.12541] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 10/24/2014] [Accepted: 11/25/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Vulvar dermatoses are often difficult to classify due to histopathologic overlap. We aimed to report our experience at a single institution. METHODS A total of 183 non-neoplastic, non-infectious vulvar biopsies were reviewed. Associations between histopathologic features and specific diagnoses were analyzed by Chi-squared tests. RESULTS Twenty-two biopsies (12.0%) showed two concurrent processes. A limited differential rather than a definitive diagnosis was rendered in 15 cases (8.2%). The final diagnoses included lichen sclerosus (LS) (38.8%), lichen simplex chronicus (LSC) (29.0%), eczematous dermatitis (23.0%), Zoon vulvitis (8.2%), non-specific/resolved dermatitis (5.5%), hidradenitis suppurativa (2.7%), Behçet disease (2.2%), lichen planus (1.6%), ruptured cyst (1.6%), ulcer not-otherwise-specified (1.6%), psoriasis (1.1%), radiation dermatitis (1.1%), sebopsoriasis (1.1%), seborrheic dermatitis (1.1%), epidermolytic hyperkeratosis (0.5%) and granular parakeratosis (0.5%). Early LS and Zoon vulvitis were commonly included as part of a differential diagnosis. LS was associated with wiry collagen with lymphocyte entrapment (p = 0.0188). LSC was associated with zones of pale epithelium (p = 0.0084), and often displayed prominent fibroblasts (p = 0.0555). Zoon vulvitis was frequently misdiagnosed, and was associated with basal keratinocytic crowding (p < 0.0001). CONCLUSIONS Our study has determined the relative frequencies of a wide variety of vulvar dermatoses, and identified new diagnostic clues for early LS, LSC and Zoon vulvitis.
Collapse
Affiliation(s)
- May P Chan
- Department of Pathology and Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Mary Jane Zimarowski
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
14
|
Abstract
Vulvar dermatoses are inflammatory conditions responsible for chronic or recurrent itching and soreness. The lesions are either circumscribed to the vulva or associated with extragenital localizations which may help to assess the diagnosis. They should be differentiated from infectious or neoplastic diseases which may have clinical similarities. As opposed to the majority of all dermatoses that have a benign and regular course, lichen sclerosus or lichen planus could exceptionally foster the occurrence of an epithelial cancer precursor which may evolve to squamous cell carcinoma. Topical corticosteroids are the mainstay treatment of vulvar dermatosis. We do not know if the treatment of vulvar lichen sclerosus and vulvar lichen planus prevents squamous cell carcinoma.
Collapse
Affiliation(s)
| | - Jeanne Wendling
- Department of Dermatology, Hôpital Tarnier Cochin, 89 rue d'Assas, 75006 Paris, France
| |
Collapse
|
15
|
D'Erme AM, Milanesi N, Agnoletti AF, Maio V, Massi D, Gola M. Efficacy of treatment with oral alitretinoin in patient suffering from lichen simplex chronicus and severe atopic dermatitis of hands. Dermatol Ther 2013; 27:21-3. [PMID: 24502306 DOI: 10.1111/dth.12035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lichen simplex chronicus (LSC) is a skin disorder characterized by chronic itching and scratching, which can lead to thick, leathery, brownish skin, sometimes with papules and can be associated with atopic eczema. We report the case of a 52-year-old man with a 45-year atopic condition and presenting LSC in his dorsum. After a 3-month treatment with alitretinoin at the daily dosage of 30 mg, we have observed a moderate improvement of the hand eczema together with a substantial clinical improvement of LSC and an almost complete resolution of pruritus. We want to report this peculiar case to suggest the use of oral alitretinoin for LSC.
Collapse
Affiliation(s)
- Angelo Massimiliano D'Erme
- Allergological and Occupational Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence, Florence
| | | | | | | | | | | |
Collapse
|