Lichen planus

Finne, K., Goransson, K. and Winckler, L. Oral Lichen Planus and Contact Allergy to Mercury , International Journal of Oral Surgery, 11, 236-39 (1982)... 

Frykholm, K. O., Frithiof, L. Fernstrom, A. I. B., Moberger, G., Blohm, S. G. and Bjorn, E. Allergy to Copper Derived from Dental Alloys as a Possible Cause of Oral Lesions of Lichen Planus Acta Dermatovenerol, 49, 268-81 (1969)... 

Ei addition, clinical observations in EFN-a-treated hqiatitis C or melanoma patients have suggested a promoting effect of type I EFN in autoreactive skin disorders such as Lichen planus. This inflammatory skin disease was, however, not restricted to EFN-a treated patients but was found to be associated with expression by so far unknown mechanisms of the EFN-induced MxA... 

Pemphigus, bullous dermatitis herpetiformis, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, mycosis fungoides, severe psoriasis, severe seborrheic dermatitis, angioedema, urticaria, various skin disorders, such as lichen planus or keloids... 

Solitary or multiple violaceous or brown flat-topped papules resembling lesions of lichen planus. 

PIH can be observed after endogenous or exogenous inflammatory conditions. Essentially any disease with cutaneous inflammation can potentially result in PIH in individuals capable of producing melanin. Several skin disorders such as acne, atopic dermatitis, allergic contact dermatitis, incontinenti pigmenti, lichen planus, lupus erythematosus, and morphea have PIH as a predominant feature. Exogenous stimuli,both... 

Skin Poikiloderma Lichen planus-like features Sclerotic features Morphea-1 ike features Lichen sclerosus-like features Depigmentation Seat impairment Ichthyosis Keratosis pilaris Hypopigmentation Hypergimentation Erythema Maculopapular rash Pruritus... 

Keratosis Lichen planus Any horny growth Inflammatory skin disease with wide, flat papules occurring in circumscribed patches... 

N. L. Rhodus, B. Cheng, S. Myers, L. Miller, V. Ho and F. Ondrey, The feasibility of monitoring NF-kappaB associated cytokines TNF-alpha, IF-1 alpha, IL-6, and IL-8 in whole saliva for the malignant transformation of oral lichen planus. Mol. Carcinog., 2005, 44(2), 77. 

Lichen planus is a condition of unknown aetiology presenting as small pruritic and shiny papules, which initially may appear purple in colour. It affects the limbs, wrists, trunk, genitalia and the mouth, in which case ulcerated lesions occur on the gingival tissue. Treatment for lichen planus involves the use of systemic antihistamines but sometimes corticosteroids are required. 

Gorouhi F, Solhpour A, Beitollahi JM, Afshar S, Davari P, Hashemi P, Nassiri Kashani M, Firooz A. (2007) Randomized trial of pimecrolimus cream versus triamcinolone acetonide paste in the treatment of oral lichen planus. J Am Acad Dermatol 57 806-813. 

Pruritus Relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses Contact dermatitis, atopic dermatitis, nummular eczema, stasis eczema, asteatotic eczema, lichen planus, lichen simplex chronicus, insect and arthropod bite reactions, first- and second-degree localized burns, and sunburns. 

Numerous glucocorticosteroids for topical application are available. Essentially they all suppress the symptoms of inflammatory and hypersensitivity reactions and their mechanism of action is similar. Their indications include seborrhoeic and atopic dermatitis, phototoxic reactions, psoriasis, chronic discoid lupus, hypertrophic lichen planus and alopecia areata. However it has to be kept in mind that the use of corticosteroids for these conditions in most cases only gives symptomatic relieve and that the problem tends to recur on cessation of therapy. Traditionally topical corticosteroid formulations are grouped according to approximate relative efficacy. This efficacy is determined by both the potency of the agent and the concentration in which the corticosteroid is used. 

Acitretin is most useful for the treatment of severe psoriasis, particularly the pustular and erythrodermic variants. Psoriatic nail changes and arthritis also may respond. Combining the drug with ultraviolet light therapy (Re-UVB, in the case of ultraviolet B radiation, or Re-PUVA, with psoralen plus ultraviolet A radiation) permits the use of lower doses of both acitretin and ultraviolet radiation. Other conditions for which the drug may be especially useful include congenital and acquired hyperkeratotic disorders, such as the ichthyoses and palmoplantar keratodermas, and severe lichen planus. 

Atopic dermatitis, contact dermatitis, dermatitis, discoid lupus erythematosus, eczema, exfoliative dermatitis, granuloma annulare, lichen planus, lichen simplex, polymorphous light eruption, pruritus, psoriasis, Rhus dermatitis, seborrheic dermatitis, xerosis ... 

Dermatology Topical steroids are useful in keloids, hypertrophic scars, other localised hypertrophic, infiltrated, inflammatory lesions of lichen planus, psoriatic plaques, granuloma annulare and lichen simplex chronicus discoid lupus erythematosus, necrobiosis lipoidica diabeticorum and alopecia areata. 

Propylene glycol is an effective keratolytic agent for the removal of hyperkeratotic debris. It is also used in combination with salicylic acid in the treatment of ichthyosis, psoriasis, keratosis pilaris and hypertrophic lichen planus. 

Propylene glycol is used under polyethylene occlusion or with 6% salicylic acid for the treatment of ichthyosis, palmar and plantar keratodermas, psoriasis, pityriasis rubra pilaris, keratosis pilaris, and hypertrophic lichen planus. 

Azzam H, Bergman R, Friedman-Birnbaum R. Lichen planus associated with metformin therapy. Dermatology 1997 194(4) 376. 

Krahn LE, Goldberg RL. Psychotropic medications and the skin. Adv Psychosom Med 1994 21 90-106. Ellgehausen P, Eisner P, Burg G. Drug-induced lichen planus. Clin Dermatol 1998 16(3) 325-32. 

When severe psychosis following treatment with chloroquine and hydroxychloroquine occurs it is usually during treatment for malaria, but it can follow treatment for connective tissue disorders. Hallucinations have been reported after hydroxychloroquine treatment for erosive lichen planus (152). 

A 75-year-old woman was given hydroxychloroquine 400 mg/day for erosive lichen planus in conjunction with topical glucocorticoids and a short course of oral methylprednisolone 0.5 mg/kg/day. After 10 days she became disoriented in time and place, followed by feelings of depersonalization and kinesthetic hallucinations, preceded by nightmares. She stopped taking hydroxychloroquine 1 week later and the hallucinations progressively disappeared. She recovered her normal mental state within 1 month and had not relapsed 2 years later. 

Adrenal steroids of highest potency are reserved for recalcitrant dermatoses, e.g. lichen simplex, lichen planus, nodular prurigo and discoid lupus erythematosus. 

Choice of preparation relates both to the disease and the site of intended use. High potency preparations are commonly needed for lichen planus and discoid lupus erythematosus weaker preparations (hydrocortisone 0,5-2.5%) are usually adequate for eczema, use on the face and in childhood. 

Lichen planus Ancipruricics potent topical corticosteroid (rarely systemic). May be drug caused, e g. a phcnothiazinc or antimalariai. 

Graham-Brown, R.A.C., Sarkany, I., Sherlock, S. Lichen planus and primary bihary cirrhosis. Brit. J. Dermatol. 1982 106 699 - 703... 

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