A case of lichen planus pigmentosus on the axilla

( Kyung Ho Kim ),( Hong Lim Kim ),( Hyun Yi Suh ),( Jae Wook Jeon ),( Ji Young Ahn ),( Mi Youn Park ),( Jai Il Youn ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Lichen planus is a common inflammatory disorder that affects the skin, mucous membranes, nails, and hair. It can be classified by configuration, morphology and involved site. Lichen planus pigmentosus is a variant of lichen planus characterized by hyperpigmented, dark-brownish macules in face and flexural folds such as neck, axilla, inframammary region and groin. It tends to occur in patients with darker pigmented skin. It may be unilateral, and usually involving less than 10% body surface area and size varies from several mm to several cm, oval in shape, and may follow lines of Blaschko. It can be associated with pruritus but much milder than in classic lichen planus. Histologically, it shows compact orthokeratosis, wedge-shaped hypergranulosis withirregular acanthosis and vaculoar alteration of the basal layer as classic lichen planus and additionally shows scattered melanophages and melanin pigment incontinence. And it accompanies with band-like dermal lymphocytic infiltration in papillary dermis. Foreign 36 year old male with dark skin type visited our clinic with irregular margined confluenting blackish papuloplaque on the right axilla. Biopsy confirmed as lichen planus pigmentosus. And patient was also diagnosed with annular lichen planus in configuration and lichen planus inversus according to the involved site.

선상 편평태선의 경구 스테로이드 치료

강유석 ( Yoo Seok Kang ),이운하 ( Un Ha Lee ),박현수 ( Hyun Su Park ),장상재 ( Sang Jai Jang ) 대한피부과학회 2008 大韓皮膚科學會誌 Vol.46 No.5

Background: Lichen planus is a chronic papulosquamous disease characterized by various clinical manifestations of the skin, mucosa, hair, and nails. Various drugs or physical treatments for lichen planus have been proposed, but the efficacies are often disappointing and controversial. Linear lichen planus is a rare variant of lichen planus, which accounts for 0.2∼0.6% of all patients with lichen planus. Systemic corticosteroids remain the most widely used treatment for lichen planus. However, there have been no clinical studies on the effectiveness of this therapy on linear lichen planus despite the fact that linear lichen planus usually lasts for more than 1 year and occasionally results in cosmetic problems. Objective: This study evaluated the efficacy and safety of oral methylprednisolone therapy for linear lichen planus. Methods: Retrospective study was performed by reviewing the medical records and clinical photographs of 12 linear lichen planus patients treated with oral methylprednisolone. The analyses of treatment response to oral methylprednisolone therapy, adverse effects, and recurrence were performed. Results: All the 12 patients who completed the oral methylprednisolone therapy achieved complete response. Most patients showed a marked improvement 1 to 2 weeks after starting oral methylprednisolone therapy. Three of the 12 patients showed recurrence at 9 to 14 weeks after cessation of the treatment. Oral methylprednisolone therapy was generally well-tolerated and no serious adverse effects were observed. Conclusion: Oral methylprednisolone therapy is an efficacious, safe, and tolerable treatment modality for linear lichen planus. (Korean J Dermatol 2008;46(5):587∼595)

Hypertrophic lichen planus on the operation-site in a patient with lichen planus

( Hong Lim Kim ),( Joo Yoon Bae ),( Hyun Yi Suh ),( Kyung Ho Kim ),( Ji Young Ahn ),( Mi Youn Park ),( Jai Il Youn ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Lichen planus is a chronic papulosquamous disease that affects the skin and mucous membranes. It is associated with a positive Koebner``s phenomenon by stress factors including trauma, such as burns, friction, and surgical incision. The pathogenesis of this phenomenon is not well understood. Hypertrophic lichen planus is the most pruritic variant of lichen planus, which is charactrerized by verrucous plaques with variable amounts of scales on the lower extremities, especially the shins and interphalangeal joints. 75-year-old female, previously diagnosed of lichen planus on the trunk, presented with severe pruritic multiple papules and plaques on the knee where she had a scar after an operation, total knee athroplasty, both, 4 years ago. At first, polygonal violaceous papules and verrucous plaques developed above the knee, both and continuously appeared along the line of scars. Histopathologic examination revealed marked hyperkeratosis, compact orthokeratosis, irregular acanthosis and wedge-shaped hypergranulosis. The patient had been treated with intralesional injection of steroid at two week interval for 2 months, topical steroid and antihistamine medication. Both skin lesion and subjective symptoms including pruritus improved remarkably. We report a rare case that hypertrophic lichen planus on the operation-site in a patient with lichen planus.

Eruptive generalized lichen planus in childhood

( Sue Jeong Kim ),( Hae Eul Lee ),( Myung Im ),( Young Joon Seo ),( Jeung Hoon Lee ),( Young Lee ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Lichen planus is an inflammatory disorder showing flat, violaceous, polygonal papules and plaques on the skin and mucous membranes. The disease occurs most commonly in adults and rarely affects in children. Among total cases of lichen planus, childhood lichen planus is reported to only 1-4%. In childhood lichen planus, the classic form of lichen planus is more commonly seen and eruptive generalized lichen planus is rare. A 3-year-old girl visited clinic with white linear patches on oral mucosa and multiple non-pruritic erythematous plaques on her whole body which appeared since 2 months ago. Histopathological examination showed dense band-like lymphocytic infiltration in the papillary dermis, vacuolar degeneration of the basal layer, necrotic keratinocytes, and irregular acanthosis with wedge shaped hypergranulosis showing typical features of lichen planus. Here, we report a rare case of eruptive generalized lichen planus in 3-year-old child.

A caes of eruptive lichen planus

( Jeong Won Jo ),( Hae Bong Jeong ),( Yun Sun Moon ),( Do Seon Jeong ),( Eui Chang Jung ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Eruptive lichen planus is a rare variant of lichen planus and variety of rapidly spreading and extensive form of lichen planus. Lichen planus is a common and chronic inflammatory disease of the skin and mucous membranes. It typically manifests as pruritic, faintly erythematous to violaceous, flat-topped, polygonal papules distributed mainly over the flexural areas of wrists, arms, and legs. It usually resolves after a variable period of time, ranging from a few months to years, leaving behind pigmentation and/or scarring. The exact pathogenesis of lichen planus is not clear. Association of a chronic active hepatitis C virus infection with lichen planus and triggering of lichen planus following a hepatitis B virus vaccination has been previously described. So we report the eruptive lichen planus in patients who have received treatment with hepatitis B infection.

구강편평태선을 동반한 천공성 광택태선

조은별 ( Eun Byul Cho ),이영숙 ( Young Wook Lee ),박은주 ( Eun Joo Park ),권인호 ( In Ho Kwon ),조희진 ( Hee Jin Cho ),감광호 ( Kwang Ho Kim ),김광중 ( Kwang Joong Kim ) 대한피부과학회 2010 대한피부과학회지 Vol.48 No.11

Lichen planus is an unique, common inflammatory disorder that affects the skin, mucous membranes, nails and hair. Oral lichen planus is among the more common mucosal conditions with an unknown etiology. Lichen nitidus is an uncommon, usually asymptomatic cutaneous eruption that is characterized by the presence of multiple, small, flesh colored papules. Perforation in lichen nitidus is a rare phenomenon. Lichen nitidus is distinguished from lichen planus on both clinical and histologic grounds. However, the possibility that lichen nitidus represents a micropapular variant of lichen planus has never been definitively excluded. Herein, we report on a case of perforating lichen nitidus associated with oral lichen planus. (Korean J Dermatol 2010;48(11):1012∼1015)

발바닥에 국한된 편평태선 1예

서기석 ( Kee Suck Suh ),이진우 ( Jin Woo Lee ),노효진 ( Hyo Jin Roh ),최수영 ( Soo Young Choi ),도기승 ( Ki Seung Doh ),김상태 ( Sang Tae Kim ) 대한피부과학회 2007 大韓皮膚科學會誌 Vol.45 No.8

Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. As palmoplantar lichen planus do not usually have the classically clinical features of lichen planus, a biopsy is very useful. Histopathologic findings are identical to classic lichen planus. According to literature, similar lichen planus may be found elsewhere on the body in palmoplantar lichen planus. We report a case of lichen planus limited to the soles in a 50 year-old female, who presents with erythematous hyperkeratotic crusted pruritic plaques on both soles. (Korean J Dermatol 2007;45(8):855∼857)

[P242] Successful long term management of severe oral lichen planus : A case report and literature review

( Ji Hyun Park ),( Tae Jun Park ),( Bo Young Kim ),( Seung Hyun Chun ),( Il-hwan Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Lichen planus is an inflammatory mucocutaneous disease that can affect the skin, hair, nails, and mucosal surfaces. Oral lichen planus is a mucosal variant of lichen planus, which can follow a chronic course and result in significant morbidity. A 59 year old male patient presented to our dermatology outpatient department with complaint of painful hemorrhagic patch on his lower lip for last two months. Patient had history of smoking and dental implantation. On clinical examination there were painless whitish reticular patches present over bilateral buccal mucosa, which he didn’t noticed. The skin biopsy was held on lower lip and buccal mucosa. The histopathologic report was both consistent with lichen planus. The initial management was held with systemic isotretinoin, topical steroid and triamcinolone intra-lesional injection. With only mild alleviation of symptoms, we changed the topical agent to cyclosporine and it responded well. With 595nm pulse dye laser treatment for maintenance therapy, the patient no longer need any medication to control his symptoms now. Herein, we report a successful managed case of oral lichen planus and the need for multimodal approach in patients with severe oral lichen planus.

한국인 편평태선의 임상적 고찰

임은화 ( Eun Hwa Lim ),임명 ( Myung Im ),이영 ( Young Lee ),김창덕 ( Chang Deok Kim ),이증훈 ( Jeung Hoon Lee ),서영준 ( Young Joon Seo ) 대한피부과학회 2013 大韓皮膚科學會誌 Vol.51 No.9

Background: The clinical presentation of lichen planus varies depending on the area involved. It occurs in less than 1% of the world’s population: also, the prevalence in Korea is relatively low. However, the number of our outpatients has been increasing rapidly. Objective: We studied the clinical characteristics of 100 patients with biopsy proven lichen planus. Methods: We reviewed the medical records and clinical photographs of 100 patients who had been diagnosed with lichen planus during the last 10 years, from January 2002 to December 2011. Results: Over the past 10 years, patients with Lichen Planus accounted for 0.196% among the new outpatients of this dermatology. The rate of Lichen Planus increased when it occurred on the skin, except for the Mucosal area. Of the 100 outpatients, 62% were men and 38% were women. The mean age at diagnosis was 54 years, and more than half of the patients were between 40 and 60 years of age. The most common site of lichen planus was the lip,which was found in 44% of the patients. Oral lesions were the second most commonly involved site at 28%,followed by the body at 20% and the genital area at 8%. The patients complained of various symptoms such as pain, burning sensation, pruritus, and irritation. Various treatments had been tried by all patients. Conclusion: This study of domestic patients with Lichen Planus is the biggest clinical research performed at a single center. The clinical features of patients in this survey share many similarities with those reported previously,but showed some differences too.

Immunohistochemical Differentiation between Actinic Cheilitis and Lichen Planus of the Lips

( Soo Eun Jung ),( Yong Hyun Jang ),( Hee Young Kang ),( Eun So Lee ),( You Chan Kim ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.1

Background: It is difficult to distinguish between actinic cheilitis and lichen planus histologically, because bothtypes of lesions exhibit variable degrees of epidermal dysplasia and dermal lichenoid inflammation. There iscurrently no consensus on suitable immunohistochemical markers for distinguishing these 2 conditions. Objective: This study aims to determine histological features and immunohistochemical markers that could be usedto differentiate actinic cheilitis from lichen planus. Methods: Fifteen cases of actinic cheilitis and 11 cases of lichen planus of the lips were included in the study. Histological changes such as parakeratosis, hyperkeratosis, atrophy, acanthosis, ulceration, necrosis, dermal solarelastosis, degrees of epidermal dysplasia and dermal inflammatory cell infiltration were examined. Verhoeff-vanGieson stained sections were quantified for the degree of elastosis using computer software. The followingimmunohistochemical markers were stained for: bcl-2, Ki-67, proliferating cell nuclear antigen, indoleamine 2,3-dioxygenase, matrix metalloproteinase-3, matrix metalloproteinase-9, CD4, CD8, c-kit, and prolyl-4-hydroxylase. Results: The only histologically appreciable difference between the diseases was the degree of epidermal dysplasia. No differences were observed with respect to solar elastosis using the Verhoeff-van Gieson stain. We found that cellproliferation markers such as proliferating cell nuclear antigen and Ki-67 were more highly expressed in actiniccheilitis than in lichen planus. In addition, the number of c-kit-positive cells observed in actinic cheilitis wassignificantly higher than in lichen planus. The expression levels of the other tested markers were not significantlydifferent between the 2 diseases. Conclusion: The immunohistochemical markers proliferating cell nuclear antigen, Ki-67, and c-kit may help todifferentiate actinic cheilitis from lichen planus of the lips. (Korean J Dermatol 2015;53(1):38∼44)