mucosal lichen planus | lichen planus nails treatment

Name Recognized Credit Tables The medical information provided in this site is for educational purposes only and is the property of the American Osteopathic College of Dermatology. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician – patient relationship. If you have a specific question or concern about a skin lesion or disease, please consult a dermatologist. Any use, re-creation, dissemination, forwarding or copying of this information is strictly prohibited unless expressed written permission is given by the American Osteopathic College of Dermatology.
This site complies with the HONcode standard for trustworthy health information: 43 MedlinePlus Tvarijonaviciute A, Aznar-Cayuela C, Rubio CP, Ceron JJ, Lopez-Jornet P. Evaluation of salivary oxidate stress biomarkers, nitric oxide and C-reactive protein in patients with oral lichen planus and burning mouth syndrome. J Oral Pathol Med. 2017;46(5):387–92.View ArticlePubMedGoogle Scholar
Media Toolkit A small, solid, raised bump on the skin that has a border with edges that are easy to see. Papules may be red, purple, brown, or pink. Pictures
For patient education material, visit the Cancer Center, as well as Cancer of the Mouth and Throat.
Donate or Volunteer Emergency Dentistry + Confluent and reticulated papillomatosis Other Actions Author: Jaisri R Thoppay, DDS, MBA, MS; Chief Editor: Jeff Burgess, DDS, MSD  more… 6. Gorouhi F, Davari P, Fazel N. Cutaneous and mucosal lichen planus: a comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis. ScientificWorldJournal. 2014. doi: 10.1155/2014/742826.
We evaluated saliva from 24 OLP patients and 24 age-matched healthy control subjects. The characteristics and clinical features of these subjects are summarized in Table 6. Salivary levels of complement component C3c, fibrinogen fragment D, and cystatin SA are also described in Table 6. Salivary levels of complement component C3c exhibited significant elevation in the OLP group, compared with the healthy control group (p = 0.041) (Table 6). There was weak statistical evidence that salivary levels of fibrinogen fragment D were higher, and salivary levels of cystatin SA were lower, in the OLP group, compared with the healthy control group (p = 0.398 and p = 0.281 for the respective comparisons).
LATEST MEDICAL NEWS US National Library of Medicine Systemic treatment for widespread or severe local disease often includes a 1–3 month course of oral prednisone, while commencing another agent from the following list:
Full Text Patient and Visitor Guide The severity and subsequent disability caused by lichen planus varies from inconsequential to severe. Skin lesions are typically present as a purple to brown in color, raised rash that can be very itchy (see Left). In addition to the oral mucosa, other mucosal surfaces such as the eyes, esophagus, and genitalia may be affected.
Frontal fibrosing alopecia is a form of lichen planopilaris that affects the anterior scalp, forehead and eyebrows.
In cutaneous disease, lesions typically resolve within 6 months (>50%) to 18 months (85%); chronic disease is more likely oral lichen planus or with large, annular, hypertrophic lesions and mucous membrane involvement
Slideshow Working Out When You’re Over 50 The exact cause of lichen planus is unclear.
(A systematic review of treatment in oral LP. Shows general lack of randomized clinical trials (RCTs) for treatment of oral LP. The RCTs that have been published show a small but statistically significant treatment benefit.)
DermNet NZ does not provide an online consultation service.  If you have any concerns with your skin or its treatment, see a dermatologist for advice.  Use of Double Layer of Acellular Dermal Matrix and Modified Tunnel Technique to Treat Multiple Adjacent Gingival Recession Defects
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Lichen planus develops when your body attacks your skin or mucous membrane cells by mistake. Doctors are not sure why this happens. Technology and Finance
Author Center How Healthy Is Your Mouth? The mainstay of treatment is corticosteroids, which alleviate symptoms and alter disease progression. Topical corticosteroids have been shown to be as effective as systemic corticosteroids in decreasing symptoms and improving remission rates and are accompanied by fewer adverse effects.3 Educating patients on how to reduce exposure to offending agents is paramount to decrease the risk of an exacerbation.
27.9 11 more Scoliosis is an abnormal curve of the spine (backbone) that can cause you to lean to one side, have… Press center + Rhinoscleroma Patient education is important. Many patients with oral lichen planus (OLP) are concerned about the possibilities of its malignancy and contagiousness. Many patients are frustrated by the lack of available patient education concerning oral lichen planus. [31]
On the skin, lichen planus often causes bumps that are shiny, firm, and reddish purple. Sometimes the bumps have tiny white lines running through them. These lines are called Wickham’s striae.
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Free content 38.7 Medscape: “Oral Lichen Planus.” Lichen striatus begins similarly to lichen planus, with small bumps (papules), but over a period of days expands to form a long streak or band of affected skin. It clears over a period of months without needing treatment. This condition is seen frequently in children less than 16 years old but, also occurs in adults.
On physical examination there are multiple variants of LP, which may demonstrate overlapping features. For descriptive purposes it is helpful to divide these variants by anatomic location, although in practice, many patients will have involvement of multiple areas.
Guide to Statistics and Medicine The regimens used for OLP therapy were as follows: (1) topical corticosteroids, 0.05% fluocinonide gel 2 to 3 times per day (prior to WFU) and 0.5% clobetasol gel 2 to 5 times per day (at WFU); (2) intralesional corticosteroid, 10 mg/kg, injection of 0.2 to 0.3 mL; (3) topical tacrolimus, 0.1% tacrolimus ointment, 2 to 3 times per day, alternating with clobetasol; (4) hydroxychloroquine, 200 mg orally twice daily; (5) retinoid, including isotretinoin, 80 mg/d, for a 70-kg patient and acetretin, 25 mg/d, for a 70-kg patient; (6) methotrexate, 2.5 to 12.5 mg/wk, depending on creatinine clearance; and (7) thalidomide, 100 mg every night on average. The adverse effects of these therapies have been described in detail elsewhere.1,13,14 Potential adverse effects were always discussed with the patient in detail, and verbal assent was documented. Patients treated with isotretinoin were in the SMART (System to Manage Accutane-Related Teratogenicity) program (which preceded iPLEDGE), and patients who received thalidomide were in the STEPS (System for Thalidomide Education and Prescribing Safety) program. Monitoring was as per American Academy of Dermatology guidelines for methotrexate.
Mobile Apps: Quality The use of topical high potency drugs such as clobetasol with hydroxychloroquine are my first-line therapies. Oral retinoids have been used, but unfortunately in my experience they induce hair loss, which is not acceptable in these cases.
3 A Clinical Trial to Study the Effects of Two Drugs, Lycopene and Prednisolone in Patients With Oral Lichen Planus Completed NCT02587117 Phase 4 lycopene;Prednisolone Author: Jaisri R Thoppay, DDS, MBA, MS; Chief Editor: Jeff Burgess, DDS, MSD  more…
+ Collection of histological slides by prof. Günter Burg Free accounts include: Share on Reddit 1 Increased gamma-H2AX phosphorylation GR00053-A 9.28 COL17A1 CXCL9 CXCR3 DEFB4A DSG3 IVL
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Melanoma, the most serious type of skin cancer, begins in skin cells called melanocytes.. van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003;32(9):507–12.View ArticlePubMedGoogle Scholar
0-9• A• B• C• D• E• F• G• H• I• J• K• L• M• N• O• P• Q• R• S• T• U• V• W• X• Y• Z Did you know some cases of lichen planus may be reaction to particular medicine?
Malaysia (English) DIFFERENTIAL DIAGNOSIS Tests and Procedures A-Z Epidemiological evidences from more than 90 controlled studies worldwide strongly suggest that Hepatitis C Virus (HCV) may be an etiologic factor in OLP. The association seems to be prevalent in Southern Europe, Japan and USA. However, countries with highest prevalence of HCV report negative or nonsignificant associations suggesting that the LP–HCV association cannot be explained on the basis of high prevalence in population alone. In OLP, HCV replication has been reported in the epithelial cells from mucosa of LP lesions by reverse transcription/polymerase chain reaction or in-situ hybridization; also, HCV-specific CD4 and CD8 lymphocytes were reported in the subepithelial band. These probably suggest that HCV-specific T lymphocytes may play a role in the pathogenesis of OLP. The characteristic band like lymphocytic infiltrate might thus be directed toward HCV infected cells. Whether HCV infected patients have increased risk of developing OLP or patients with OLP have enhanced risk of developing HCV infection is yet to be answered. The putative pathogenetic link between OLP and HCV still remains controversial and needs a lot of prospective and interventional studies for a better understanding.[11]
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If they’re unsure of the diagnosis, they’ll likely order a biopsy of one or more of the lesions to collect samples of tissue. A laboratory will analyze the samples using a microscope to help with a diagnosis for oral lichen planus.
Jump up ^ Freedberg, Irwin M., ed. (2003). Fitzpatrick’s dermatology in general medicine (6th ed.). New York, NY: McGraw-Hill. pp. 366, 470–71. ISBN 0-07-138076-0.
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erosive lichen planus | lichen planus erosive lichen planus | tinea versicolor erosive lichen planus | athletes foot

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    Patients who presented as new untreated cases (ie, no previous treatment) received different treatments than those who had received prior OLP treatment (Table 3). Furthermore, the number of prior treatments at WFU also affected the choice of subsequent WFU treatment, demonstrating the implementation of the therapeutic ladder in this patient population. For example, 36 of 44 patients who received topical corticosteroids either alone or with topical tacrolimus as their first WFU treatment had no prior OLP therapy, while methotrexate was the first choice therapy in only 3 of 18 patients and thalidomide was never a first choice. As patients progressed through a therapeutic ladder of sequential treatments at WFU, therapy choices shifted from topical to oral treatments (usually with continued topical treatment) and eventually to oral treatments with more potential toxic effects (Table 4).
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    17. Handa S, Sahoo B. Childhood lichen planus: a study of 87cases. Int J of Dermatol. 2002;41(7):423-427.
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    Some metals such as gold salts, arsenic, bismuth, cinnamon (cinnamic aldehyde), or exposure to certain chemicals, may cause an eruption indistinguishable from LP, either oral or cutaneous. When a patient has symptoms of LP, physicians will likely ask about medication history because multiple medications have been associated with a drug-induced LP including antimalarials (hydroxychloroquine, quinacrine and chloroquine), blood pressure medications, proton pump inhibitors, some antibiotics, TNF inhibitors, NSAIDS (such as ibuprofen), and many others. If the eruption is due to exposure to metals, chemicals, or drugs, symptoms usually resolve a few weeks to months after eliminating the exposure but may still recur intermittently over time.
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    31. van der Hem PS, Egges M, van der Wal JE, Roodenburg JL. CO2 laser evaporation of oral lichen planus. Int J Oral Maxillofac Surg. 2008;37:630–3. [PubMed]
    Nails: Lichen planus may appear on some or all of your fingernails and toenails. Thinning, ridges, splitting and nail loss are signs of the condition.
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    Fitzpatrick SG, Hirsch SA, Gordon SC. The malignant transformation of oral lichen planus and oral lichenoid lesions: a systematic review. J Am Dent Assoc. 2014 Jan. 145 (1):45-56. [Medline].

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  4. Pharmacologic therapies include the following:
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    Epidemiological evidences from more than 90 controlled studies worldwide strongly suggest that Hepatitis C Virus (HCV) may be an etiologic factor in OLP. The association seems to be prevalent in Southern Europe, Japan and USA. However, countries with highest prevalence of HCV report negative or nonsignificant associations suggesting that the LP–HCV association cannot be explained on the basis of high prevalence in population alone. In OLP, HCV replication has been reported in the epithelial cells from mucosa of LP lesions by reverse transcription/polymerase chain reaction or in-situ hybridization; also, HCV-specific CD4 and CD8 lymphocytes were reported in the subepithelial band. These probably suggest that HCV-specific T lymphocytes may play a role in the pathogenesis of OLP. The characteristic band like lymphocytic infiltrate might thus be directed toward HCV infected cells. Whether HCV infected patients have increased risk of developing OLP or patients with OLP have enhanced risk of developing HCV infection is yet to be answered. The putative pathogenetic link between OLP and HCV still remains controversial and needs a lot of prospective and interventional studies for a better understanding.[11]
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    Drug reactions, with the most common inducers including gold salts, beta blockers, traditional antimalarials (e.g., quinine), thiazide diuretics, furosemide, spironolactone, metformin and penicillamine.[40]
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    Acitretin (Soriatane) is an expensive and toxic oral retinoid that is used in more severe cases of cutaneous lichen planus that do not respond to topical treatment.14 Acitretin is a strong teratogen that remains in the body for at least three months after the last dose; therefore, women who may become pregnant are not candidates for the therapy. Acitretin is not approved by the U.S. Food and Drug Administration (FDA) for the treatment of lichen planus, and the label includes an FDA boxed warning recommending that it be used only by physicians with experience treating severe psoriasis, prescribing oral retinoids, and handling teratogenic medications. Referral to a dermatologist is warranted for patients with severe lichen planus requiring systemic therapy with acitretin or an oral immunosuppressant.
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    16. Lo Muzio L, della Valle A, Mignogna MD, Pannone G, Bucci P, Bucci E, et al. The treatment of oral aphthous ulceration or erosive lichen planus with topical clobetasol propionate in three preparations: A clinical and pilot study on 54 patients. J Oral Pathol Med. 2001;30:611–7. [PubMed]

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    32. Cafaro A, Albanese G, Arduino PG, Mario C, Massolini G, Mozzati M, et al. Effect of low-level laser irradiation on unresponsive oral lichen planus: Early preliminary results in 13 patients. Photomed Laser Surg. 2010;28(Suppl 2):S99–103. [PubMed]
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  8. Sugerman PB, Satterwhite K, Bigby M. Autocytotoxic T-cell clones in lichen planus. Br J Dermatol. 2000 Mar. 142(3):449-56. [Medline].
    Nonostante si possa idealmente diffondere in tutte le zone corporee, il lichen ruber planus colpisce prevalentemente i polsi, la zona lombo-sacrale, i fianchi ed i genitali; inoltre, anche le unghie, le mucose orali e genitali, ed il cuoio capelluto sono possibili target della dermatosi.
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