Lichen planus pigmentosus-inversus: Two case reports and clinical review

Introduction: Lichen planus is an inflammatory mucocutaneous dermatosis involving skin, appendages and mucosa. Oral mucosa is the most commonly involved in all its sites, rarely the lips especially when isolated. The aim was to conduct a literature review about isolated lichen planus of the lips and reporting two case reports of this lesion in order to highlight epidemiologic, clinical and histological features and therapeutic modalities of this lesion. Observations: Case report 1: a 34-year-old diabetic male patient consulted for an erosive, crusted and hemorrhagic cheilitis of the lower lip. Clinical and histological examination led to the diagnosis of isolated lichen planus of the lips. Case report 2: a 33-year-old female patient was referred from dermatology department for biopsy of chronic cheilitis of the lower lip. Clinical and histological examination confirmed the diagnosis of isolated lichen planus of the lips. Discussion: The review based on 34 case reports of isolated lichen planus of the lips, in addition to literature data confirmed that it is a benign rare lesion affecting mostly male patients having middle age with preponderance of the lower lip, its erosive form is the most frequent and it presents a favorable healing with topical treatment particularly corticosteroids.

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Lichen Planus: A Clinical Review

International Journal of Clinical Reviews ◽

10.5275/ijcr.2011.03.05 ◽

2011 ◽

Author(s):

Shilpa Sawardekar ◽

Bryan Anderson

Keyword(s):

Clinical Review ◽

Lichen Planus

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Efficacy of Topical Calcineurin Inhibitors in Lichen Planus

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347541201600403 ◽

2012 ◽

Vol 16 (4) ◽

pp. 221-229 ◽

Cited By ~ 15

Author(s):

Michael Samycia ◽

Andrew N. Lin

Keyword(s):

Lichen Planus ◽

Strong Evidence ◽

Oral Lichen Planus ◽

Case Reports ◽

Calcineurin Inhibitors ◽

Double Blind ◽

Tacrolimus Ointment ◽

Topical Tacrolimus ◽

Topical Calcineurin Inhibitors ◽

Oral Lichen

Background: Topical calcineurin inhibitors have been studied in many skin disorders, including lichen planus. Objective: To evaluate published reports of the use of topical calcineurin inhibitors in lichen planus. Methods: We searched PubMed, Ovid/Cochrane, and Embase using the keywords “tacrolimus,” “pimecrolimus,” “topical calcineurin inhibitors,” and “lichen planus.” Results: We examined 5 double-blind studies, 1 investigator-blinded study, 10 open prospective studies, 6 retrospective studies, and 28 case reports evaluating tacrolimus or pimecrolimus for oral, vulvovaginal, and cutaneous lichen planus. Conclusions: Strong evidence (double-blind and open studies) supports the use of topical tacrolimus ointment in oral lichen planus, with efficacy at least equal to topical clobetasol propionate 0.05% ointment. Treatment of oral lichen planus with topical tacrolimus ointment can result in demonstrable blood tacrolimus levels, but without clinically significant adverse events. Strong evidence (double-blind and open studies) supports the use of topical pimecrolimus 1% cream in oral lichen planus, with efficacy equal to that of topical triamcinolone acetonide 0.1% paste. For vulvovaginal lichen planus, pimecrolimus was superior to placebo in one double-blind study, and tacrolimus was effective in open studies. Only case reports support the efficacy of topical calcineurin inhibitors in cutaneous lichen planus.

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Lichen Planus Pemphigoides Induced by Enalapril: A Case Report and a Review of Literature

Case Reports in Dermatology ◽

10.1159/000481449 ◽

2017 ◽

Vol 9 (3) ◽

pp. 217-224 ◽

Cited By ~ 5

Author(s):

Woranit Onprasert ◽

Kumutnart Chanprapaph

Keyword(s):

Lichen Planus ◽

Early Recognition ◽

Case Reports ◽

Direct Immunofluorescence ◽

Drug Induced ◽

First Case ◽

Bullous Dermatosis ◽

Culprit Drug ◽

History Of ◽

Hands And Feet

Lichen planus pemphigoides (LPP) is a rare autoimmune bullous dermatosis. The clinical presentation of LPP may mimic bullous pemphigoid making the diagnosis difficult. A thorough clinical, histopathological, and immunological evaluation is essential for the diagnosis of LPP. The etiology is largely idiopathic; however, there are several case reports of drug-induced LPP. We report an 81-year-old Thai woman with underlying hypertension and type 2 diabetes mellitus who presented with a 4-week history of multiple tense bullae initially on the hands and feet that subsequently expanded to the trunk and face. Enalapril was commenced to control hypertension. The histopathology and direct immunofluorescence were compatible with LPP. Circulating anti-basement antibodies BP180 was also positive. The patient was treated with topical corticosteroid with a modest effect. Enalapril was discontinued and complete resolution of LPP occurred within 12 weeks. There was no recurrence after a 1-year follow-up period. To the best of our knowledge, we present the first case of enalapril-induced LPP. Early recognition and prompt discontinuation of the culprit drug allow resolution of the disease. Medication given for LPP alone, without cessation of the offending drug, may not change the course of this condition.

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Rare Causes of Hypercalcemia: 2021 Update

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab504 ◽

2021 ◽

Author(s):

Yasaman Motlaghzadeh ◽

John P Bilezikian ◽

Deborah E Sellmeyer

Keyword(s):

Primary Hyperparathyroidism ◽

Clinical Review ◽

Calcium Metabolism ◽

Case Reports ◽

Evidence Synthesis ◽

Unknown Mechanism ◽

Search Terms

Abstract Context Primary hyperparathyroidism and malignancy are the etiologies in 90% of cases of hypercalcemia. When these entities are not the etiology of hypercalcemia, uncommon conditions need to be considered. In 2005, Jacobs and Bilezikian published a clinical review of rare causes of hypercalcemia, focusing on mechanisms and pathophysiology. This review is an updated synopsis of rare causes of hypercalcemia, extending the observations of the original article. Evidence Acquisition Articles reporting rare associations between hypercalcemia and unusual conditions were identified through a comprehensive extensive PubMed-based search using the search terms “hypercalcemia” and “etiology,” as well as examining the references in the identified case reports. We categorized the reports by adults vs. pediatric and further categorized the adult reports based on etiology. Some included reports lacked definitive assessment of etiology and are reported as unknown mechanism with discussion of likely etiology. Evidence Synthesis There is a growing understanding of the breadth of unusual causes of hypercalcemia. When the cause of hypercalcemia is elusive, a focus on mechanism and review of prior reported cases is key to successful determination of the etiology. Conclusions The ever-expanding reports of patients with rare and even unknown mechanisms of hypercalcemia illustrate the need for continued investigation into the complexities of human calcium metabolism.

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