Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.

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Prevalence and impact of allergic rhinitis in school going children

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211565 ◽

2021 ◽

Vol 7 (5) ◽

pp. 760

Author(s):

Sucheta Gupta ◽

Vinod Gupta ◽

Akhil Gupta

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Negative Impact ◽

Community Health Center ◽

Medical Intervention ◽

House Dust Mites ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Co Morbidity

Background: Allergic rhinitis (AR) is a chronic inflammatory disorder affecting the nasal mucosa. There is negative impact of AR on several aspects of day to day living and quality of life (QoL), which include: daily functioning, sleep, absenteeism, school productivity and academic performance. Almost 40% of children are being affected by AR.Method: An observational study was conducted on randomly selected 100 parents of school going children aging 2 to 15 years, attending OPD in community health center, Chenani, district Udhampur, J and K, for a period of one year from June 2018 to Nov 2018. Children having frequent episodes of allergic rhinitis were enquired about their history of sneezing, runner itchy nose and eyes, thick mucus, nasal blockage or breathless with associated symptoms were selected.Results: 81% of subjects had a worse problem during specific months of the year; and 67% had itchy-watery eyes. In 15% of subjects, AR impacted daily activities. A prevalence of 28% for nasal symptoms and 14% for allergic rhino-conjunctivitis was found. Study also showed significantly higher proportion of blockers (61%) than sneeze runners (39%). 56% children had one or more co morbidity, whereas 44% had ‘nil’ co-morbidities. The most common allergens were: pollens (grass, trees and weeds), house dust mites, pets, molds, fungi and food.Conclusions: AR adversely affects quality of life of patients and furthermore studies should be conducted for more clarity on the subject, besides a timely medical intervention and treatment could possibly avoid the rising morbidity associated with the disease.

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Factors affecting asthma psychomorbidity, control and illness-related quality of life: what is the interaction?

European Psychiatry ◽

10.1016/s0924-9338(11)73449-6 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1745-1745

Author(s):

N. Pilipenko ◽

M. Karekla

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Research Literature ◽

Smoking History ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Asthma Patients ◽

Related Quality ◽

The Impact

Asthma is a chronic inflammatory disorder of the airways, ounknown etiology and growing prevalence (GINA, 2009). Appropriate asthma management can control the disorder and enable patients to enjoy a good quality of life (WHO, 2007).Yet, many asthma patients are unable to maintain asthma control (Rabe et al., 2003) for various reasons, including psychological ones (Feldman et al., 2005).This study examined the prevalence of psychomorbidity, and its interaction with asthma control difficulties and asthma-related quality of life in a sample of 200 asthma patients in Cyprus. Asthma diagnoses and severity were established by medical chart review.Psychomorbidity was evaluated using the Patient Health Questionnaire (Spitzer, 1999). Additionally, the impact of asthma-specific (e.g. asthma knowledge), health-specific (e.g. smoking history) and socio-demographic (e.g. perceived poverty) factors was examined as prior research literature suggests these may significantly impact asthma control and asthma-related quality of life.Currently, the present study is in its final stages of data collection (to conclude 2010). The results will offer valuable insights into the mechanisms and factors which affect asthma control, quality of life, and psychomorbidity. In doing so, the present study will contribute to the improved understanding of asthma patients’ experiences, essential to guide medical and psychological interventions.

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Linear Lichen Planus: Continuum From Skin to Mucosa

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475417733463 ◽

2017 ◽

Vol 22 (2) ◽

pp. 232-233

Author(s):

Mikhin George Thomas ◽

Ambooken Betsy

Keyword(s):

Lichen Planus ◽

Oral Mucosa ◽

Unusual Presentation ◽

Inflammatory Disorder ◽

Upper Lip ◽

Middle Aged ◽

Linear Distribution ◽

Chronic Inflammatory Disorder ◽

Mucous Membranes

Lichen planus (LP) is a chronic inflammatory disorder that most commonly affects middle-aged individuals. LP involves the skin and/or mucous membranes, including oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. Linear LP, a rare distinct variant of LP, is characterised by pruritic eruption of lichenoid and violaceous papules in a linear distribution. We report an unusual presentation of linear LP in a 14-year-old child that extended from the left anterior nares to upper lip and into the oral mucosa up to the upper gum margin.

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Th1/Th2 Cytokine Ratio in Tissue Transudates from Patients with Oral Lichen Planus

Mediators of Inflammation ◽

10.1155/2007/19854 ◽

2007 ◽

Vol 2007 ◽

pp. 1-5 ◽

Cited By ~ 43

Author(s):

Nelson L. Rhodus ◽

Bin Cheng ◽

Frank Ondrey

Keyword(s):

Disease Activity ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Oral Lesion ◽

Tnf Alpha ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Oral Fluids ◽

Therapeutic Decisions ◽

Oral Lichen

Objective. The characteristics of oral lichen planus (OLP) provoke investigators to explore possible biomarkers by which to monitor disease activity and therapeutic efficacy. Oral fluids may provide an accessible medium for analysis of such biomarkers. Previous studies have shown that activation of nuclear factor-kappa B (NF-κB) plays an important role in the pathogenesis of oral lichen planus (OLP), which is a chronic inflammatory disorder mediated by T cells. Prior to the present investigation, reports of the levels of NF-κB and its dependent cytokines in oral fluids have not been forthcoming. The purpose of this study was to detect the level of NF-κB dependent cytokines, TNF-alpha, IL-1-alpha, IL-6, and IL-8 in tissue transudates directly from lesions of OLP, and explore the feasibility of the data for clinical application.Study design. Thirteen definitively diagnosed OLP subjects were enrolled in the study as were 13 age-sex matched controls. In each subject, lesion tissue transudates (TTs) were collected by a novel collection technique with a filter paper. The level of cytokines, TNF-alpha, IL-1-alpha, IL-6, and IL-8 in three types of oral fluids were determined by ELISA.Results. In the tissue transudate(TT), there were significantly higher level of cytokines TNF-alpha, IL-1-alpha, IL-6, and IL-8 detected in OLP patients than in controls: (TT:40.0±9.8versus4.5±0.7,710±114versus305±78,150±25versus1.7±0.5,2800±260versus1450±130,P<.0001; unit: pg/mL).Conclusions. These results indicate that NF-κB dependent inflammatory cytokines may be detected at increased levels in oral lesion tissue transudates which may have diagnostic and prognostic potentials for monitoring disease activity and making therapeutic decisions in patients with OLP.

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CHRONIC PERSISTENT ASTHMA

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.07.144 ◽

2018 ◽

Vol 25 (07) ◽

pp. 1094-1101

Author(s):

Syed Saud Hasan ◽

Moosa Khan ◽

Musarrat Sultana ◽

Muhammad Talha Farooqui ◽

Asif Iqbal

Keyword(s):

Safety Profile ◽

Seed Oil ◽

Persistent Asthma ◽

Inflammatory Disorder ◽

Night Sleep ◽

Interventional Study ◽

Once Daily ◽

Chronic Inflammatory Disorder ◽

Group B

Asthma, a chronic inflammatory disorder, prevalence is high in all ages,characterizes by cough, dyspnea, chest compression, wheezing and considerable impairmentin physical activities. Study Design: An interventional study. Objectives: Observe improvementin pulmonary functions, symptoms& quality of daily life with safety profile in chronic moderatepersistent asthma. Place & Duration: Approved with BASR University of Karachi and conductedwith the participation BMSI (Pharmacology), JPMC & Eastern Medicine HMU, Karachi. Method& Materials: Total 120 diagnosed with objective signs of reversibility, by measuring at least12% increase in FEV1, after 15 minutes with an inhalation of 200 microgram (μg) Salbutamol ofasthmatic patients were registered & divided in two groups.Group-A treated with oral Borage1.3 gram once plus Echium seed oil 500mg twice daily & Group B treated with Borage 1.3 gramonce plus Echium seed oil 500mg twice along with oral Bambuterol 10mg once daily for 90days, results of Spirometry, PEFR, daily dairy symptoms card and clinical questionnaire werestatistically evaluated, to estimate the improvement and compliance of the drugs. Results:Borage & Echium treated groups from baseline to day-90, FEV1 mean 1.30+0.02 (L) change of4.7%, FVC mean 2.3+0.3 increase of 2.19%, PEFR mean 186.3+34.1 (L/mints) change 4.1%.In group-B, FEV1 mean 1.5+0.3 increase of 13.3%, FVC mean 2.5+0.4 increase of 9.2%, PEFRmean 215.8+50.3, change of 15.2%, results are highly significant. Symptoms of daily dairycard in both group shows improvement, and reduction in night sleep awakening and clinicalquestionnaire shows improved symptoms, decreased need of recue medicine at day-90.Conclusion: Combination therapy, provided synergistic effect, to reduce the severity, improvesymptoms, quality of life along with the safety profile, results are highly significant.

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Joint Ventures: Helping Those With Rheumatoid Arthritis Live Well

International Journal of Yoga Therapy ◽

10.17761/ijyt.23.2.m453443w8g822207 ◽

2013 ◽

Vol 23 (2) ◽

pp. 91-100 ◽

Cited By ~ 1

Author(s):

Aggie Stewart

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Stress Reduction ◽

Symptom Relief ◽

Well Being ◽

Inflammatory Disorder ◽

Yoga Therapy ◽

Chronic Inflammatory Disorder ◽

Stiffness Loss

Objectives: Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory disorder that causes pain, swelling, stiffness, loss of joint function, and reduced quality of life. Yoga therapy may help individuals with RA manage stress and increase well-being. This study focused on the identification of therapeutic objectives and a methodology to achieve symptom relief, regain function, and enhance quality of life for individuals with RA. Methods: Four women with RA participated in private yoga therapy sessions for 2.5 months. Assessment based, tailored home practices were developed and modified to address participant - identified goals. Results: Participants reported decreased pain, fatigue, swelling, and flares; increased energy; pain-free range of motion and strength around affected joints; and a heightened sense of well-being. Conclusions: Tailored yoga therapy that emphasizes stress reduction may be beneficial for individuals with RA.

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Mesenchymal Stromal Cell Therapy in the Management of Perianal Fistulas in Crohn’s Disease: An Up-To-Date Review

Medicina ◽

10.3390/medicina56110563 ◽

2020 ◽

Vol 56 (11) ◽

pp. 563

Author(s):

Gaetano Gallo ◽

Vincenzo Tiesi ◽

Serena Fulginiti ◽

Gilda De Paola ◽

Giuseppina Vescio ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Stromal Cells ◽

Tissue Repair ◽

Negative Impact ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Entire Gastrointestinal Tract

Crohn’s Disease (CD) is a chronic inflammatory disorder that potentially involves the entire gastrointestinal tract. Perianal fistulizing CD (pCD) is a serious and frequent complication associated with significant morbidities and a heavy negative impact on quality of life. The aim of CD treatment is to induce and maintain disease remission and to promote mucosal repair. Unfortunately, even the best therapeutic regimens in pCD do not have long-term efficacy and cause a significant number of side effects. Therefore, it is mandatory to study new therapeutical options such as the use of mesenchymal stromal cells (MSCs). These cells promote tissue repair via the induction of immunomodulation. The present review aims to analyze the existing updated scientific literature on MSCs adoption in the treatment of pCD to evaluate its efficacy and safety and to compare the use of bone marrow and adipose tissue derived MSCs, type of administration, and dose required for recovery.

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A Case Report: The Effect of Thread Embedding Acupuncture on Partly-Controlled Asthma

Journal of Agromedicine and Medical Sciences ◽

10.19184/ams.v7i2.26635 ◽

2021 ◽

Vol 7 (2) ◽

pp. 104

Author(s):

Yusuf Gunawan ◽

Irma Nareswari ◽

Irma Nareswari

Keyword(s):

Case Report ◽

Inflammatory Process ◽

Complementary Therapies ◽

Inflammatory Disorder ◽

Control Test ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Chronic Inflammatory Disorder ◽

Anti Inflammation

Asthma is a chronic inflammatory disorder of the respiratory tract where many cells and cellular elements play a role, especially eosinophils, IgE, and other components. Uncontrolled asthma causes the quality of the patient's life to decline. Acupuncture is one of the complementary therapies that are scientifically proven to help cure asthma. Many studies have proven that acupuncture plays a role in the anti-inflammatory process. In this case report, we used the acupuncture method of thread embedding penetration from point EX-B1 to BL13, LI11, ST36, and BL23 on both sides. Acupuncture therapy is done once when the patient first arrives. The results after 3 months observations showed that patients experienced an improvement in eosinophil count, decreased level of IgE, and increased Asthma Control Test values. The improvement showed patients were fully controlled in the first month until the end of the evaluation. Therefore, thread embedding could be a good, safe, and effective treatment for asthma in adults.Keywords: asthma, thread embedding acupuncture, anti-inflammation

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Exercise Capacity in Chronic Heart Failure

US Cardiology Review ◽

10.15420/usc.2012.9.1.57 ◽

2012 ◽

Vol 9 (1) ◽

pp. 57-60 ◽

Cited By ~ 1

Author(s):

Gina G Mentzer ◽

Alex J Auseon

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Exercise Training ◽

Exercise Capacity ◽

Positive Impact ◽

Pharmacologic Therapy ◽

The Past ◽

Diagnosis And Prognosis ◽

Future Therapy

Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. clinically, there is acceptance that exercise is safe in hf and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for hf patients in exercise testing and therapy to provide comprehensive cardiac care. it is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from hf.

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Relationship Between Gamma-glutamyl Transpeptidase Activity and Inflammatory Response in Lichen Planus

Revista de Chimie ◽

10.37358/rc.18.3.6189 ◽

2018 ◽

Vol 69 (3) ◽

pp. 739-743 ◽

Cited By ~ 3

Author(s):

Madalina Irina Mitran ◽

Ilinca Nicolae ◽

Corina Daniela Ene ◽

Cristina Iulia Mitran ◽

Clara Matei ◽

...

Keyword(s):

Inflammatory Response ◽

Lichen Planus ◽

Inflammatory Process ◽

Molecular Mechanisms ◽

Functional Adaptation ◽

Physical Factors ◽

Inflammatory Disorder ◽

Gamma Glutamyl Transpeptidase ◽

Gamma Glutamyl ◽

Glutamyl Transpeptidase

Chemicals used in the manufacture of synthetic fibers have been associated with undesirable side effects such as itching or skin lesions and it seems that they are involved in the induction of pathological processes such as oxidative stress and inflammation. Lichen planus (LP) can be regarded as an inflammatory disorder, chemical and physical factors playing an important role in the perpetuation of the inflammatory process. Gamma-glutamyl transpeptidase (GGT) plays an important role in the preservation of skin architecture and modulation of skin inflammation. In this study, we found that GGT activity is increased in LP patients with mild inflammation, whilst GGT is inactivated under conditions of severe inflammation. Therefore, GGT is involved in the inflammatory process, but there is no a positive correlation between its activity and the intensity of the inflammatory response. This functional adaptation of the enzyme may be due to down-regulation of its synthesis under free radical overload conditions. Understanding the molecular mechanisms involved in the modulation of intracellular redox homeostasis is an important step in the pharmacological management of patients with LP.

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