scholarly journals Lichen Planus Pigmentosus Inversus: A Rare Subvariant of Lichen Planus Pigmentosus

2021 ◽  
pp. 407-410
Author(s):  
Anne Guertler ◽  
Natalie Evenschor ◽  
Marlene Seegraeber ◽  
Lars Einar French ◽  
Véronique Weiler ◽  
...  
Keyword(s):  
High Risk ◽  
Lichen Planus ◽  
Medical Literature ◽  
Calcineurin Inhibitors ◽  
Skin Lesions ◽  
Topical Steroids ◽  
Skin Atrophy ◽  
Topical Calcineurin Inhibitors ◽  
Oral Corticosteroids ◽  
Safe Treatment Option

Lichen planus pigmentosus inversus (LPPI) is a rare subvariant of Lichen planus pigmentosus (LPP), presenting with sharply defined brown to gray macules, papules, and plaques limited to the intertriginous areas, with only a few cases reported in the medical literature so far. While LPP mostly affects patients with Fitzpatrick skin type III–IV in sun-exposed areas such as the neck, LPPI is seen in Caucasians and spares sun-exposed areas. Skin lesions tend to be very refractory to treatment attempts including potent topical steroids and oral corticosteroids. Given the increased penetration of potent topical steroids and the high risk of skin atrophy, especially when applied to intertriginous areas, this case shows that topical calcineurin inhibitors (tacrolimus 0.1%) might offer an effective and safe treatment option for LPPI.

Efficacy of Topical Calcineurin Inhibitors in Lichen Planus

2012 ◽  
Vol 16 (4) ◽  
pp. 221-229 ◽  
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.

scholarly journals Oral lichen planus with linear lichen planus: a rare association

2019 ◽  
Vol 5 (2) ◽  
pp. 429
Author(s):  
N. Padmapriya ◽  
K. Karthikeyan
Keyword(s):  
Oral Cavity ◽  
Lichen Planus ◽  
Rare Variant ◽  
Oral Lichen Planus ◽  
Skin Lesions ◽  
Topical Steroids ◽  
Rare Association ◽  
Oral Lichen

<p class="abstract">Lichen planus (LP) is a papulosquamous disorder with both cutaneous and mucosal manifestation. Linear lichen planus is rare variant of lichen planus which occurs in the extremities. Oral lichen planus is another variant of lichen planus. Coexistence of linear lichen planus with oral lichen planus is rare and only one case has been reported before this case. A 35 year old female presented with hyperpigmented linear lesion in the leg and whitish plaques in the oral cavity. Biopsy of the skin lesions showed features of lichen planus. The patient was started on topical steroids and oral hydroxychloroquine. Patient responded to treatment.</p>

scholarly journals External therapy of allergic dermatoses in children (literature review)

2020 ◽  
pp. 41-47
Author(s):  
O.M. Mochulska ◽  
Keyword(s):  
Clinical Course ◽  
Life Quality ◽  
Allergic Inflammation ◽  
Local Therapy ◽  
Calcineurin Inhibitors ◽  
Allergic Diseases ◽  
Skin Lesions ◽  
Stevens Johnson Syndrome ◽  
Topical Calcineurin Inhibitors ◽  
Allergic Skin

Allergic dermatoses have a special place in the structure of allergic diseases in children due to their weight. The most common allergic skin lesions: simple and allergic contact dermatitis, atopic dermatitis, various forms of eczema, acute and chronic allergic urticaria, Quincke's edema, multiforme exudative erythema (Stevens—Johnson syndrome), acute epidermal necrolysis (Lyell's syndrome), toxicodermias, as well as less common dermatoses, in the pathogenesis of which are leading allergic reactions. Despite a number of research research, the difficulties in the determining of the therapeutic approach of allergic dermatoses in children are still observed. According to the international program documents EAACI (European Academy of Allergy and Clinical Immunology), AAAAI (American Academy of Allergy, Asthma & Immunology), PRACТALL (Practical Allergology Consensus Report) in treatment of allergic dermatoses the leading place takes external therapy, which requires an individual approach and daily care of skin. External therapy consists of local application of emollients, topical glucocorticosteroids, topical calcineurin inhibitors, topical antihistamines, keratolytic, keratoplastic, reparants, epithelializing and anti-inflammatory medications, in the case of complicated clinical course of the disease — antibacterial, antifungal, antiviral medications, also with skin care. Purpose — to increase information on modern possibilities of external therapy of allergic dermatoses in children. External pharmacotherapy of allergic dermatoses should be etiopathogenetic and should affect on the mechanisms of allergic inflammation in the skin, elimination of itching, dryness,so finding ways to improve it will help to control the clinical course of the disease, to reduce disability, will promote to improve the life quality in patients. No conflict of interest was declared by the author. Key words: children, allergy, allergic dermatoses, external therapy, local therapy.

scholarly journals Atopic dermatitis – Recent advances in the management

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Ramkumar Ramamoorthy
Keyword(s):  
Atopic Dermatitis ◽  
Calcineurin Inhibitors ◽  
Skin Barrier ◽  
T Cell Subsets ◽  
Topical Steroids ◽  
Topical Calcineurin Inhibitors ◽  
Complex Interactions ◽  
Recent Advances ◽  
Molecular Events ◽  
Chronic Skin

Atopic dermatitis (AD) is a chronic skin disorder resulting from complex interactions between skin barrier defects and a dysregulated immune system, marked by activation of multiple T cell subsets at different stages of the disease. Until recently, the management of AD rested mainly on the judicious use of emollients, topical steroids, and topical calcineurin inhibitors in the majority of patients and systemic immunosuppressants were advocated in severely diseased. However, in the last few years, new therapeutic strategies were designed and developed to target the various steps in the chain of molecular events that lead to the AD phenotype. This review article will focus on the recent advances in the management of AD.

scholarly journals Epidemiology, Comorbidities, and Prescription Patterns of Korean Prurigo Nodularis Patients: A Multi-Institution Study

2021 ◽  
Vol 11 (1) ◽  
pp. 95
Author(s):  
Yu-Ri Woo ◽  
Sehee Wang ◽  
Kyung-Ah Sohn ◽  
Hei-Sung Kim
Keyword(s):  
Medical Center ◽  
Conditional Logistic Regression ◽  
Pearson Correlation ◽  
Calcineurin Inhibitors ◽  
Topical Steroids ◽  
Prurigo Nodularis ◽  
Prescription Patterns ◽  
Diagnostic Codes ◽  
Topical Calcineurin Inhibitors ◽  
Comorbidity Burden

Prurigo nodularis (PN) is a chronic dermatosis typified by extraordinarily itchy nodules. However, little is known of the nature and extent of PN in Asian people. This study aimed to describe the epidemiology, comorbidities, and prescription pattern of PN in Koreans based on a large dermatology outpatient cohort. Patients with PN were identified from the Catholic Medical Center (CMC) clinical data warehouse. Anonymized data on age, sex, diagnostic codes, prescriptions, visitation dates, and other relevant parameters were collected. Pearson correlation analysis was used to calculate the correlation between PN prevalence and patient age. Conditional logistic regression modeling was adopted to measure the comorbidity risk of PN. A total of 3591 patients with PN were identified at the Catholic Medical Center Health System dermatology outpatient clinic in the period 2007–2020. A comparison of the study patients with age- and sex-matched controls (dermatology outpatients without PN) indicated that PN was associated with various comorbidities including chronic kidney disease (adjusted odds ratio (aOR), 1.48; 95% confidence interval (CI), 1.29–1.70), dyslipidemia (aOR, 1.88; 95% CI, 1.56–2.27), type 2 diabetes mellitus (aOR, 1.37; 95% CI, 1.22–1.54), arterial hypertension (aOR, 1.50; 95% CI, 1.30–1.73), autoimmune thyroiditis (aOR, 2.43; 95% CI, 1.42–4.16), non-Hodgkin’s lymphoma (aOR, 1.95; 95% CI, 1.23–3.07), and atopic dermatitis (aOR, 2.16, 95% CI, 1.91–2.45). Regarding prescription patterns, topical steroids were most favored, followed by topical calcineurin inhibitors; oral antihistamines were the most preferred systemic agent for PN. PN is a relatively rare but significant disease among Korean dermatology outpatients with a high comorbidity burden compared to dermatology outpatients without PN. There is great need for breakthroughs in PN treatment.

Comorbidity and Therapeutic Approaches in Patients with Necrobiosis Lipoidica

Dermatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Cornelia Erfurt-Berge ◽  
Veronika Heusinger ◽  
Finja Reinboldt-Jockenhöfer ◽  
Joachim Dissemond ◽  
Regina Renner
Keyword(s):  
Fumaric Acid ◽  
Calcineurin Inhibitors ◽  
Compression Therapy ◽  
Topical Steroids ◽  
Necrobiosis Lipoidica ◽  
Therapeutic Approaches ◽  
Fumaric Acid Esters ◽  
Topical Calcineurin Inhibitors ◽  
Randomized Controlled Studies ◽  
Acid Esters

<b><i>Background:</i></b> Necrobiosis lipoidica (NL) is a rare granulomatous disorder of unknown aetiology. Randomized controlled studies are not available due to it being an orphan disease. <b><i>Objectives:</i></b> We evaluated patients in 2 dermatological centres to cluster data about epidemiology, the therapeutic approaches for NL, and their efficacy. <b><i>Materials and Methods:</i></b> Comorbidity and the efficacy of the applied treatment was assessed for 98 patients. <b><i>Results:</i></b> We identified 54% of patients with concomitant diabetes and 19% with thyroidal disorders. Topical steroids (85.7%) were predominantly used followed by calcineurin inhibitors (31%) and phototherapy (41.8%). Systemically, fumaric acid esters were more frequently applied (26.8%) than steroids (24.4%) and dapsone (24.4%). Steroids, compression therapy, calcineurin inhibitors, phototherapy, fumaric acid esters, and dapsone showed remarkable efficacy. <b><i>Conclusion:</i></b> Therapeutic options were chosen individually in accordance with the severity of NL and presence of ulceration. Topical calcineurin inhibitors, systemic application of fumaric acid esters, and dapsone represent effective alternatives to the use of steroids.

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