The oral lichenoid lesion(OLL) is response that occurs on the oral mucosa. The OLL include allergic responseto the dental materials, drugs, and on graft-vs-host disease(GVHD). OLL to dental material happen when restor...The oral lichenoid lesion(OLL) is response that occurs on the oral mucosa. The OLL include allergic responseto the dental materials, drugs, and on graft-vs-host disease(GVHD). OLL to dental material happen when restorative materials, most commonly amalgam, are in direct contact with the mucosa in sensitized individuals. Medications that produce OLL are oral hypoglycemic agents, angiotensin-converting enzyme inhibitors, and nonsteroidal anti-inflammatory agents. GVHD is a complication in bone marrow transplantation and OLL is a common lesion observed in this disease especially in chronic GVHD. The clinical and histological aspects of OLL are similar to oral lichen planus and turn it difficult to make a differential diagnosis. The purpose of this paper is review about OLL related to the dental materials, drug use and GVHD.展开更多
BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associat...BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associated with several skin diseases,including atopic dermatitis(AD).The treatment of LA is considered to be difficult.However,as there is some overlap in the etiopathogenesis of LA and AD,AD treatment may also be effective for LA.CASE SUMMARY Case 1:A 70-year-old man was diagnosed with severe AD with LA based on large dark erythema and papules on the trunk and buttocks and dense hemispherical millet-shaped papules with pruritus on the extensor side of the lower limbs.He had a long history of the disease(8 years),with repeated and polymorphic skin lesions.Given the poor efficacy of traditional treatments,this patient was recommended to receive dupilumab treatment.At the initial stage,300 mg was injected subcutaneously every 2 wk.After 28 wk,the drug interval was extended to 1 mo due to the pandemic.Follow-up observations revealed that the patient reached an Eczema Area Severity Index of 90(skin lesions improved by 90%compared with the baseline)by the end of the study.Moreover,Investigator's Global Assessment score was 1,and scoring atopic dermatitis index and numeric rating scale improved by 97.7%and 87.5%compared with the baseline,respectively,with LA skin lesions having largely subsided.Case 2:A 30-year-old woman was diagnosed with severe AD with LA,due to dense and substantial papules on the dorsal hands similar to changes in cutaneous amyloidosis,and erythema and papules scattered on limbs and trunk with pruritus,present for 25 years.After 16 wk of dupilumab treatment,she stopped,and skin lesions completely subsided,without recurrence since the last follow-up.CONCLUSION Dupilumab shows rational efficacy and safety in the treatment of severe AD with LA,in addition to benefits in the quality of life of the patients.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Oral potentially malignant disorders, which include oral lichen planus ...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Oral potentially malignant disorders, which include oral lichen planus (OLP), are clinical presentations that carry a risk of development to cancer in the oral cavity. Oral lichenoid lesions (OLLs) are also termed interface/lichenoid mucositis. Malignant transformation of them remains controversial, but distinct clinical and histological criteria for how to differentiate OLP from OLLs have not been developed.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> The purpose of this study was to elucidate findings that can allow histopathological differentiation of OLP and OLLs using histomorphological and immunohistochemical analyses.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Materials and Methods:</span></b><span style="font-family:Verdana;"> Analyses were performed in 10 cases diagnosed with OLP and 9 cases diagnosed with OLLs. Cytokeratin 19 (CK19), Ki-67 and CD3 were used as primary antibodies to detect basal cells, proliferative activity and T-cell distribution, respectively</span><span style="font-family:Verdana;">, and</span><span style="font-family:Verdana;"> Perlecan and COX-2 to evaluate epithelial intracellular arrangements and interstitial distributions of proteoglycans and enzymes. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> For CK19, positive cells were significantly found in OLLs at both the prominent area and site adjacent to the lesion comparison with those of OLP’s. The number of COX-2 positive cells was significantly higher in spinous and basal layers in OLLs of the prominent area. Additionally, OLLs showed mild to moderate expression for perlecan in the basal to spinous layers and in subepithelial tissue. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Almost no basal cells were noted in the prominent area in OLP. COX-2 and perlecan were found in the basal to spinous layers in OLLs. Although there are restrictions, these suggested the possibility of helping to distinguish between OLP and OLLs.</span>展开更多
Proliferative verrucous leukoplakia is an intriguing disease, which occurs particularly in women aged greater than 60 years, is not associated with tobacco and alcohol, and has a high risk of recurrence and malignant ...Proliferative verrucous leukoplakia is an intriguing disease, which occurs particularly in women aged greater than 60 years, is not associated with tobacco and alcohol, and has a high risk of recurrence and malignant transformation. Although it is well known that the typical presentation is characterized by multifocal and verrucous white lesions, there is no description that its initial clinical presentation may simulate a lichenoid reaction.展开更多
To the Editor:Hailey-Hailey disease(HHD),first discovered by the brothers Howard and Hugh Hailey,[1]is a genodermatosis at intertriginous sites.Mutation of ATP2C1 on chromosome 3q21-2 coding a calciumdependent ATPase ...To the Editor:Hailey-Hailey disease(HHD),first discovered by the brothers Howard and Hugh Hailey,[1]is a genodermatosis at intertriginous sites.Mutation of ATP2C1 on chromosome 3q21-2 coding a calciumdependent ATPase gives rise to calcium dysfunction within keratinocytes,resulting in acantholysis due to a signal transduction disorder.[2]It has been suggested that this gene mutation combined with irritation such as frequent friction,cold,and ultraviolet exposure leads to the development of HHD.[3]展开更多
口腔苔藓样药物反应(oral lichenoid drug reactions,OLDR)是指过敏体质者使用特定药物后引起口腔黏膜苔藓样表现的疾病。诱发OLDR的药物种类繁多,由免疫治疗诱发的口腔苔藓样药物反应临床上报道较少。本文报道了1例由阿替利珠和贝伐珠...口腔苔藓样药物反应(oral lichenoid drug reactions,OLDR)是指过敏体质者使用特定药物后引起口腔黏膜苔藓样表现的疾病。诱发OLDR的药物种类繁多,由免疫治疗诱发的口腔苔藓样药物反应临床上报道较少。本文报道了1例由阿替利珠和贝伐珠单抗联合抗癌治疗诱发的口腔苔藓样药物反应及牙龈出血,探讨该疾病的临床特点及诊治原则,以期为临床上此类疾病的诊疗提供参考。展开更多
Introduction:Immune-related adverse events induced by immune checkpoint inhibitors are quite common.Cutaneous lichenoid immune-related adverse events are among the most frequent.However,oral lichenoid adverse reaction...Introduction:Immune-related adverse events induced by immune checkpoint inhibitors are quite common.Cutaneous lichenoid immune-related adverse events are among the most frequent.However,oral lichenoid adverse reactions are extremely rare.We herein describe a patient who was treated with pembrolizumab for metastatic lung cancer and developed an erosive oral lichenoid reaction induced by immunotherapy.Case presentation:An 87-year-old man treated with pembrolizumab for metastatic lung adenocarcinoma developed multifocal erosions of the oral mucosa with multiple small,irregular,hyperkeratotic areas.Histopathological examination showed epithelial necrosis and a dense band-like layer of an inflammatory infiltrate of lymphocytes and histiocytes within the upper dermis.Direct immunofluorescence was negative for both IgG and C3.A diagnosis of erosive oral lichenoid reaction of the mucosa induced by immunotherapy was established.Pembrolizumab treatment was withheld and concomitant topical and systemic steroids were started.After 1 month,the drug-related toxicity was ameliorated and immunotherapy was re-introduced.Discussion:Only one other case of pembrolizumab-induced erosive lichen planus of the oral mucosa has been described to date.Previously reported drug-induced lichenoid rashes were mainly localized on the skin.Clinically,the main differential diagnoses of lichenoid erosive lesions are bullous immune-related disorders.In our patient,histological examination combined with negative results of both direct immunofluorescence and enzyme-linked immunosorbent assays confirmed the diagnosis of erosive lichenoid drug reaction.Conclusion:Clinicians should be aware of lichenoid involvement of the oral mucosa because related pain and food intake difficulties may seriously compromise treatment compliance.Prompt treatment of oral drug-related reactions may prevent interruption of immunotherapy and improve patients’quality of life.展开更多
文摘The oral lichenoid lesion(OLL) is response that occurs on the oral mucosa. The OLL include allergic responseto the dental materials, drugs, and on graft-vs-host disease(GVHD). OLL to dental material happen when restorative materials, most commonly amalgam, are in direct contact with the mucosa in sensitized individuals. Medications that produce OLL are oral hypoglycemic agents, angiotensin-converting enzyme inhibitors, and nonsteroidal anti-inflammatory agents. GVHD is a complication in bone marrow transplantation and OLL is a common lesion observed in this disease especially in chronic GVHD. The clinical and histological aspects of OLL are similar to oral lichen planus and turn it difficult to make a differential diagnosis. The purpose of this paper is review about OLL related to the dental materials, drug use and GVHD.
基金Supported by National Natural Science Foundation of China,No.81803160Scientific Development Program of Jilin Province,No.20200801078GH.
文摘BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associated with several skin diseases,including atopic dermatitis(AD).The treatment of LA is considered to be difficult.However,as there is some overlap in the etiopathogenesis of LA and AD,AD treatment may also be effective for LA.CASE SUMMARY Case 1:A 70-year-old man was diagnosed with severe AD with LA based on large dark erythema and papules on the trunk and buttocks and dense hemispherical millet-shaped papules with pruritus on the extensor side of the lower limbs.He had a long history of the disease(8 years),with repeated and polymorphic skin lesions.Given the poor efficacy of traditional treatments,this patient was recommended to receive dupilumab treatment.At the initial stage,300 mg was injected subcutaneously every 2 wk.After 28 wk,the drug interval was extended to 1 mo due to the pandemic.Follow-up observations revealed that the patient reached an Eczema Area Severity Index of 90(skin lesions improved by 90%compared with the baseline)by the end of the study.Moreover,Investigator's Global Assessment score was 1,and scoring atopic dermatitis index and numeric rating scale improved by 97.7%and 87.5%compared with the baseline,respectively,with LA skin lesions having largely subsided.Case 2:A 30-year-old woman was diagnosed with severe AD with LA,due to dense and substantial papules on the dorsal hands similar to changes in cutaneous amyloidosis,and erythema and papules scattered on limbs and trunk with pruritus,present for 25 years.After 16 wk of dupilumab treatment,she stopped,and skin lesions completely subsided,without recurrence since the last follow-up.CONCLUSION Dupilumab shows rational efficacy and safety in the treatment of severe AD with LA,in addition to benefits in the quality of life of the patients.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Oral potentially malignant disorders, which include oral lichen planus (OLP), are clinical presentations that carry a risk of development to cancer in the oral cavity. Oral lichenoid lesions (OLLs) are also termed interface/lichenoid mucositis. Malignant transformation of them remains controversial, but distinct clinical and histological criteria for how to differentiate OLP from OLLs have not been developed.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> The purpose of this study was to elucidate findings that can allow histopathological differentiation of OLP and OLLs using histomorphological and immunohistochemical analyses.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Materials and Methods:</span></b><span style="font-family:Verdana;"> Analyses were performed in 10 cases diagnosed with OLP and 9 cases diagnosed with OLLs. Cytokeratin 19 (CK19), Ki-67 and CD3 were used as primary antibodies to detect basal cells, proliferative activity and T-cell distribution, respectively</span><span style="font-family:Verdana;">, and</span><span style="font-family:Verdana;"> Perlecan and COX-2 to evaluate epithelial intracellular arrangements and interstitial distributions of proteoglycans and enzymes. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> For CK19, positive cells were significantly found in OLLs at both the prominent area and site adjacent to the lesion comparison with those of OLP’s. The number of COX-2 positive cells was significantly higher in spinous and basal layers in OLLs of the prominent area. Additionally, OLLs showed mild to moderate expression for perlecan in the basal to spinous layers and in subepithelial tissue. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Almost no basal cells were noted in the prominent area in OLP. COX-2 and perlecan were found in the basal to spinous layers in OLLs. Although there are restrictions, these suggested the possibility of helping to distinguish between OLP and OLLs.</span>
文摘Proliferative verrucous leukoplakia is an intriguing disease, which occurs particularly in women aged greater than 60 years, is not associated with tobacco and alcohol, and has a high risk of recurrence and malignant transformation. Although it is well known that the typical presentation is characterized by multifocal and verrucous white lesions, there is no description that its initial clinical presentation may simulate a lichenoid reaction.
基金National Natural Science Foundation of China(81371731)Milstein Medical Asian American Partnership foundation(2017,dermatology)Education Reform Projects of Peking Union Medical College(No.2016zlgc0106).
文摘To the Editor:Hailey-Hailey disease(HHD),first discovered by the brothers Howard and Hugh Hailey,[1]is a genodermatosis at intertriginous sites.Mutation of ATP2C1 on chromosome 3q21-2 coding a calciumdependent ATPase gives rise to calcium dysfunction within keratinocytes,resulting in acantholysis due to a signal transduction disorder.[2]It has been suggested that this gene mutation combined with irritation such as frequent friction,cold,and ultraviolet exposure leads to the development of HHD.[3]
文摘口腔苔藓样药物反应(oral lichenoid drug reactions,OLDR)是指过敏体质者使用特定药物后引起口腔黏膜苔藓样表现的疾病。诱发OLDR的药物种类繁多,由免疫治疗诱发的口腔苔藓样药物反应临床上报道较少。本文报道了1例由阿替利珠和贝伐珠单抗联合抗癌治疗诱发的口腔苔藓样药物反应及牙龈出血,探讨该疾病的临床特点及诊治原则,以期为临床上此类疾病的诊疗提供参考。
文摘Introduction:Immune-related adverse events induced by immune checkpoint inhibitors are quite common.Cutaneous lichenoid immune-related adverse events are among the most frequent.However,oral lichenoid adverse reactions are extremely rare.We herein describe a patient who was treated with pembrolizumab for metastatic lung cancer and developed an erosive oral lichenoid reaction induced by immunotherapy.Case presentation:An 87-year-old man treated with pembrolizumab for metastatic lung adenocarcinoma developed multifocal erosions of the oral mucosa with multiple small,irregular,hyperkeratotic areas.Histopathological examination showed epithelial necrosis and a dense band-like layer of an inflammatory infiltrate of lymphocytes and histiocytes within the upper dermis.Direct immunofluorescence was negative for both IgG and C3.A diagnosis of erosive oral lichenoid reaction of the mucosa induced by immunotherapy was established.Pembrolizumab treatment was withheld and concomitant topical and systemic steroids were started.After 1 month,the drug-related toxicity was ameliorated and immunotherapy was re-introduced.Discussion:Only one other case of pembrolizumab-induced erosive lichen planus of the oral mucosa has been described to date.Previously reported drug-induced lichenoid rashes were mainly localized on the skin.Clinically,the main differential diagnoses of lichenoid erosive lesions are bullous immune-related disorders.In our patient,histological examination combined with negative results of both direct immunofluorescence and enzyme-linked immunosorbent assays confirmed the diagnosis of erosive lichenoid drug reaction.Conclusion:Clinicians should be aware of lichenoid involvement of the oral mucosa because related pain and food intake difficulties may seriously compromise treatment compliance.Prompt treatment of oral drug-related reactions may prevent interruption of immunotherapy and improve patients’quality of life.
