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
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
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
在实验室条件下,对比研究了营养盐浓度变化对菊花江蓠(Gracilaria lichenoides)和细基江蓠繁枝变型(G.te-nuistipitata var. liui)的生长、生化组成和生理的影响。结果表明,不同的营养盐浓度变动对2种江蓠的生长、藻体藻红素、叶绿素a...在实验室条件下,对比研究了营养盐浓度变化对菊花江蓠(Gracilaria lichenoides)和细基江蓠繁枝变型(G.te-nuistipitata var. liui)的生长、生化组成和生理的影响。结果表明,不同的营养盐浓度变动对2种江蓠的生长、藻体藻红素、叶绿素a、总碳、总氮含量、硝酸还原酶以及过氧化氢酶活性影响有所不同。菊花江蓠生长在中等浓度(45μmol/L)的营养盐条件下最佳,而细基江蓠繁枝变型的生长反应则依前期环境中营养盐水平不同而有所差异。总体上看,当营养盐浓度由3μmol/L变动为45和150μmol/L时,2种江蓠藻体藻红素、叶绿素a、总碳和总氮含量以及硝酸还原酶的活性均有所提高;而当营养盐浓度由45和150μmol/L变动为3μmol/L时,2种江蓠藻体的上述指标则有所下降。营养盐浓度45和150μmol/L的相互变动对2种江蓠硝酸还原酶的活性影响不大。随着无机氮浓度的逐渐增加,过氧化氢酶的活性呈现显著下降的趋势。当营养盐浓度由3μmol/L向150μmol/L变动时,2种江蓠过氧化氢酶活性显著下降;而营养盐浓度由150μmol/L向3μmol/L变动时,过氧化氢酶活性则有所增强。综合比较表明,细基江蓠繁枝变型更容易受环境中营养盐浓度变动的影响,对环境中营养盐浓度变动的适应能力可能要低于菊花江蓠。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.
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.
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]
文摘在实验室条件下,对比研究了营养盐浓度变化对菊花江蓠(Gracilaria lichenoides)和细基江蓠繁枝变型(G.te-nuistipitata var. liui)的生长、生化组成和生理的影响。结果表明,不同的营养盐浓度变动对2种江蓠的生长、藻体藻红素、叶绿素a、总碳、总氮含量、硝酸还原酶以及过氧化氢酶活性影响有所不同。菊花江蓠生长在中等浓度(45μmol/L)的营养盐条件下最佳,而细基江蓠繁枝变型的生长反应则依前期环境中营养盐水平不同而有所差异。总体上看,当营养盐浓度由3μmol/L变动为45和150μmol/L时,2种江蓠藻体藻红素、叶绿素a、总碳和总氮含量以及硝酸还原酶的活性均有所提高;而当营养盐浓度由45和150μmol/L变动为3μmol/L时,2种江蓠藻体的上述指标则有所下降。营养盐浓度45和150μmol/L的相互变动对2种江蓠硝酸还原酶的活性影响不大。随着无机氮浓度的逐渐增加,过氧化氢酶的活性呈现显著下降的趋势。当营养盐浓度由3μmol/L向150μmol/L变动时,2种江蓠过氧化氢酶活性显著下降;而营养盐浓度由150μmol/L向3μmol/L变动时,过氧化氢酶活性则有所增强。综合比较表明,细基江蓠繁枝变型更容易受环境中营养盐浓度变动的影响,对环境中营养盐浓度变动的适应能力可能要低于菊花江蓠。
