Top PDF A case with Lichen planus in the lines of Blaschko

Lichen planus is an inlammatory disorder that may in- volve skin and mucous membranes. Linear lichen planus is a rare disorder occurring in approximately 0.2% of pa- tients with lichen planus. We report a case of linear lichen planus on the upper extremity which lesions followed the lines of Blaschko. J Clin Exp Invest 2011; 2 (4): 430-432 Key words: Linear lichen planus, Blaschko’s lines, case ÖZET

thick slices were prepared with H & A to confirm the diagnosis and sufficient sample size stained. Then another 4 microns were prepared for immunohistochemical studies. The slides for 24 hours at 37 ° C and one hour were kept at a temperature of 60 ° C to excess paraffin on a slide is removed, then Deparaffinization& Rehydration by placing the samples in xylen 100% and alcohol were graded. Antigens by placing slides in TBS buffer in a microwave (for 22 minutes) were recovered.Then slides with primary antibody (monoclonal mouse anti human-clone 4H12-UK- Nvocastra) cox-2 carefully 1.100 incubated for one hour at room temperature.Then, slide in the container include TBS with PH = 7.6 washed for 5 minutes, and for an hour inside en Vision tube is placed, TBS buffer Were washed and after putting on their DAB were washed with running water and after staining with hematoxylin Mayer were mounted.The percentage of cells stained for indicator COX-2 just counting in ten microscopic fields were calculated based on the following system: when the stained cells was no score 0, between 1 and 19% of cells were stained score1, between 20 and 49% of cells were stained score2 and if more than 50% of cells stained were score3 were considered. Positive control samples were used for ulcerative colitis.

Lichen nitidus is a disease of unknown etiology, first described in 1907 by Pinkus. It is characterized by flesh-colored, shiny papules of 1-2mm. The localized form affects preferentially the genitalia, upper limbs, trunk and abdomen. There is no sex or race predilec- tion, but it is more common among children and young adults. 1

rexpression in the biopsies of 28 patients with oral lichen planus done periodically during 96 months. No dysplasia was seen in 15 of these patients across the study period (group 1). In seven patients there was synchronism be- tween the diagnosis of lichen planus and the development of epidermoid carcinoma (group 2); in the remaining patients, this progression was seen months or years later (group 3). The percentage of p53-positive epithelial cells was considerably higher in groups 2 and 3 compared to group 1. The cell proliferation rate, evaluated by the im- munohistochemical expression of the MIB-1 protein, was not statistically different among the groups. Although no conclusion is yet possible about the molecular pathways that cause oral lichen planus to undergo malignant trans- formation, results suggest that an immunohistochemical assessment of p53 expression may become a useful tool for selecting those cases at a higher risk for malignancy.

polymorphisms of TNFα has been reported to affect the susceptibility and the progression of OLP 2,10 . In this study, we focused on a functional polymorphism of TNFα −308 G/A. Based on seven case-control studies, our meta-analysis revealed that TNFα −308 G/A polymorphism was associated with a significant increase in the risk of OLP (OR=2.33; 95%CI:1.07– 5.11; p=0.03). Hepatitis C virus has been proposed to be involved in the etiopathogenesis of OLP. Significant increased risk of OLP was found among patients with mixed HCV infection status (OR=3.77, 95%CI=1.07- 13.2, p=0.04), but not in patients without HCV infection (OR=2.09, 95%CI=0.63-6.91, p=0.22) and patients with HCV infection (OR=0.47, 95%CI=0.13-1.69, p=0.25). HCV infection induces an abnormal immune response in the host, enhancing TNFα production, and potentially influences the pathogenesis of OLP lesions. Thus, distinct pathogenetic mechanisms are involved in OLP patients with HCV infection and without HCV infection. The HCV status may be a confounding factor in association studies between OLP risk and TNFα

Increased production of TNFα is associated with the development of autoimmune/chronic inflammatory diseases, including psoriasis, lichen planus, rheumatoid arthritis and IBD. We have used the unique advantages of the zebrafish embryo for in vivo imaging and cell tracking to demonstrate that the genetic depletion of Tnfa or Tnfr2, but not Tnfr1, caused the infiltration of neutrophils into the skin and hyperproliferation of keratinocytes through the activation of an H2O2/NF-κB/Duox1 positive feedback inflammatory loop (Fig. 8). Strikingly, neutrophils, but not macrophages, are rapidly attracted to the skin. However, the activation of NF-κB and the induction of the gene encoding Il1b in the skin occurred before the appearance of the first neutrophils in the developing embryo. More importantly, DUOX1 was also strongly induced in the skin lesions of psoriasis and lichen planus patients. Collectively, these results (i) indicate a critical role of Tnfa/Tnfr2 signaling in the protection of the skin against oxidative stress, (ii) might explain the appearance of psoriasis and lichen planus in patients treated with anti-TNFα therapies [5-10], and (iii) support the idea that specific inhibition of the TNFα/Tnfr1 signaling axis while leaving TNFα/Tnfr2 signaling unaffected would inhibit the pathological effects of TNFα but reducing the side effects associated with this therapy [19,36]. This apparent discrepancy with TNFα-deficient mice, which do not show skin inflammation, may be due to developmental and/or physiological compensations, which probably do not exist in the human [37-39].

shed in the literature between 1950 and 1976 on the pre- malignant nature of oral lichen planus and concluded it was not possible to establish a safe correlation between lichen planus and oral cancer due to the lack of clinical and histopathology data from the analyzed cases. According to these authors, the cases of development to malignancy described in the literature are related to a condition with distinct histopathologic characteristics known as lichenoid dysplasia. This condition manifests characteristics that are similar to the ones encountered in oral lichen planus, but it also presents altered epithelial cell maturation patterns, thus excluding lichen planus from the diagnostic possi- bilities.

The immunodetection of VEGF and angiopoietins (ANG) 1 and 2, as well as the number of blood vessels was investigated in reticular (ROLP) (n=21) and atrophic-erosive (AEOLP) (n=11) oral lichen planus, as well as in oral fibroepithelial hyperplasia (OFH) (n=10), epithelial dysplasia (OED) (n=10) and squamous cell carcinoma (OSCC) (n=10). There was no significant difference in the immunodetection of ANG-1 and ANG-2, nor in the number of blood vessels between OLP groups. The ROLP group showed significantly greater immunodetection of VEGF compared with the AEOLP group. The comparison between the OLP group and each control group showed significantly greater levels of ANG-1 in the OLP group compared to the OFH group and no significant difference in ANG-2. VEGF levels in the OLP group were significantly higher than in the OFH group and significantly lower compared to the OSCC group. The results indicate that angiogenesis in OLP can not be associated to the different clinical forms of this disease. The lack of correlation between the markers in the different groups indicates the involvement of other pro-angiogenic agents in the neoformation vascular and reflects the complexity this process. Immunodetection of these growth factors in the OLP and OED groups was similar, suggesting that angiogenesis in OLP may behave similarly to the epithelial dysplastic lesion.

Aim: analysis of different dermatoscopic patterns of lichen planus and psoriasis. Material and methods. We ob- served 80 patients: 40 with psoriasis, 40 — with lichen planus. Dermatoscopic study was conducted using video- dermatoscope of expert class “MoleMaxHD” (Derma Medical Systems company, Austria), under magniication from x30 to x80. Results. Comparing the dermotoscopic indings of psoriatic plaque and lichen planus, vascular features were found to be more signiicant in psoriasis and in lichen planus non-vascular features were more prominant. Conclusion. Dermoscopy can be successfully used in differential diagnosis of these dermatoses.

The present results suggest that the higher cellular proliferative activity in previously treated HCV+ patients may indicate a possible relationship between the latter condition and one of the histopathological manifestations of OLP, the cell proliferative activity. In this sense, Schlesinger et al. (10) described a case of OLP that started in a patient treated with interferon alfa-2b and Griffiths et al. (8) stated that interferon can induce the expression of surface antigens on keratinocytes, which may play an important role in the origin of lichen planus. Still, for Sookoian et al. (9), ribavirin increases the risk of adverse skin reactions, among them the OLP (11,12).

ABSTRACT – Due to the development of large areas of permanent alopecia, patients with lichen planopilaris are more likely to evolve with psychosocial disorders and lower quality of life. Lichen planopilaris (LPP) is characterized by an autoimmune response against antigens of the hair follicle. It is known that can coexist with systemic autoimmune di- seases, although this relationship is not well understood. Early recognition and prompt therapy are to protect the base of the hair follicle and fibrosis can stop the progression of hair loss. We present a therapy used with excellent results in a case of lichen planus pillar overlap that occurred in dermatomyositis and scleroderma.

Twenty-two patients (17 women and 5 men; mean age = 50.6 ± 16.38 years; range 25-78 years) with chronic and symptomatic gingival lesions caused by autoimmune and inflammatory mucocutaneous diseases participated in the study. The patients were divided into 2 groups: group 1 consisted of 5 patients, all women, mean age 48.2 ± 8.13 years (range 38-58 years), treated systemically with prednisone and/or azathioprine for at least 6 months for control of their mucocutaneous diseases. All patients in this group presented PV; the duration of the disease was 8.2 ± 3.42 years (range 4-11 years). Group 2 consisted of 17 patients, 12 women, 5 men, mean age 51.4 ± 18.25 years (range 25-78 years), not under systemic treatment. In this group, 3 patients presented PV, 5 presented mucous membrane pemphi- goid (MMP), and 9 had oral lichen planus (OLP); the duration of these diseases, taken together, was 5.6 ± 4.04 years, range 1-15 years. The characteristics of the patients are shown in Table 1.

as loss of heterozygosity (LOH) in dysplastic OLP that are also seen in SCC. Zhang et al. (10) found a low loss of heterozygosity (6%) in OLP without dysplasia when compared with dysplastic OLP (40% for dysplasia average). These indings support that epithelial dysplasia in OLP is an indication to the risk of malignancy of the lesion (10). Lichen planus is an autoimmune mucocutaneous disease that does not have an effective treatment and that most frequently causes signiicant discomfort and pain for the patient. A suitable protocol for lichen planus includes the correct identiication of lesions by biopsy and histopathological analysis and the use of anti-inlammatory drugs as a treatment. When lichen planus occurs in the skin, patients should always be referred to dermatologists; in other words, there is a very important role of the multiprofessional actuation to treat lichen planus, and regular clinical monitoring is important because of the risk of malignant transformation reported by some authors.

ABSTRACT: Lichen planus pemphigoides describe a rare subset of patients who usually have typical lichen planus and then develop blistering on their lichen planus lesions and in normal skin. Less commonly the blistering antedates the lichen planus. They clinically appear to be a combination of lichen planus and bullous phemphigoid. Oral disease may occur and may resemble either lichen planus or bullous phemphigoid. Histopathologically, lichen planus lesions show features of lichen plannus and bullous lesions show features of bullous phemphigoid. D/F is positive in linear pattern with IgG and C3 along the basement membrane zone. Lichen planus phemphigoides is less severe and responds faster and better to steroids as compared to bullous phemphigoid.

2.6 times more often than men, nearly half of the subjects (48.5 %) were aged between 35 and 55 years. The disease lasted for more than a year in 76.5 % of cases. In one-third of cases the disease has developed on the background of endocrine pathology. The most commonly found clinical variants were vulgaris (accounted for more than half of the cases) and hypertrophic (1/3 cases) form. Involvement of mucous membrane was observed in 22.1 % of cases, and this was seen more commonly associated with destructive forms (erosive ulcerous and exudative hyperemic). Conclusion. The results indicate an increase in the incidence of lichen planus in the Krasnodar region with a predominance of typical forms of cutaneous lichen planus and destructive forms of lichen planus of the mucous membranes.

Lichen Planus is a muco-cutaneous disorder affecting females. The oral lesions precede the skin lesions, with malignant potential rate, ranging from 0.3 to 3%. Malig- nant changes are usually associated with stress and co- carcinogens. Usually, malignant transformation is presented as solitary lesion in the oral cavity, Oral Squa- mous Cell Carcinoma (OSCC), developing at multiple sites, as a very rare finding in patients of Oral Lichen Planus (OLP). A case of OLP without risk factors and strong history of stress, the Grinspan syndrome with field cancerization is presented in this article.

Abstract: This study considered a possible relationship between the severity of oral lichen planus (OLP), serum anti-TPO autoantibodies (TPOAb) titer and thyroid disease in OLP patients. Forty-six OLP patients with positive TPOAb results (> 35 IU/ml) who had also been diagnosed with thyroid disease were included in the study group. The control group consisted of 46OLP patients with no thyroid disease. The study and control groups (92) were divided to two subgroups of erosive OLP (EOLP) and non-erosive OLP (NEOLP). Serum TPOAb levels and IL-8 (to measure OLP severity) were evaluated using the independent t-test, chi-square and conditional logistic regression analysis (α = 0.05). A signiicant positive correlation was found between serum IL-8 and TPOAb levels in the study group (r = 0.783; p = 0.001). The positive blood levels of TPOAb were signiicantly associated with an increased risk of EOLP (OR = 4.02 at 95%CI; 1.21–13.4; p = 0.023). It is possible to used positive serum TPOAb levels in patients with OLP as in indicator of possible undetected thyroid disorders in those patients. Because erosive OLP has been associated with TPOAb in thyroid patients, it may be useful to determine TPOAb levels of such patients to diagnose a possible undetected thyroid disorders and follow-up for malignancy.

This prospective cross-sectional study was conducted on all patients enrolled with a diagnosis of mucosal lichen planus within 18 months from the start of the study who were referred to the department of dermatology or Farshchian hospital (Skin Center in Hamedan province). Five mililiter of blood clots were taken from each patient, and was saved at a temperature of minus 70 degrees Celsius after centrifugation till anti- HCV testing (DIA-PRO kit Italy)was done. Study design was such that if the anti-HCV was positive, two mililiter of blood clots would be taken from a patient in sterile conditions in a special tube for HCV-Rt-PCR test (Sinazhen kit Iran). Controls were randomly selected from the general population, and wereage and gender matched. An inclusion criterion was developing oral lichen planus, which was diagnosed by a dermatologist and defined according to pathology.

1. INTRODUCTION In the period prior to 2003 Polytechnics in Zimbabwe had a mix of Information Communication Technologies (ICTs), varying from one institution to the other. There was no uniformity as to what ICTs individual institutions invested in, so while some institutions had several computer laboratories of clone desktops, some did not have even a single lab. While some had connected to the internet through the dialup system which came through telephone lines, some had no idea what internet was.A breakthrough came in 2003 when a non- governmental organization called VVOB, a Belgian abbreviation which translates in English to Flemish for Technical Assistance, came in with a project called the College Information Technology Enhancement Programme (CITEP), which helped to finance, train personnel and equip polytechnics with standard computer and network infrastructure (VVOB project document, 2003). They conducted training workshops for personnel, procured standard desktops, and installed fibre internet connectivity and setup Ethernet networks in these institutions. This project became the basis for mobile computing in Polytechnics. When the project ended in 2008, the institutions were now coordinated and some managed to go a step further by installing wireless access points within institutions using the fibre backbone. This allowed staff and students who had WIFI enabled devices to be able to access internet and research

Data for this study was collected from the banking hall of Ghana Commercial Bank (GCB) Ltd. Kumasi Main Branch. The methods used during the data collection were direct observation and personal interview and questionnaire administering. The data gathered were the daily record of queuing system over a month. The variables measured included arrival and service rate per hour. They were analyzed for simultaneous efficiency in customer satisfaction and economic cost minimization through the use of a multi-channel single-line queuing model, which were compared for a number of queue performances such as; the average number of customers in the queue and in the system, average time each customer spends in the queue and in the system and the probability of the system being idle. The following assumptions were made for modeling the queuing system at Ghana Commercial Bank (GCB) Ltd. Kumasi Main Branch.