Home About us Contact | |||
Lichenoid Reactions (lichenoid + reaction)
Kinds of Lichenoid Reactions Selected AbstractsLichenoid reaction induced by adalimumabJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2008C De Simone [source] US3 Allergy in dental practiceORAL DISEASES, Issue 2006D Bio, ina-Lukenda Allergy reactions of the oral mucosa comprise an array of clinical manifestations, some of them difficult to differentiate from toxic reactions. Type-I reactions are most frequently seen related to application of polymers in the oral cavity, such as orthodontic bonding and fissure sealant materials. There may also be systemic manifestations such as urticaria. Type-IV reactions may be seen related to most dental materials used, from amalgam and gold to polymers. These reactions appear as chronic reddening and/or ulceration of the oral mucosa. Lichenoid reactions have histopathological characteristics compatible with type-IV allergy reactions and are the most prevalent material-adverse reactions seen in the oral cavity. Recent advances have been made in characterizing the more prevalent allergens on oral mucosa, such as methacrylates, natural rubber latex (NRL) proteins, rubber glove chemicals and disinfectants. This improved understanding has clearly enhanced the success, particularly for type I NRL allergies. Skin patch tests, applying a series of dental materials in non-toxic concentrations on the skin, have been used to identify sensitization. However, the value of those tests can be questioned. Although obvious advances have been made in characterizing dental allergens and understanding potential exposure, improved diagnostic and management techniques are still needed. Corticosteroid therapy is all too often the only treatment. Drug allergy including local anaesthetics, and systemic antibiotics and NSAIDs, may also present in the dental environment, causing life-threatening emergencies specially in 'at risk patients'. The GDP has to know the principles of prevention, diagnosis and management of these situations. [source] New millennium, new nail problemsDERMATOLOGIC THERAPY, Issue 2 2002Robert Baran The major nail disorders in the new millennium may well be related to systemic drugs used for conditions other than nail problems. Conversely the new therapies for onychomycosis, a condition whose incidence is increasing, may result in drug interactions. We have chosen to report on the most common iatrogenic causes of nail disorders, such as toxic epidermal necrolysis, psoriasis or acral psoriasiform reaction, lichen planus or lichenoid reaction, antineoplastic therapy-induced palmar-plantar erythrodysesthesia, paronychia and pyogenic granuloma, drug-induced onycholysis and photo-onycholysis, and drug-induced scleroderma and sclerodermiform conditions. The adverse effects and drug interactions of the newer oral antifungal agents will be quoted and their management will be discussed. [source] Disorder-specific changes in innervation in oral lichen planus and lichenoid reactionsJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 8 2000Sirkku Niissalo Abstract: The peripheral nervous system was analysed in the oral mucosa of eight patients with oral lichen planus (OLP), five with a lichenoid reaction (LR) and three with mild chronic inflammation (MCI), by morphometric analysis of nerve fibres containing immunoreactive PGP 9.5, substance P (SP), calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP), or C-flanking peptide of neuropeptide Y (CPON). Overall nerve fibre density was higher in OLP (P=0.039) and LR (P=0.026) compared with healthy oral mucosa and was compatible with sprouting and collateral formation. In contrast to the innervation visualized with structural nerve fibre-marker PGP 9.5, the densities of neuropeptide-immunoreactive nerves were low in inflamed tissue. This is consistent with depletion via local release. Retraction and local loss of innervation were found in areas coinciding with the most severe inflammation and basal membrane (BM) damage. Interestingly, LR showed a twenty-eight-fold loss of post-ganglionic CPON-ir sympathetic nerve fibres (P=0.044). In LR, CPON-ir innervation was markedly lower than in OLP. Finally, the pattern of innervation in relation to inflammatory cell infiltrates and tissue structures differed between OLP and LR. In conclusion, the peripheral nervous system is implicated in the immunopathogenesis of lichen planus and lichenoid reactions, with a disorder-specific difference in this involvement. [source] Rosacea lymphoedema of the eyelidACTA OPHTHALMOLOGICA, Issue 6 2004Tze Foon Lai Abstract. Purpose:,To present a patient with rosacea lymphoedema of one upper eyelid resulting in unilateral complete ptosis. Methods:,A 51-year-old white man presented with a 12-month history of progressive painless swelling of the left upper eyelid. An incisional biopsy of the upper eyelid was performed. Results:,The biopsy showed dermal oedema with lymphangiectasia and telangiectasia, accompanied by a mild to moderate mixed chronic inflammatory infiltrate of lymphocytes, histiocytes, plasma cells and rare eosinophils. Stains for fungi and mycobacteria were negative. The lack of lichenoid reaction, dermal mucin or lip swelling indicated a lymphoedematous manifestation of rosacea. The patient was treated with minocycline and prednisolone with no effect. Conclusion:,Rosacea lymphoedema involving the eyelid, as in our case, is a rare complication and can present diagnostic and therapeutic challenges to the ophthalmologist. [source] Dental gold alloys and contact allergyCONTACT DERMATITIS, Issue 2 2002Halvor Möller Contact allergy to gold as demonstrated by patch testing is very common among patients with eczematous disease and seems to be even more frequent among patients with complaints from the oral cavity. There is a positive correlation between gold allergy and the presence of dental gold. Gold allergy is often found in patients with non-specific stomatitides as well as in those with lichenoid reactions or with only subjective symptoms from the oral cavity. The therapeutic effect of substituting other dental materials for gold alloys is conspicuous in casuistic reports but less impressive in larger patient materials. The amount of dental gold is correlated qualitatively and quantitatively to the blood level of gold and the effects if any of circulating blood gold are unknown. There is clearly a need for prospective studies in the field and gold sodium thiosulfate is considered an important item in the dental series for patch testing. [source] Disorder-specific changes in innervation in oral lichen planus and lichenoid reactionsJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 8 2000Sirkku Niissalo Abstract: The peripheral nervous system was analysed in the oral mucosa of eight patients with oral lichen planus (OLP), five with a lichenoid reaction (LR) and three with mild chronic inflammation (MCI), by morphometric analysis of nerve fibres containing immunoreactive PGP 9.5, substance P (SP), calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP), or C-flanking peptide of neuropeptide Y (CPON). Overall nerve fibre density was higher in OLP (P=0.039) and LR (P=0.026) compared with healthy oral mucosa and was compatible with sprouting and collateral formation. In contrast to the innervation visualized with structural nerve fibre-marker PGP 9.5, the densities of neuropeptide-immunoreactive nerves were low in inflamed tissue. This is consistent with depletion via local release. Retraction and local loss of innervation were found in areas coinciding with the most severe inflammation and basal membrane (BM) damage. Interestingly, LR showed a twenty-eight-fold loss of post-ganglionic CPON-ir sympathetic nerve fibres (P=0.044). In LR, CPON-ir innervation was markedly lower than in OLP. Finally, the pattern of innervation in relation to inflammatory cell infiltrates and tissue structures differed between OLP and LR. In conclusion, the peripheral nervous system is implicated in the immunopathogenesis of lichen planus and lichenoid reactions, with a disorder-specific difference in this involvement. [source] Gene expression of differentiation-specific keratins (K4, K13, K1 and K10) in oral non-dysplastic keratoses and lichen planusJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 8 2000Balvinder K. Bloor Abstract: Gene expression for the differentiation-specific keratins (K4, K13, K1 and K10) was analyzed in oral non-dysplastic keratoses, oral lichen planus (OLP) and lichenoid reactions (LR) by comparative in situ hybridization (ISH) and immunohistochemistry (IHC) to investigate molecular changes in the altered differentiation pattern from non- to para- or orthokeratinization. At the protein level, K4 and K13 were detected homogeneously in the suprabasal compartment of parakeratotic epithelium but showed reduced expression in orthokeratoses, particularly in the presence of lymphocytes. Corresponding transcripts were restricted to basal and lower prickle cells. Synthesis of K1 and K10 was upregulated and more pronounced in orthokeratotic epithelia. The study showed an alteration in the pattern of differentiation-specific keratins, although involvement of the lymphocytic infiltrate in OLP and LR resulted in further gene modulation. In both diseases, K1 and K10 showed transcriptional control, proteins having the same distribution as their transcripts. This represented a change from post-transcriptional regulation in normal buccal epithelium, in which mRNAs for K1 and K10 are more widely expressed than their proteins. Thus, the pattern of keratin gene expression may be altered in response to frictional/smoking stimuli or immune-mediated mechanisms. [source] Association between oral lichenoid reactions and amalgam restorationsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2008S Pezelj-Ribari Abstract Background The aim of this study was to perform a clinical assessment of the association between oral lichenoid reactions (OLR) and amalgam restorations and to determine the salivary concentrations of interleukin-6 (IL-6) and IL-8 before and after replacement of the amalgam restorations. Methods The study included 20 patients with OLR and 20 healthy volunteers, who were examined between 2001 and 2005 at the Oral Medicine Unit of the Medical Faculty University of Rijeka. All patients were skin patch tested by an experienced physician. Saliva samples were collected, prepared and analysed for IL-6 and IL-8 concentrations using enzyme-linked immunosorbent assay. Results Sixteen out of 20 patch-tested patients showed a sensitization to inorganic mercury or amalgam. Total replacement of all amalgam fillings was carried out on 20 patients with fillings based on composite resin, gold, porcelain or a combination of these. Sixteen out of 20 patients showed complete healing of OLR; three patients had marked improvement, whereas one patient showed no improvement. Levels of IL-6 detected before replacement were significantly higher than IL-6 levels following the replacement (P = 0.003). The IL-8 levels measured before replacement procedure were significantly higher than the IL-8 levels after replacement of the fillings (P < 0.001). Conclusions On the basis of clinical observations, restorative therapy resulted in tissue healing. Following the replacement of amalgam fillings with fillings based on other restorative materials, levels of both IL-6 and IL-8 shifted towards normal, as measured in healthy subjects. [source] US5 Oral lichen planusORAL DISEASES, Issue 2006M Jontell The lichenoid reactions are one of the most prevalent pathological reaction patterns of the oral mucosa. Oral lichen planus (OLP), lichenoid contact reactions (LCR) and graft-versus-host disease belong to this group of lichenoid reactions. Apart from a common clinical appearance, these disorders cannot be discriminated from each other by the use of histopathological techniques. New knowledge about the etiology behind LCR and GvHD can also, to some extent, be extrapolated to the immune mechanisms, which participate in the pathogeneses of OLP. Besides a discussion on different etiological aspects of OLP, this presentation will focus on treatment strategies used to manage lichenoid reactions. During recent years a debate has been conducted on the malignant potential of lichenoid reactions. [source] Studies of drug-induced lichenoid reactions: criteria for case selectionORAL DISEASES, Issue 4 2003BE McCartan No abstract is available for this article. [source] Orofacial effects of antiretroviral therapiesORAL DISEASES, Issue 4 2001C Scully This paper summarises some of the oral adverse effects of antiretroviral agents. Some are related to bone marrow suppression which may also predispose to mouth ulcers. Erythema multiforme and toxic epidermal necrolysis are especially well recognized in HIV disease, particularly as reactions to sulphonamides and to antiretroviral agents. Oral lichenoid reactions have been described in HIV disease often relating to zidovudine use. Didanosine has also produced erythema multiforme and not unusually induces xerostomia, again by an unknown mechanism. Xerostomia may be seen in up to one-third of patients taking didanosine. Taste abnormalities are common with the protease inhibitors and oral and perioral paraesthesia can be a disturbing adverse effect. Ritonavir in particular can give rise to circumoral paraesthesia in over 25% of patients. Indinavir can also produce cheilitis. [source] Oral lichenoid reactions associated with amalgam: improvement after amalgam removalBRITISH JOURNAL OF DERMATOLOGY, Issue 1 2003A. Dunsche Summary Background The pathogenetic relationship between oral lichenoid reactions (OLR) and dental amalgam fillings is still a matter of controversy. Objectives To determine the diagnostic value of patch tests with amalgam and inorganic mercury (INM) and the effect of amalgam removal in OLR associated with amalgam fillings. Methods In 134 consecutive patients 467 OLR were classified according to clinical criteria. One hundred and fifty-nine biopsies from OLR lesions were histologically diagnosed according to the World Health Organization criteria for oral lichen planus (OLP) and compared with 47 OLP lesions from edentulous patients without amalgam exposure. One hundred and nineteen patients were patch tested with an amalgam series. In 105 patients (357 of 467 lesions) the amalgam fillings were removed regardless of the patch test results and OLR were re-examined within a follow-up period of about 3 years. Twenty-nine patients refused amalgam removal and were taken as a control group. Results Eleven patients with OLR (8·2%) had skin lesions of lichen planus (LP). Histologically, the lesions in the OLR group could not be distinguished from those seen in the OLP group. Thirty-three patients (27·7%) showed a positive patch test to INM or amalgam. Amalgam removal led to benefit in 102 of 105 patients (97·1%), of whom 31 (29·5%) were cured completely. Of 357 lesions, 213 (59·7%) cleared after removal of amalgam, whereas 65 (18·2%) did not improve. In the control group without amalgam removal (n = 29) only two patients (6·9%) showed an improvement (P < 0·05). Amalgam removal had the strongest impact on lesions of the tongue compared with lesions at other sites (P < 0·05), but had very little impact on intraoral lesions in patients with cutaneous LP compared with patients without cutaneous lesions (P < 0·05). Patients with a positive patch test reaction to amalgam showed complete healing more frequently than the amalgam-negative group (P < 0·05). After an initial cure following amalgam removal, 13 lesions (3·6%) in eight patients (7·6%) recurred after a mean of 14·6 months. Conclusions Of all patients with OLR associated with dental amalgam fillings, 97·1% benefited from amalgam removal regardless of patch test results with amalgam or INM. We suggest that the removal of amalgam fillings can be recommended in all patients with symptomatic OLR associated with amalgam fillings if no cutaneous LP is present. [source] |