BUSCANDO EL ORIGEN DEL LIQUEN PLANO !!
LOOKING FOR THE ORIGIN OF LICHEN PLANUS !!
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Hola amigos de la red. DERMAGIC de nuevo con ustedes. En esta nueva revisión sobre el LIQUEN PLANO, enfermedad descrita hace más de 150 años y que hoy día su tratamiento sigue siendo todo un reto para los dermatólogos de la nueva era.
ERASMUS WILSON fue el primero en utilizar el termino LIQUEN PLANO en el año 1869. La primera variante de la enfermedad fue descrita por Kaposi en 1892 denominándola LIQUEN RUBER PENFIGOIDES, y frederic WICKHAM en 1895 describió las estrías blancas en la parte superior de las lesiones.
Después de muchos años el avance de la ciencia a logrado descifrar numerosos eventos acerca del LIQUEN PLANO, ellos son:
1.- INMUNOMEDIACIÓN
El liquen plano es una enfermedad inflamatoria crónica que hoy dia es considerada de etiología desconocida, la cual es producida por una REACCIÓN INMUNITARIA, mediada por linfocitos T citotóxicos que atacan queratinocitos basales, causando daño y apoptosis en la piel y mucosas,
2.) FACTORES DESENCADENANTES:
Diversos factores pueden actuar como desencadenantes, entre ellos
figuran:
A.- INFECCIONES VIRALES: siendo el virus de la hepatitis C y hepatitis B las asociaciones más importantes.
B.- MEDICAMENTOS:
- Antihipertensivos: inhibidores de la enzima convertidora de angiotensina (IECA=Enalapril), y betabloqueadores: metoprolol, atenolol, propranolol, bisoprolol, carvedilol, labetalol, nebivolol).
- Aantimaláricos (cloroquina e hidroxicloroqiina).
- Antiinflamatorios NO ESTEROIDEOS (AINES): como el ibuprofeno y naproxeno, y otros.
-Medicamentos para la diabetes tipo2: (sulfonilurea).
- Diureticos: tiazidas.
- Penicilamina (utilizada en enfermedades reumaticas).
Estos son los mas frecuentemente descritos, pero en la experiencia cotidiana, cualquier medicamento te puede ocasionar un LIQUEN PLANO, muchas veces encontrado en la literatura como ERUPCIÓN LIQUENOIDE POR DROGAS, pero histopatológica y clínicamente se trata de un LIQUEN PLANO.
C.- CONTACTO CON ALÉRGENOS: el contacto con alérgenos dentales como la amalgama, y los reveladores utilizados en PLACAS RADIOLÓGICAS, y FOTOGRAFÍA.
3.) PREDISPOSICIÓN GENÉTICA:
Existe una asociación comprobada del LIQUEN PLANO con los antígenos de Histocompatibilidad, con ciertos haplotipos HLA, con las moleculas clase II, HLA-DR1, y la aparición de casos familiares, lo cual demuestra un componente genético en la susceptibilidad a presentar esta patología.
4.) ENFERMEDADES AUTOINMUNES ASOCIADAS:
El liquen plano suele coexistir con otras enfermedades
autoinmunes, entre las que se describen:
a.- Alopecia areata.
b.- Colitis ulcerosa.
c.-
Lupus discoide crónico.
d.- reforzando su naturaleza
inmunitaria.
e.- Enfermedad celíaca.
f.-
Dermatomiositis.
g.- Tiroiditis autoinmune (de
Hashimoto).
h.- Liquen escleroso y atrófico.
5.) FACTORES AMBIENTALES Y SISTÉMICOS:
El estrés psicológico, alteraciones en el microbioma (virus bacterias y hongos que habitan en el cuerpo humano), y sustancias químicas (ya descritas), también pueden modificar la respuesta inmune y pueden disparar la aparición de esta patología.
NOTA:
Hasta hoy día no ha sido descrito NINGÚN ORGANISMO específico, o AGENTE VIVO como causante primario del LIQUEN PLANO.
Las lesiones pueden presentarse en cualquier parte del cuerpo, incluyendo mucosas y anexos como uñas y cuero cabelludo.
En la mucosa bucal se presentan en el paladar y la superficie de la lengua como estriaciones blanquecinas, son por lo general dolorosas, incluyendo la región genital.
Puede presentarse tanto en masculinos como femeninos, y por lo general en la edad adulta, pero también se ha descrito en adolescentes y niños. LA ENFERMEDAD NO ES CONTAGIOSA
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1.) Actínico.
2.) Anular.
3.) Buloso.
4.) Clásico.
5.) Eritematoso.
6.) Exfoliativo.
7.) Familiar
8.) En gota.
9.) Hipertrófico.
10.) "invisible"
11.) Lineal.
12.)uco-membranoso (genital, esófago)
13.) Uñas.
14.) Oral.
15.) Penfigoide.
16.) Perforante.
17.) Pigmentoso.
18.) Plano Pilar.
19.) Ulcerativo
20.) Zosteriforme
El oral tiene 6 tipos: Reticulado, atrófico, papular, en placa, erosivo y buloso.
ENFERMEDADES ASOCIADAS:
-----------------------------------------------
Se han descrito numerosas enfermedades asociadas con LIQUEN PLANO entre ellas:
A.) MALIGNAS:
----------------------
1.) Cáncer de estómago.
2.) Linfoma.
3.) Neuroblastoma.
4.) Adenoma de la pituitaria.
5.) Fibrohistiocitoma.
6.) Paraproteinemia monoclonal por IGA Kappa.
7.) Craneofaringioma
8.) Malignidad pararenal.
9.) Sarcoma.
B.) ENFERMEDADES GASTROINTESTINALES Y ENDOCRINAS.
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1.) Cirrosis biliar primaria.
2.) Hepatitis crónica activa.
3.) Colitis Ulcerativa.
4.) Diabetes mellitus.
5.) Anormalidad en el funcionamiento del hígado (enzimas)
C.) ENFERMEDADES AUTOINMUNES:
----------------------------------------------------------
1.) Alopecia Areata.
2.) Dermatomiositis.
3.) Dermatitis Herpetiforme.
4.) Tiroiditis de Hashimoto.
5.) Queratoconjuntivitis seca y xerostomía.
6.) Morfea.
7.) Miastenia Gravis.
8.) Pénfigo foliáceo.
9.) Pénfigo Vulgar.
10.) Anemia perniciosa.
11.) Esclerosis sistémica.
12.) Timoma.
13.) Vitíligo.
También el LIQUEN PLANO a sido asociado al uso de numerosas drogas y sustancias:
DROGAS ASOCIADAS CON LIQUEN PLANO :
Numerosas drogas han estado involucradas en la aparición de LIQUEN PLANO, denominadas LIQUEN PLANO-LIKE reacciones, entre ellas:
A.) ANTIHIPERTENSIVOS: Captopril, cloro tiazida, Enalapril, Hidroclorotiazida, Labetolol, Metildopa, practolol, propanolol, espironolactona.
B.) ANTIBIÓTICOS: Demaclociclina, Etambutol, Griseofulvina, Ketoconazol, Levamisol, Acido para-amino-salicílico, estreptomicina, tetraciclina.
C: AINES: (ANTIINFLAMATORIOS NO ESTEROIDEOS:
Naproxeno, Indometacina, Feclofenac, Diflunisal, Flurbiprofen, Benoxaprofen, Acido acetil salicílico.
D: ANTIMALARICOS:
Cloroquina, Quinacrina, Quinidina, Quinina.
E.) PSICOTROPICOS:
Carbamazepina, Levomepromazina, Metopromazina,
F.) AGENTES REVELADORES DE FILMS:
4-Amino-N-dietil-analina sulfato (TTS), CD2, CD3, P-isopropilamino-difenilamina (IPPD)
G.) SULFONILUREAS:
Clorpropamida, Tolazamida, Tolbutamida.
H.) MISCELANEOS:
Alopurinol, anfenazole, arsénico, cinarizina, oro, meticran, Musk ambrette, penicilamina, probenecid, pirimetamina, mercaptopropionilglicina, piritioxina, Medios de radiocontraste, trihexifenidil, interferon-alpha-N1
... y probablemente existan otras mas que no están en esta lista.
Genéticamente se ha establecido una asociación de los antígenos HLA y EL LIQUEN PLANO, también el STRESS emocional es un factor desencadenante, el consumo de TABACO también se ha relacionado al mismo y las infecciones.
ALTERNATIVAS TERAPÉUTICAS:
---------------------------------------------------Se ha utilizado varias propuestas para el tratamiento del LIQUEN PLANO, entre ellas destacan:
1.) RETINOIDES: Isotretinoina, Etretinato, Acitretin,
2.) GRISEOFULVINA.
3.) CICLOSPORINA A.
4.) ANTIBIÓTICOS: Penicilina, Isoniacida, Aureomicina, Trimetoprim-Sulfametoxazol, tetraciclina
5.) ANTIPARASITARIOS: Metronidazol, Levamisol.
6.) DAPSONA y TALIDOMIDA
9.) ANTIMETABOLITOS: Ciclofosfamida, metotrexato.
10.) CORTICOSTEROIDES: Clobetasol y acetonido de triamcinolona.
11.) MEDICACIÓN PSIQUIÁTRICA: Sulpiride.
12.) AZATIOPRINA.
13.) PUVA: psoralenos mas radiación UVA
14.) CIRUGÍA.
15.) VIEJAS TERAPIAS INCLUYEN: Mercurio sistémico, Acido nicotínico, Bismuto, vitaminas, calcio intravenoso, y arsenicales.
LIQUEN PLANO DE LA LENGUA
NUEVAS ALTERNATIVAS DE TRATAMIENTO:
------------------------------------------------------------1.) DERIVADOS DE PLAQUETAS E INMUNOSUPRESIÓN.
2.) glycyrrhizin (LICORICE), HIERBA DE ORIGEN CHINO.
3.) TACROLIMUS Y PIMECROLIMUS TÓPICO
4.) HEPARINA (ENOXAPARIN)
5.) INTERFERON ALFA- 2b
6.) FOTOQUIMIOTERAPIA EXTRACORPOREA.
7.) MICOFENOLATO DE MOFETIL
8.) AMLEXANOX PASTA FORMULADA AL 5%
9.) LASER DE DIODO. (Terapia de Laser de bajo nivel)
12.) RUXOLITINIB (Inhibidor topico de la Janus Kinasa 1 y 2).
En base a todos estos hallazgos PODRÍAMOS CLASIFICAR EL LIQUEN PLANO DENTRO DE 7 VARIANTES, en cuanto a su ORIGEN:
1.) ASOCIADO A ENFERMEDAD HEPÁTICA.
2.) ASOCIADO A OTRAS ENFERMEDADES NO HEPÁTICAS.
3.) INDUCIDO POR DROGAS Y CONTAMINANTES.
4.) IDIOPÁTICO.
5.) MARCADOR CUTÁNEO DE MALIGNIDAD.
6.) GENÉTICO (HLA ANTÍGENOS)
7.) ASOCIADO A VACUNACIÓN CONTRA HEPATITIS B
LIQUEN PLANO LINEAL: FRENTE A PUNTA DE NARIZ
.. En estas 81 referencias los hechos en el adjunto: liquen plano clásico, lineal, boca y pecho.
Saludos a Todos.
Dr. José Lapenta R.
Hello friends of the net. DERMAGIC again with you. In this new review about the LICHEN PLANUS, disease described more than 150 years ago and that nowadays their treatment continues being an entire challenge for the dermatoligist of the new era.
ERASMUS WILSON was the first to use the term LICHEN PLANUS in 1869. The first variant of the disease was described by Kaposi in 1892, calling it Lichen Ruber Pemphigoides ruber pemphigoids, and Frederic Wickham in 1895 described the WHITE STRIATIONS on the upper surface of the lesions.
Darier later described the histopathological characteristics of the disease in 1905.
After many years of scientific advancement, numerous factors have been clarified regarding LICHEN PLANUS. These factors are:
ETIOLOGY:
1. IMMUNOMEDIATION
Lichen planus is a chronic inflammatory disease currently considered of unknown etiology. It is caused by an IMMUNE REACTION mediated by cytotoxic T lymphocytes that attack basal keratinocytes, causing damage and apoptosis in the skin and mucous membranes.
2. TRIGGERING FACTORS:
Several factors can act as triggers, including:
A. VIRAL INFECTIONS: the hepatitis C and hepatitis B viruses being the most important associations.
B.- MEDICINES:
- Antihypertensives: angiotensin-converting enzyme inhibitors (ACE inhibitors = enalapril) and beta-blockers: metoprolol, atenolol, propranolol, bisoprolol, carvedilol, labetalol, nebivolol).
- Antimalarials (chloroquine and hydroxychloroquine).
- Nonsteroidal anti-inflammatory drugs (NSAIDs): such as ibuprofen and naproxen, among others.
- Medications for type 2 diabetes: (sulfonylurea).
- Diuretics: thiazides.
- Penicillamine (used in rheumatic diseases).
These are the most frequently described, but in everyday experience, any medication can cause lichen planus. Lichen planus is often described in the literature as LICHENOID DRUG ERUPTION, but histopathologically and clinically it is actually lichen planus.
C. CONTACT WITH ALLERGENS: Contact with dental allergens such as amalgam, and the developers used in X-ray films and photography.
3. GENETIC PREDISPOSITION:
There is a proven association of lichen planus with histocompatibility antigens, certain HLA haplotypes, class II molecules, HLA-DR1, and the occurrence of familial cases, which demonstrates a genetic component in the susceptibility to this disease.
4.) ASSOCIATED AUTOIMMUNE DISEASES:
Lichen planus often coexists with other autoimmune diseases, including:
a. Alopecia areata.
b. Ulcerative colitis.
c. Chronic discoid lupus.
d. Reinforcing its immune nature.
e. Celiac disease.
f. Dermatomyositis.
g. Autoimmune thyroiditis (Hashimoto's).
h. Lichen sclerosus et atrophicus.
5.) ENVIRONMENTAL AND SYSTEMIC FACTORS:
Psychological stress, alterations in the microbiome (viruses, bacteria, and fungi that inhabit the human body), and chemical substances (already described) can also modify the immune response and trigger the onset of this pathology.
NOTE:
To date, no SPECIFIC ORGANISM or LIVING AGENT has been described as the primary cause of lichen planus.
CLINICAL FEATURES:
It is characterized by flat, purplish, shiny lesions with polygonal papules that have whitish striations on their surface, called WICKHAM'S STRIATIONS, named after its discoverer. The pruritus or itching is typically described in cycles (sometimes present, sometimes not).
The lesions can appear anywhere on the body, including mucous membranes and appendages such as nails and scalp.
On the oral mucosa, they appear as whitish striations on the palate and the surface of the tongue. They are generally painful, including the genital region.
It can occur in both men and women, and usually in adults, but has also been described in adolescents and children. THE DISEASE IS NOT CONTAGIOUS.
CLINICAL TYPES OF LICHEN PLANUS:
2.) Annulare
3.) Bullous.
4.) Classic.
5.) Erythematosus.
6.) Exfoliative.
7.) familial
8.) Guttate.
9.) Hypertrophic.
10.) "invisible"
11.) Lineal.
12.) Muco-membranous (genital, esophagus)
13.) Nail.
14.) Oral.
15.) Penphigoides.
16.) Perforanting.
17.) Pigmentosus.
18.) Planopilaris.
19.) Ulcerative.
20.) Zosteriform.
ASSOCIATE DISEASES:
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Numerous illnesses associated with LICHEN PLANUS have been described, among them:
A.) MALIGNANCIES:
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1.) Stomach Cancer.
2.) Lymphoma.
3.) Neuroblastoma.
4.) Adenoma of the pituitary.
5.) Fibrohistiocytoma.
6.) IGA Kappa monoclonal paraproteinemia.
7.) Craniopharyngioma
8.) Pararrenal malignancy.
9.) Sarcoma.
2.) Chronic active hepatitis (CAH).
3.) Ulcerative colitis.
4.) Diabetes mellitus.
5.) Abnormalities in the liver function (enzymes).
2.) Dermatomyositis.
3.) Dermatitis Herpetiformis.
4.) Hashimoto's Thyroiditis.
5.) Keratoconjunctivitis sicca and xerostomia.
6.) Morphea.
7.) Myasthenia Gravis.
8.) Penphigus foliaceus.
9.) Penphigus Vulgaris.
10.) Pernicious anemia.
11.) systemic sclerosis.
12.) Thymoma.
13.) Vitiligo.
Also the LICHEN PLANUS had been associated to the use of numerous drugs and substances:
DRUG ASSOCIATED WITH LICHEN PLANUS:
--------------------------------------------
Numerous drugs have been involved in the appearance of LICHEN PLANUS, called LP-like reactions, among them:
A.) ANTIHYPERTENSIVE: Captopril, chlorothiazide, Enalapril, Hydroclorothiazide, Labetolol, Methyldopa, practolol, propranolol, pironolactone.
B.) ANTIBIOTICS: Demeclocycline, Ethambutol, Griseofulvin, Ketoconazole, Levamisole, Para-amino-salicylic acid, streptomycin, teracycline.
C.) NON STEROIDAL ANTIINFLAMMATORY DRUGS:
Naproxen, Indomethacin, Feclofenac, Diflunisal, Flurbiprofen, Benoxaprofen, acetylsalicylic acid.
D: ANTIMALARIALS:
Chloroquine, Quinacrine, Quinidine, Quinine, hydroxychloroquine.
E.) PSYCHOTROPIC /NEUROLOGIC:
Carbamazepine, Levomepromazine, Metopromazine, Olanzapine.
F.) FILMS DEVELOPING AGENTS:
4-Amino-N-diethyl-analine sulfate (TTS), CD2, CD3, p-Isopropylamino-diphenylamine (IPPD).
G.) SULFONYLUREAS:
Chlorpropamide, Tolazamide, Tolbutamide.
H.) MISCELLANEOUS:
Allopurinol, anphenazole, arsenic, cinnarizine, gold, methycran, Musk ambrette, penicillamine, probenecid, phyrimethamine, mercaptopropionylglycine, pyrithioxin, radiocontrast media, trihexyphenidyl, interferon-alpha-N1.
... and probably exist other but that are not in this list.
Genetically an association of the HLA antigens and THE LICHEN PLANUS it has been observed, also the emotional STRESS is a causing factor, the consumption of TOBACCO has also been related to the same one, and the infections.
THERAPEUTIC ALTERNATIVES:
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It has been used several proposals for the treatment of the LICHEN PLANUS, among them they highlight:
1.) RETINOIDS: Isotretinoin, Etretinat, Acitretin, Temarotene.
2.) GRISEOFULVIN.
3.) CYCLOSPORINE A.
4.) ANTIBIOTICS: Penicillin, Isoniazid, Aureomycin, Trimethoprim-Sulfamethoxazole, tetracycline.
5.) ANTIPARASITE DRUGS: Metronidazole, Levamisole.
6.) DAPSONE and THALIDOMIDE
7.) ANTIMALARIALS: Phenytoin.
8.) RADIOTHERAPY.
9.) ANTIMETABOLITES: Cyclophosphamide, metotrexate.
10.) CORTICOSTEROIDS: Clobetasol and triamcinolone acetonide.
11.) PSYCHIATRIC MEDICATION: Sulpiride.
12.) AZATHIOPRINE.
13.) PUVA: psoralens plus UVA radiation.
14.) SURGERY.
15.) OLD THERAPIES INCLUDE: Systemic Mercury, nicotinic acid, Bismuth, vitamins, intravenous calcium, and arsenicals.
OTHERS NEW ALTERNATIVES OF TREATMENT:
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1.) RECOMBINANT PLETELET-DERIVED GROWHT FACTOR AND INMUNOSUPRESION.
2.) glycyrrhizin (LICORICE), GRASS OF CHINESE ORIGIN.
3.) TACROLIMUS AND PIMECROLIMUS TOPIC.
4.) HEPARIN. (ENOXAPARIN)
5.) INTERFERON ALFA - 2b
6.) EXTRACORPOREAL PHOTOCHEMOTHERAPY.
7.) MOFETIL MYCOPHENOLATE
8.) Amlexanox, formulated in a 5% paste
9.) DIODE LASER (Low level laser therapy)
11.) TOFACITINIB (Janus Kinase JAK 1 and 3 Inhibitor)
12.) RUXOLITINIB (Topical Janus Kinase 1 and 2 Inhibitor).
13. DEUCRACITINIB (It is a selective inhibitor of tyrosine kinase 2 (TYK2, currently being studied in Lichen planus).
14. UPACITINIB (Janus Kinase JAK 1 Inhibitor).
Based on all these discoveries we could CLASSIFY THE LICHEN PLANUS on their origin IN SEVEN (7) VARIANTS.
1.) ASSOCIATED TO HEPATIC DISEASES.
2.) ASSOCIATED TO OTHER NON HEPATIC DISEASES.
3.) INDUCED BY DRUGS AND POLLUTANTS.
4.) IDIOPATHIC.
5.) CUTANEOUS MARKER OF MALIGNANCY.
6.) GENETIC (HLA ANTIGENS)
7.) INDUCED BY HEPATITIS B VACCINE
Erasmus Wilson probably NEVER THOUGHT the great relationship that has been discovered between the LICHEN PLANUS AND HEPATIC or ABNORMALITIES in the HEPATIC FUNCTION, And even more the appearance of the same after the vaccination against another disease (HEPATITIS B).
in these 81 references the facts ... in the attach clasical lichen planus, lineal, oral and chest manifestations !
Greetings to all
Dr. Jose Lapenta R.
REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES
===============================================================
A.- Updates In Therapeutics for Lichen Planus Pigmentosus (2022).
B.- Review of Nail Lichen Planus: Epidemiology, Pathogenesis, Diagnosis, and Treatment (2021).
C.- Oral Lichen Planus: An Update on Diagnosis and Management (2024). D.- Treatment of Oral Erosive Lichen Planus With Upadacitinib (2022). E.- [Treatment of oral lichen planus-a review] (2025).
F.- Erosive Lichen Planus (2017).
G.- Coexistence of oral lichen planus and vulvar lichen sclerosus (2025).
H.- Lichen Planus: What Is New in Diagnosis and Treatment? (2024).
I.- Hypertrophic Lichen Planus: An Up-to-Date Review and Differential Diagnosis (2024).
J.- Distinct Variations in Gene Expression and Cell Composition Across Lichen Planus Subtypes 2024).
K.- Successful Treatment of Erosive Lichen Planus With Tofacitinib: A Case Series and Review of the Literature 2024).
L.- JAK inhibitors in lichen planus: a review of pathogenesis and treatments (2022).
M.- Successful treatment of childhood lichen planus with upadacitinib (2024).
N.- Successful treatment of erosive lichen planus with Upadacitinib complicated by oral squamous cell carcinoma 2023).
O.- TYK2 inhibition with deucravacitinib ameliorates erosive oral lichen planus (2024).
P.- Rapid response of lichen planus to baricitinib associated with suppression of cytotoxic CXCL13+CD8+ T cells (2024).
Q.- Recalcitrant multi-variant lichen planus successfully treated with oral baricitinib and topical ruxolitinib cream (2024).
R.- Mycophenolate mofetil and lichen planopilaris: systematic review and meta-analysis 2022).
S.- Assessment of 5% Amlexanox, 0.1% Triamcinolone Acetonide and 0.03% Tacrolimus in the Management of Oral Lichen Planus (2023).
T. Bidirectional Association between Lichen Planus and Hepatitis C-An Update Systematic Review and Meta-Analysis 2023).
W.- Survey of Medical Referral by Japanese Dentists for Patients With Hepatitis B, Hepatitis C, and Lichen Planus (2024).
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1.) Lichen planus involving the esophagus.
2.) Hepatitis C virus infection prevalence in lichen planus: examination of lesional and normal skin of hepatitis C virus-infected patients with lichen planus for the presence of hepatitis C virus RNA.
3.) [Lichen planus and hepatitis C virus. Apropos of 5 new cases] TO: Lichen plan et virus de l'hepatite C. A propos de 5 nouveaux cas.
4.) Lichen planus occurring after hepatitis B vaccination: a new case.
5.) A case of oral lichen planus with chronic hepatitis C successfully treated by glycyrrhizin (LICORICE)
6.) Nail lichen planus in children: clinical features, response to treatment, and long-term follow-up.
7.) Azathioprine for the treatment of severe erosive oral and generalized lichen planus.
8.) Ulcerative lichen planus: a case responding to recombinant platelet-derived growth factor BB and immunosuppression.
9.) [Study on regulatory effect of composite taixian tablet on immune function of red blood cell in patients with oral lichen planus]
10.) Topical tacrolimus and pimecrolimus: future directions.
11.) Tacrolimus clinical studies for atopic dermatitis and other conditions.
12.) Low-dose low-molecular-weight heparin (enoxaparin) is beneficial inlichen planus: a preliminary report
13.) Low-dose low-molecular-weight heparin in lichen planus
14.) Management of recalcitrant ulcerative oral lichen planus with topical tacrolimus.
15.) Topical tacrolimus in the treatment of symptomatic oral lichen planus: a series of 13 patients.
16.) Mast cell degranulation and the role of T cell RANTES in oral lichen planus.
17.) Levamisole and/or Chinese medicinal herbs can modulate the serum level of squamous cell carcinoma associated antigen in patients with erosive oral lichen planus.
18.) Dramatic response to levamisole and low-dose prednisolone in 23 patients with oral lichen planus: a 6-year prospective follow-up study.
19.) Successful treatment of generalized lichen planus with recombinant interferon alfa-2b.
20.) [Prevalence of oral lichen planus and oral leukoplakia in 112 patients with oral squamous cell carcinoma]
21.) Dental metal allergy in patients with oral, cutaneous, and genital lichenoid reactions.
22.) [Cellular immune alterations in fifty-two patients with oral lichen planus.]
23.) Isolated lichen planus of the toe nails treated with oral prednisolone.
24.) Lichen planus-like eruption following autologous bone marrow transplantation for chronic myeloid leukaemia.
25.) Immune mechanisms in oral lichen planus.
26.) Cyclosporin A in the treatment of lichen planus.
27.) Oral metronidazole treatment of lichen planus.
28.)Idiopathic lichen planus: treatment with metronidazole.
29.) Intestinal amebiasis, lichen planus, and treatment with metronidazole.
30.) Urinary tract infection as a cause of lichen planus: metronidazole therapy.
31.) [Metronidazole treatment of the erosive ulcerative form of lichen ruber planus of the oral mucosa]
32.) Clinical and pathological characteristics of oral lichen planus in hepatitis C-positive and -negative patients.
33.) High prevalence of anticardiolipin antibodies in patients with HCV-associated oral lichen planus.
34.) The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients.
35.) Management of oral lichen planus.
36.) Lichen planus occurring after hepatitis B vaccination: a new case.
37.) TT virus detection in oral lichen planus lesions.
38.) Lichenoid eruption following hepatitis B vaccination: first North American case report.
39.) Increased frequency of HLA-DR6 allele in Italian patients with hepatitis C virus-associated oral lichen planus.
40.) Extrahepatic manifestations of chronic viral hepatitis.
41.) Prevalence of hepatitis C virus in patients with lichen planus of the oral cavity and chronic liver disease.
42.) Histopathological and immunohistochemical study of oral lichen planus-associated HCV infection.
43.) Previous tuberculosis, hepatitis C virus and lichen planus. A report of 10 cases, a causal or casual link?
44.) [Skin diseases and hepatitis virus C infection]
45.) [Extrahepatic manifestations of hepatitis C virus infection]
46.) Detection of hepatitis C virus RNA in oral lichen planus and oral cancer tissues.
46.) Oral lichenoid lesions after hepatitis B vaccination.
47.) [The extrahepatic manifestations in hepatitis C virus (HCV) infection]
48.) Association of HLA-te22 antigen with anti-nuclear antibodies in Chinese patients with erosive oral lichen planus.
49.) Treatment of autoimmune and extra-hepatic manifestations of HCV infection.
50.) Lichen planus, erythema nodosum, and erythema multiforme in a patient with chronic hepatitis C.
51.) [Clinical considerations and statistical analysis on 100 patients with oral lichen planus]
52.) Lichen planus in children: a possible complication of hepatitis B vaccines.
53.) Lichen planus actinicus treated with acitretin and topical corticosteroids.
54.) Alendronate-induced lichen planus.
55.) Hepatitis C virus and lichen planus in Nigerians: any relationship?
56.) Helicobacter pylori Infection in Skin Diseases: A Critical Appraisal.
57.) Presence of lichen planus during a course of interferon alpha-2a therapy for a viral chronic C hepatitis.
58.) Lichen planus-like eruption following autologous bone marrow transplantation for chronic myeloid leukaemia.
59.) [Clinical evaluation in oral lichen planus with chronic hepatitis C: the role of interferon treatment]
60.) Oral lichen planus induced by interferon-alpha-N1 in a patient with hepatitis C.
61.) Treatment of lichen planus. An evidence-based medicine analysis of efficacy.
62.) Successful Treatment of Resistant Hypertrophic and Bullous Lichen Planus With Mycophenolate Mofetil
63.) Liver abnormalities in patient with lichen planus.
64.) Lichen planus.
65.) Evaluation of Hepatitis B Vaccination among Lichen Planus Patients.
66.) Lichen planus associated with hepatitis C virus: no viral transcripts are found in the lichen planus, and effective therapy for hepatitis C virus does not clear lichen planus.
67.) Lichen planus secondary to hepatitis B vaccination.
68.) A clinical evaluation of the efficacy of photodynamic therapy in the treatment of erosive oral lichen planus: A case series.
69.) Possible alternative therapies for oral lichen planus cases refractory to steroid therapies.
70). Novel therapies for oral lichen planus.
71.) The effect of diode laser and topical steroid on serum level of TNF-alpha in oral lichen planus patients.
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