Isolated Conjunctival Lichen Planus

Muñoz, Eduardo Rozas; Martínez-Escala, Maria Estela; Juanpere, Núria; Armentia, J.; Herrero-González, Josep E.

doi:10.1001/archdermatol.2011.68

Cited by 24 publications

(32 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other ophthalmologic signs include eyelid lesions [82, 83], keratouveitis [80], keratoconjunctivitis sicca [80], punctate epithelial erosions [80, 84], corneal ulceration/scarring [84], and dysplastic conjunctival lesions resembling ocular surface squamous neoplasia [85]. LP was also reported as chronic keratoconjunctivitis with diffuse conjunctival hyperemia, subconjunctival fibrosis, and forniceal symblephara with foreshortening of the lower fornix in the isolated ocular form [86]. This form of the disease can be a diagnostic challenge [87].…”

Section: Resultsmentioning

confidence: 99%

“…This form of the disease can be a diagnostic challenge [87]. Biopsy for histopathologic examination and immunofluorescence studies is the only way to differentiate ocular LP from other causes of irreversible scarring keratoconjunctivitis [86]. The presence of subepithelial fibrinogen is not necessarily inclusive of any particular eye disease on immunofluorescence analysis, but a fragmented and shaggy subepithelial fibrinogen layer in the conjunctiva is indicative of LP [88, 89].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

Gorouhi

Davari

Fazel

2014

The Scientific World Journal

399

391

View full text Add to dashboard Cite

Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

Gorouhi

Davari

Fazel

2014

The Scientific World Journal

399

391

View full text Add to dashboard Cite

show abstract

“…Conjunctival involvement with LP is a relatively rare feature of the disease, with 64 cases described in the literature and the vast majority of patients presenting with cicatricial changes. 5,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24 Even more uncommonly reported is LP with lacrimal drainage system involvement. Only 11 such patients have been described in various case reports and series 9,10 before Durrani et al (2008) performed a retrospective review of 184 patients with canalicular obstruction.…”

Section: Discussionmentioning

confidence: 99%

Immunopathology and histopathology of conjunctival biopsies in patients with presumed idiopathic punctal stenosis

et al. 2016

View full text Add to dashboard Cite

Background/Aims Numerous processes have been implicated as causes of punctal stenosis. Recent studies have highlighted inflammation in punctoplasty specimens in patients with punctal stenosis. Conjunctival biopsy has been suggested as a means to determine underlying etiologies, although little is known regarding what conjunctival pathologies are associated with punctal stenosis. Our objective is to examine the pathologic and immunologic findings in conjunctival biopsy specimens in patients with presumed idiopathic punctal stenosis. Methods A retrospective chart review was performed at a single institution over a five year period of patients with presumed idiopathic punctal stenosis who underwent conjunctival biopsy for routine histopathologic and/or direct immunofluorescent (DIF) examination. Patients with known etiologies of punctal stenosis were excluded. Results 23 patients met inclusion criteria. Conjunctival biopsies (n = 36) from all 23 patients underwent histological examination. 35 of 36 specimens (97.2%) showed a lymphocytic infiltrate. Two patients (8.7%) had findings suggestive of sarcoidosis. Conjunctival biopsies from 18 of the 23 patients were also evaluated by DIF. Nine patients (50.0%) had fibrinogen characteristics suggestive of lichen planus. There were no complications related to the conjunctival biopsy procedures. Conclusion Conjunctiva appears to be an excellent proxy in the evaluation of patients with presumed idiopathic punctal stenosis. The biopsy is safe and provides ample tissue. 11 of the 23 patients in this study demonstrated findings consistent with underlying immunologic disorders, suggesting that conjunctival biopsy may play a role in identifying the underlying etiology of punctal stenosis. Knowledge of these underlying conditions impacted medical and surgical treatments for several patients.

show abstract

“…6 To date, only 7 adult cases of isolated conjunctival LP have been reported in adults. 1,[7][8][9] Ocular LP, irrespective of site, needs to be managed aggressively with immunosuppressive agents, because chronic ocular inflammation may lead to progressive subepithelial fibrosis, symblepharon, secondary ocular dryness, entropion, trichiasis, and corneal opacification, which may in turn lead to severe visual impairment. 10 To our knowledge, this is the first case of ocular LP reported in a child.…”

Section: Discussionmentioning

confidence: 99%