Lichen planus and cicatricial conjunctivitis: disease course and response to therapy of 11 patients

Brewer, JD; Ekdawi, N. S.; Torgerson, R. R.; Camilleri, M. J.; Bruce, AJ; Rs, Rogers; Maguire, L. J.; Baratz, K. H.

doi:10.1111/j.1468-3083.2010.03693.x

Cited by 34 publications

(41 citation statements)

References 12 publications

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“…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]. It is essential to diagnose and treat such disease quickly and efficiently to avoid the dire consequences of blindness [90]. …”

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

402

391

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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.

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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

402

391

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“…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

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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.

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“…Conjunctival involvement is rare, and it usually presents as a chronic cicatrizing keratoconjunctivitis in association with other clinical manifestations of LP. [1][2][3][4][5][6][7][8][9][10][11][12] Lichen planus with exclusive involvement of the conjunctiva is exceptional. According to our review criteria, only 6 cases of isolated conjunctival LP have been previously reported.…”

Section: Commentmentioning

confidence: 99%

Isolated Conjunctival Lichen Planus

Muñoz

Martínez-Escala²,

Juanpere³

et al. 2011

Arch Dermatol

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Background: Lichen planus is a common inflammatory autoimmune condition of unknown etiology that commonly affects the skin and mucous membranes. Isolated ocular lichen planus is an extremely rare presentation that most commonly involves the eyelids, conjunctiva, and cornea, leading to severe scarring, and is clinically indistinguishable from other causes of cicatricial conjunctivitis.Observations: A 79-year-old man complained of a chronic keratoconjunctivitis refractory to multiple topical treatments. Slit-lamp examination revealed diffuse bilateral conjunctival hyperemia, subepithelial fibrosis, and symblepharon, with a marked shortening of the lower conjunctival fornix. There were no other skin or mucosal lesions. Hematoxylin-eosin staining revealed acanthosis, focal thickening of the basement membrane, and a dense subepithelial mononuclear infiltrate. Direct im-

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Lichen planus and cicatricial conjunctivitis: disease course and response to therapy of 11 patients

Abstract: Lichen planus should be considered in the differential diagnosis of cicatricial conjunctivitis, especially when severe lichen planus is noted at other sites.

Cited by 34 publications

References 12 publications

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

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

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

Isolated Conjunctival Lichen Planus

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