Lichen planus and lichenoid dermatoses

Clinical overview and molecular basis
      Deriving from the Greek word λειχήν for “tree moss” and the Latin word planus for “planar,” lichen planus is a relatively uncommon and heterogeneous cutaneous disorder that typically develops in middle-aged adults. Despite the significant clinical burden associated with the disorder, little well-conducted molecular research has been undertaken, possibly because of heterogeneity impeding consistent and confident phenotyping. The multiple variants of lichenoid disease bear overlapping clinical and pathologic features despite manifesting as distinct clinical disorders. The first article in this 2-part continuing medical education series provides a comprehensive overview of the clinical and pathologic characteristics of cutaneous lichenoid dermatoses and links these manifestations to recent advances in our understanding of the underlying pathobiology of such diseases.

      Key words

      Abbreviations used:

      LP ( lichen planus), LPP ( lichen planopilaris), NLP ( nail lichen planus), HCV ( hepatitis C virus), LDE ( lichenoid drug eruption), LPLK ( lichen planus–like keratosis), LS ( lichen sclerosus), BP ( bullous pemphigoid), LE ( lupus erythematosus), IL ( interleukin), IFN ( interferon), HLA ( human leukocyte antigen), SNP ( single nucleotide polymorphism)
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      References

        • Le Cleach L.
        • Chosidow O.
        Clinical practice. Lichen planus.
        N Engl J Med. 2012; 366: 723-732
        • Depaoli M.
        Clinico-statistical data on lichen ruber planus.
        Minerva Dermatol. 1964; 39: 166-171
        • Schmidt H.
        Frequency, duration and localization of lichen planus. A study based on 181 patients.
        Acta Derm Venereol. 1961; 41: 164-167
        • Bhattacharya M.
        • Kaur I.
        • Kumar B.
        Lichen planus: a clinical and epidemiological study.
        J Dermatol. 2000; 27: 576-582
        • Wagner G.
        • Rose C.
        • Sachse M.M.
        Clinical variants of lichen planus.
        J Dtsch Dermatol Ges. 2013; 11: 309-319
        • Pandhi D.
        • Singal A.
        • Bhattacharya S.N.
        Lichen planus in childhood: a series of 316 patients.
        Pediatr Dermatol. 2014; 31: 59-67
        • Steffen C.
        • Dupree M.L.
        Louis-Frederic Wickham and the Wickham’s striae of lichen planus.
        Skinmed. 2004; 3: 287-289
        • Lehman J.S.
        • Tollefson M.M.
        • Gibson L.E.
        Lichen planus.
        Int J Dermatol. 2009; 48: 682-694
        • Lee C.W.
        • Yoon J.Y.
        Lichen planus specific antigen and antibodies—in a patient with generalized lichen planus.
        J Korean Med Sci. 1987; 2: 259-262
        • Akarsu S.
        • Ilknur T.
        • Ozer E.
        • Fetil E.
        Lichen planus pigmentosus distributed along the lines of Blaschko.
        Int J Dermatol. 2013; 52: 253-254
        • Mohrenschlager M.
        • Engst R.
        • Hein R.
        • Ring J.
        Primary manifestation of a zosteriform lichen planus: isotopic response following herpes zoster sine herpete?.
        Br J Dermatol. 2008; 158: 1145-1146
        • Irvine C.
        • Irvine F.
        • Champion R.H.
        Long-term follow-up of lichen planus.
        Acta Derm Venereol. 1991; 71: 242-244
        • Weedon D.
        The lichenoid reaction pattern (interface dermatitis).
        in: Weedon’s Skin Pathology. 3rd ed. Elsevier Limited, Edinburgh2010: 35
        • Mobini N.
        • Toussaint S.
        • Kamino H.
        Noninfectious erythematous, papular, and squamous diseases.
        in: Elder D.E. Lever’s Histopathology of the Skin. 10th ed. Lippincott Williams & Wilkins, Philadelphia2009: 169
        • Usatine R.P.
        • Tinitigan M.
        Diagnosis and treatment of lichen planus.
        Am Fam Physician. 2011; 84: 53-60
        • Lallas A.
        • Kyrgidis A.
        • Tzellos T.G.
        • et al.
        Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea.
        Br J Dermatol. 2012; 166: 1198-1205
        • Halevy S.
        • Shai A.
        Lichenoid drug eruptions.
        J Am Acad Dermatol. 1993; 29: 249-255
        • Filipovich A.H.
        • Weisdorf D.
        • Pavletic S.
        • et al.
        National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report.
        Biol Blood Marrow Transplant. 2005; 11: 945-956
        • Reich H.L.
        • Nguyen J.T.
        • James W.D.
        Annular lichen planus: a case series of 20 patients.
        J Am Acad Dermatol. 2004; 50: 595-599
        • Li B.
        • Li J.H.
        • Xiao T.
        • He C.D.
        • Gao X.H.
        • Chen H.D.
        Annular atrophic lichen planus.
        Eur J Dermatol. 2010; 20: 842-843
        • Friedman D.B.
        • Hashimoto K.
        Annular atrophic lichen planus.
        J Am Acad Dermatol. 1991; 25: 392-394
        • Morales-Callaghan Jr., A.
        • Martinez G.
        • Aragoneses H.
        • Miranda-Romero A.
        Annular atrophic lichen planus.
        J Am Acad Dermatol. 2005; 52: 906-908
        • Willsteed E.
        • Bhogal B.S.
        • Das A.K.
        • Wojnarowska F.
        • Black M.M.
        • McKee P.H.
        Lichen planus pemphigoides: a clinicopathological study of nine cases.
        Histopathology. 1991; 19: 147-154
        • Welsh J.P.
        • Skvarka C.B.
        • Allen H.B.
        A novel visual clue for the diagnosis of hypertrophic lichen planus.
        Arch Dermatol. 2006; 142: 954
        • Manz B.
        • Paasch U.
        • Sticherling M.
        Squamous cell carcinoma as a complication of long-standing hypertrophic lichen planus.
        Int J Dermatol. 2005; 44: 773-774
        • Al-Mutairi N.
        • El-Khalawany M.
        Clinicopathological characteristics of lichen planus pigmentosus and its response to tacrolimus ointment: an open label, non-randomized, prospective study.
        J Eur Acad Dermatol Venereol. 2010; 24: 535-540
        • Kashima A.
        • Tajiri A.
        • Yamashita A.
        • Asada Y.
        • Setoyama M.
        Two Japanese cases of lichen planus pigmentosus-inversus.
        Int J Dermatol. 2007; 46: 740-742
        • Eisen D.
        • Carrozzo M.
        • Bagan Sebastian J.V.
        • Thongprasom K.
        Number V oral lichen planus: clinical features and management.
        Oral Dis. 2005; 11: 338-349
        • Scully C.
        • Carrozzo M.
        Oral mucosal disease: lichen planus.
        Br J Oral Maxillofac Surg. 2008; 46: 15-21
        • Zendell K.
        Genital lichen planus: update on diagnosis and treatment.
        Semin Cutan Med Surg. 2015; 34: 182-186
        • Fruchter R.
        • Melnick L.
        • Pomeranz M.K.
        Lichenoid vulvar disease: a review.
        Int J Womens Dermatol. 2017; 3: 58-64
        • Badri T.
        • Kenani N.
        • Benmously R.
        • Debbiche A.
        • Mokhtar I.
        • Fenniche S.
        Isolated genital annular lichen planus.
        Acta Dermatovenerol Alp Pannonica Adriat. 2011; 20: 31-33
        • Mehregan D.A.
        • Van Hale H.M.
        • Muller S.A.
        Lichen planopilaris: clinical and pathologic study of forty-five patients.
        J Am Acad Dermatol. 1992; 27: 935-942
        • Tziotzios C.
        • Stefanato C.M.
        • Fenton D.A.
        • Simpson M.A.
        • McGrath J.A.
        Frontal fibrosing alopecia: reflections and hypotheses on etiology and pathogenesis.
        Exp Dermatol. 2016; 25: 847-852
        • Tosti A.
        • Piraccini B.M.
        Dermatological diseases.
        in: Scher R.K. Daniel R.C. Nails: Diagnosis, Therapy, and Surgery. 3rd ed. Elsevier Saunders, Oxford, United Kingdom2005: 105
        • Rich P.
        • Scher R.K.
        Nail manifestations of cutaneous disease.
        in: Rich P. Scher R.K. An Atlas of Diseases of the Nail. Parthenon Publishing, New York2003: 51
        • Scher R.K.
        Lichen planus of the nail.
        Dermatol Clin. 1985; 3: 395-399
        • Tosti A.
        • Peluso A.M.
        • Fanti P.A.
        • Piraccini B.M.
        Nail lichen planus: clinical and pathologic study of twenty-four patients.
        J Am Acad Dermatol. 1993; 28: 724-730
        • Goettmann S.
        • Zaraa I.
        • Moulonguet I.
        Nail lichen planus: epidemiological, clinical, pathological, therapeutic and prognosis study of 67 cases.
        J Eur Acad Dermatol Venereol. 2012; 26: 1304-1309
        • Fox G.N.
        • Harrell C.C.
        • Mehregan D.R.
        Extensive lichenoid drug eruption due to glyburide: a case report and review of the literature.
        Cutis. 2005; 76: 41-45
        • Antiga E.
        • Melani L.
        • Cardinali C.
        • et al.
        A case of lichenoid drug eruption associated with sildenafil citratus.
        J Dermatol. 2005; 32: 972-975
        • Brauer J.
        • Votava H.J.
        • Meehan S.
        • Soter N.A.
        Lichenoid drug eruption.
        Dermatol Online J. 2009; 15: 13
        • Asarch A.
        • Gottlieb A.B.
        • Lee J.
        • et al.
        Lichen planus-like eruptions: an emerging side effect of tumor necrosis factor-alpha antagonists.
        J Am Acad Dermatol. 2009; 61: 104-111
        • Harber L.C.
        • Lashinsky A.M.
        • Baer R.L.
        Photosensitivity due to chlorothiazide and hydrochlorothiazide.
        N Engl J Med. 1959; 261: 1378-1381
        • Kubo Y.
        • Fukumoto D.
        • Ishigami T.
        • Hida Y.
        • Arase S.
        Diltiazem-associated photodistributed hyperpigmentation: report of two Japanese cases and published work review.
        J Dermatol. 2010; 37: 807-811
        • Stein K.R.
        • Scheinfeld N.S.
        Drug-induced photoallergic and phototoxic reactions.
        Expert Opin Drug Saf. 2007; 6: 431-443
        • Moore D.E.
        Drug-induced cutaneous photosensitivity: incidence, mechanism, prevention and management.
        Drug Saf. 2002; 25: 345-372
        • Bork K.
        Lichenoid eruptions.
        in: Bork K. Cutaneous Side Effects of Drugs. WB Saunders, Philadelphia1988: 170
        • West A.J.
        • Berger T.G.
        • LeBoit P.E.
        A comparative histopathologic study of photodistributed and nonphotodistributed lichenoid drug eruptions.
        J Am Acad Dermatol. 1990; 23: 689-693
        • Lage D.
        • Juliano P.B.
        • Metze K.
        • de Souza E.M.
        • Cintra M.L.
        Lichen planus and lichenoid drug-induced eruption: a histological and immunohistochemical study.
        Int J Dermatol. 2012; 51: 1199-1205
        • Anderson T.E.
        Lichen planus following quinidine therapy.
        Br J Dermatol. 1967; 79: 500
        • Seehafer J.R.
        • Rogers 3rd, R.S.
        • Fleming C.R.
        • Dickson E.R.
        Lichen planus-like lesions caused by penicillamine in primary biliary cirrhosis.
        Arch Dermatol. 1981; 117: 140-142
        • Sontheimer R.D.
        Lichenoid tissue reaction/interface dermatitis: clinical and histological perspectives.
        J Invest Dermatol. 2009; 129: 1088-1099
        • Van den Haute V.
        • Antoine J.L.
        • Lachapelle J.M.
        Histopathological discriminant criteria between lichenoid drug eruption and idiopathic lichen planus: retrospective study on selected samples.
        Dermatologica. 1989; 179: 10-13
        • Barbaud A.
        • Goncalo M.
        • Bruynzeel D.
        • Bircher A.
        Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions.
        Contact Dermatitis. 2001; 45: 321-328
        • Barbaud A.
        Drug patch testing in systemic cutaneous drug allergy.
        Toxicology. 2005; 209: 209-216
        • Lomaga M.A.
        • Polak S.
        • Grushka M.
        • Walsh S.
        Results of patch testing in patients diagnosed with oral lichen planus.
        J Cutan Med Surg. 2009; 13: 88-95
        • Chen W.
        • Schramm M.
        • Zouboulis C.C.
        Generalized lichen nitidus.
        J Am Acad Dermatol. 1997; 36: 630-631
        • Francoeur Jr., C.J.
        • Frost M.
        • Treadwell P.
        Generalized pinhead-sized papules in a child. Generalized lichen nitidus.
        Arch Dermatol. 1988; 124: 935-936
        • Wall L.M.
        • Heenan P.J.
        • Papadimitriou J.M.
        Generalized lichen nitidus: a case report.
        Australas J Dermatol. 1985; 26: 36-40
        • Soroush V.
        • Gurevitch A.W.
        • Peng S.K.
        Generalized lichen nitidus: case report and literature review.
        Cutis. 1999; 64: 135-136
        • Bettoli V.
        • De Padova M.P.
        • Corazza M.
        • Virgili A.
        Generalized lichen nitidus with oral and nail involvement in a child.
        Dermatology. 1997; 194: 367-369
        • Munro C.S.
        • Cox N.H.
        • Marks J.M.
        • Natarajan S.
        Lichen nitidus presenting as palmoplantar hyperkeratosis and nail dystrophy.
        Clin Exp Dermatol. 1993; 18: 381-383
        • Park S.H.
        • Kim S.W.
        • Noh T.W.
        • et al.
        A case of palmar lichen nitidus presenting as a clinical feature of pompholyx.
        Ann Dermatol. 2010; 22: 235-237
        • Podder I.
        • Mohanty S.
        • Chandra S.
        • Gharami R.C.
        Isolated palmar lichen nitidus-a diagnostic challenge: first case from Eastern India.
        Indian J Dermatol. 2015; 60: 308-309
        • Pinkus H.
        • Shair H.M.
        Koebner phenomenon in lichen nitidus; report of two cases.
        AMA Arch Derm Syphilol. 1952; 65: 82-87
        • Tay E.Y.
        • Ho M.S.
        • Chandran N.S.
        • Lee J.S.
        • Heng Y.K.
        Lichen nitidus presenting with nail changes–case report and review of the literature.
        Pediatr Dermatol. 2015; 32: 386-388
        • Taniguchi S.
        • Chanoki M.
        • Hamada T.
        Recurrent generalized lichen nitidus associated with amenorrhea.
        Acta Derm Venereol. 1994; 74: 224-225
        • Patrizi A.
        • Di Lernia V.
        • Pauluzzi P.
        Generalized lichen niditus, trisomy 21 and congenital megacolon.
        Ann Dermatol Venereol. 1991; 118: 725
        • Lestringant G.G.
        • Piletta P.
        • Feldmann R.
        • Galadari I.
        • Frossard P.M.
        • Saurat J.H.
        Coexistence of atopic dermatitis and lichen nitidus in three patients.
        Dermatology. 1996; 192: 171-173
        • Kato N.
        Familial lichen nitidus.
        Clin Exp Dermatol. 1995; 20: 336-338
        • Leung A.K.
        • Ng J.
        Generalized lichen nitidus in identical twins.
        Case Rep Dermatol Med. 2012; 2012: 982084
        • Shapiro L.
        • Ackerman A.B.
        Solitary lichen planus-like keratosis.
        Dermatologica. 1966; 132: 386-392
        • Morgan M.B.
        • Stevens G.L.
        • Switlyk S.
        Benign lichenoid keratosis: a clinical and pathologic reappraisal of 1040 cases.
        Am J Dermatopathol. 2005; 27: 387-392
        • Bugatti L.
        • Filosa G.
        Dermoscopy of lichen planus–like keratosis: a model of inflammatory regression.
        J Eur Acad Dermatol Venereol. 2007; 21: 1392-1397
        • Wallace H.J.
        Lichen sclerosus et atrophicus.
        Trans St Johns Hosp Dermatol Soc. 1971; 57: 9-30
        • Ridley C.M.
        Lichen sclerosus et atrophicus.
        Arch Dermatol. 1987; 123: 457-460
        • Garcia-Bravo B.
        • Sanchez-Pedreno P.
        • Rodriguez-Pichardo A.
        • Camacho F.
        Lichen sclerosus et atrophicus. A study of 76 cases and their relation to diabetes.
        J Am Acad Dermatol. 1988; 19: 482-485
        • Meffert J.J.
        • Davis B.M.
        • Grimwood R.E.
        Lichen sclerosus.
        J Am Acad Dermatol. 1995; 32: 393-416
        • Cooper S.M.
        • Ali I.
        • Baldo M.
        • Wojnarowska F.
        The association of lichen sclerosus and erosive lichen planus of the vulva with autoimmune disease: a case-control study.
        Arch Dermatol. 2008; 144: 1432-1435
        • Birenbaum D.L.
        • Young R.C.
        High prevalence of thyroid disease in patients with lichen sclerosus.
        J Reprod Med. 2007; 52: 28-30
        • Meyrick Thomas R.H.
        • Ridley C.M.
        • McGibbon D.H.
        • Black M.M.
        Lichen sclerosus et atrophicus and autoimmunity-a study of 350 women.
        Br J Dermatol. 1988; 118: 41-46
        • Kirtschig G.
        • Becker K.
        • Gunthert A.
        • et al.
        Evidence-based (S3) guideline on (anogenital) lichen sclerosus.
        J Eur Acad Dermatol Venereol. 2015; 29: e1-e43
        • Kreuter A.
        • Wischnewski J.
        • Terras S.
        • Altmeyer P.
        • Stucker M.
        • Gambichler T.
        Coexistence of lichen sclerosus and morphea: a retrospective analysis of 472 patients with localized scleroderma from a German tertiary referral center.
        J Am Acad Dermatol. 2012; 67: 1157-1162
        • Kreuter A.
        • Kryvosheyeva Y.
        • Terras S.
        • et al.
        Association of autoimmune diseases with lichen sclerosus in 532 male and female patients.
        Acta Derm Venereol. 2013; 93: 238-241
        • Simpkin S.
        • Oakley A.
        Clinical review of 202 patients with vulval lichen sclerosus: a possible association with psoriasis.
        Australas J Dermatol. 2007; 48: 28-31
        • Oyama N.
        • Chan I.
        • Neill S.M.
        • et al.
        Autoantibodies to extracellular matrix protein 1 in lichen sclerosus.
        Lancet. 2003; 362: 118-123
        • Oyama N.
        • Chan I.
        • Neill S.M.
        • et al.
        Development of antigen-specific ELISA for circulating autoantibodies to extracellular matrix protein 1 in lichen sclerosus.
        J Clin Invest. 2004; 113: 1550-1559
        • Edmonds E.V.
        • Hunt S.
        • Hawkins D.
        • Dinneen M.
        • Francis N.
        • Bunker C.B.
        Clinical parameters in male genital lichen sclerosus: a case series of 329 patients.
        J Eur Acad Dermatol Venereol. 2012; 26: 730-737
        • Cooper S.M.
        • Wojnarowska F.
        Influence of treatment of erosive lichen planus of the vulva on its prognosis.
        Arch Dermatol. 2006; 142: 289-294
        • Velazquez E.F.
        • Cubilla A.L.
        Lichen sclerosus in 68 patients with squamous cell carcinoma of the penis: frequent atypias and correlation with special carcinoma variants suggests a precancerous role.
        Am J Surg Pathol. 2003; 27: 1448-1453
        • Chiesa-Vottero A.
        • Dvoretsky P.M.
        • Hart W.R.
        Histopathologic study of thin vulvar squamous cell carcinomas and associated cutaneous lesions: a correlative study of 48 tumors in 44 patients with analysis of adjacent vulvar intraepithelial neoplasia types and lichen sclerosus.
        Am J Surg Pathol. 2006; 30: 310-318
        • Lee A.
        • Bradford J.
        • Fischer G.
        Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women.
        JAMA Dermatol. 2015; 151: 1061-1067
        • Jones R.W.
        • Sadler L.
        • Grant S.
        • Whineray J.
        • Exeter M.
        • Rowan D.
        Clinically identifying women with vulvar lichen sclerosus at increased risk of squamous cell carcinoma: a case-control study.
        J Reprod Med. 2004; 49: 808-811
        • Wang W.L.
        • Lazar A.
        Lichenoid and interface dermatitis.
        in: Calonje J.E. Brenn T. Lazar A.J. McKee P.H. McKee’s Pathology of the Skin. 4th ed. Elsevier/Saunders, London, England2011: 219
        • Johnson M.
        • Walker D.
        • Galloway W.
        • Gardner J.M.
        • Shalin S.C.
        Interface dermatitis along Blaschko's lines.
        J Cutan Pathol. 2014; 41: 950-954
        • Patrizi A.
        • Neri I.
        • Fiorentini C.
        • Bonci A.
        • Ricci G.
        Lichen striatus: clinical and laboratory features of 115 children.
        Pediatr Dermatol. 2004; 21: 197-204
        • Tosti A.
        • Peluso A.M.
        • Misciali C.
        • Cameli N.
        Nail lichen striatus: clinical features and long-term follow-up of five patients.
        J Am Acad Dermatol. 1997; 36: 908-913
        • Zhang Y.
        • McNutt N.S.
        Lichen striatus. Histological, immunohistochemical, and ultrastructural study of 37 cases.
        J Cutan Pathol. 2001; 28: 65-71
        • Gianotti R.
        • Restano L.
        • Grimalt R.
        • Berti E.
        • Alessi E.
        • Caputo R.
        Lichen striatus—a chameleon: an histopathological and immunohistological study of forty-one cases.
        J Cutan Pathol. 1995; 22: 18-22
        • Zaraa I.
        • Mahfoudh A.
        • Sellami M.K.
        • et al.
        Lichen planus pemphigoides: four new cases and a review of the literature.
        Int J Dermatol. 2013; 52: 406-412
        • Tamada Y.
        • Yokochi K.
        • Nitta Y.
        • Ikeya T.
        • Hara K.
        • Owaribe K.
        Lichen planus pemphigoides: identification of 180 kd hemidesmosome antigen.
        J Am Acad Dermatol. 1995; 32: 883-887
        • Kim H.
        • Pomeranz M.K.
        Lupus erythematosus and lichen planus overlap syndrome.
        J Drugs Dermatol. 2004; 3: 311-312
        • Rana S.
        • Gupta R.
        • Singh S.
        • Mohanty S.
        • Gupta K.
        • Kudesia M.
        Localization of T-cell subsets in cutaneous lichen planus: an insight into pathogenetic mechanism.
        Indian J Dermatol Venereol Leprol. 2010; 76: 707-709
        • Domingues R.
        • de Carvalho G.C.
        • Aoki V.
        • da Silva Duarte A.J.
        • Sato M.N.
        Activation of myeloid dendritic cells, effector cells and regulatory T cells in lichen planus.
        J Transl Med. 2016; 14: 171
        • Chen X.
        • Liu Z.
        • Yue Q.
        The expression of TNF-alpha and ICAM-1 in lesions of lichen planus and its implication.
        J Huazhong Univ Sci Technolog Med Sci. 2007; 27: 739-741
        • Rhodus N.L.
        • Cheng B.
        • Ondrey F.
        Th1/Th2 cytokine ratio in tissue transudates from patients with oral lichen planus.
        Mediators Inflamm. 2007; 2007: 19854
        • Hussein M.R.
        Evaluation of angiogenesis in normal and lichen planus skin by CD34 protein immunohistochemistry: preliminary findings.
        Cell Biol Int. 2007; 31: 1292-1295
        • Ibrahim Z.A.
        • El Ashmawy A.A.
        • Abd El-Naby N.M.
        • Ghoraba H.M.
        Immunohistochemical expression of cathepsin L in atopic dermatitis and lichen planus.
        Indian J Dermatol. 2015; 60: 13-20
        • El-Rifaie A.A.
        • Rashed L.A.
        • Doss R.W.
        The role of cyclooxygenase-2 and prostaglandin E2 in the pathogenesis of cutaneous lichen planus.
        Clin Exp Dermatol. 2015; 40: 903-907
        • Welz-Kubiak K.
        • Kobuszewska A.
        • Reich A.
        IL-31 is overexpressed in lichen planus but its level does not correlate with pruritus severity.
        J Immunol Res. 2015; 2015: 854747
        • Abdel-Haq A.
        • Kusnierz-Cabala B.
        • Darczuk D.
        • et al.
        Interleukin-6 and neopterin levels in the serum and saliva of patients with lichen planus and oral lichen planus.
        J Oral Pathol Med. 2014; 43: 734-739
        • Chen J.
        • Feng J.
        • Chen X.
        • et al.
        Immunoexpression of interleukin-22 and interleukin-23 in oral and cutaneous lichen planus lesions: a preliminary study.
        Mediators Inflamm. 2013; 2013: 801974
        • Shaker O.
        • Hassan A.S.
        Possible role of interleukin-17 in the pathogenesis of lichen planus.
        Br J Dermatol. 2012; 166: 1367-1368
        • Zhang Y.
        • Zhang D.
        • Tu C.
        • et al.
        Wnt5a is involved in the pathogenesis of cutaneous lichen planus.
        Clin Exp Dermatol. 2015; 40: 659-664
        • Vybohova D.
        • Mellova Y.
        • Adamicova K.
        • Adamkov M.
        • Heskova G.
        Quantitative immunohistochemical assessment of blood and lymphatic microcirculation in cutaneous lichen planus lesions.
        Histol Histopathol. 2015; 30: 697-706
        • El-Rebey H.S.
        • Maree A.H.
        • El-Salakawy S.
        Immunohistochemical expression of TGF-beta1 in lichen planus.
        Appl Immunohistochem Mol Morphol. 2015; 23: 422-429
        • Abdel-Latif A.M.
        • Abuel-Ela H.A.
        • El-Shourbagy S.H.
        Increased caspase-3 and altered expression of apoptosis-associated proteins, Bcl-2 and Bax in lichen planus.
        Clin Exp Dermatol. 2009; 34: 390-395
        • Flier J.
        • Boorsma D.M.
        • van Beek P.J.
        • et al.
        Differential expression of CXCR3 targeting chemokines CXCL10, CXCL9, and CXCL11 in different types of skin inflammation.
        J Pathol. 2001; 194: 398-405
        • Domingues R.
        • de Carvalho G.C.
        • da Silva Oliveira L.M.
        • et al.
        The dysfunctional innate immune response triggered by Toll-like receptor activation is restored by TLR7/TLR8 and TLR9 ligands in cutaneous lichen planus.
        Br J Dermatol. 2015; 172: 48-55
        • Wenzel J.
        • Scheler M.
        • Proelss J.
        • Bieber T.
        • Tuting T.
        Type I interferon-associated cytotoxic inflammation in lichen planus.
        J Cutan Pathol. 2006; 33: 672-678
        • de Vries H.J.
        • van Marle J.
        • Teunissen M.B.
        • et al.
        Lichen planus is associated with human herpesvirus type 7 replication and infiltration of plasmacytoid dendritic cells.
        Br J Dermatol. 2006; 154: 361-364
        • de Vries H.J.
        • Teunissen M.B.
        • Zorgdrager F.
        • Picavet D.
        • Cornelissen M.
        Lichen planus remission is associated with a decrease of human herpes virus type 7 protein expression in plasmacytoid dendritic cells.
        Arch Dermatol Res. 2007; 299: 213-219
        • Fah J.
        • Pavlovic J.
        • Burg G.
        Expression of MxA protein in inflammatory dermatoses.
        J Histochem Cytochem. 1995; 43: 47-52
        • Vermi W.
        • Lonardi S.
        • Morassi M.
        • et al.
        Cutaneous distribution of plasmacytoid dendritic cells in lupus erythematosus. Selective tropism at the site of epithelial apoptotic damage.
        Immunobiology. 2009; 214: 877-886
        • Tomasini D.
        • Mentzel T.
        • Hantschke M.
        • et al.
        Plasmacytoid dendritic cells: an overview of their presence and distribution in different inflammatory skin diseases, with special emphasis on Jessner’s lymphocytic infiltrate of the skin and cutaneous lupus erythematosus.
        J Cutan Pathol. 2010; 37: 1132-1139
        • Sleiman R.
        • Kurban M.
        • Abbas O.
        Evaluation of the diagnostic value of plasmacytoid dendritic cells in differentiating the lymphocytic cicatricial alopecias.
        Dermatology. 2015; 231: 158-163
        • Ammar M.
        • Mokni M.
        • Boubaker S.
        • El Gaied A.
        • Ben Osman A.
        • Louzir H.
        Involvement of granzyme B and granulysin in the cytotoxic response in lichen planus.
        J Cutan Pathol. 2008; 35: 630-634
        • Shi G.
        • Sohn K.C.
        • Choi D.K.
        • et al.
        Brn2 is a transcription factor regulating keratinocyte differentiation with a possible role in the pathogenesis of lichen planus.
        PLoS One. 2010; 5: e13216
        • Krasowska D.
        • Pietrzak A.
        • Surdacka A.
        • Tuszynska-Bogucka V.
        • Janowski K.
        • Rolinski J.
        Psychological stress, endocrine and immune response in patients with lichen planus.
        Int J Dermatol. 2008; 47: 1126-1134
        • Shengyuan L.
        • Songpo Y.
        • Wen W.
        • Wenjing T.
        • Haitao Z.
        • Binyou W.
        Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis.
        Arch Dermatol. 2009; 145: 1040-1047
        • Lodi G.
        • Giuliani M.
        • Majorana A.
        • et al.
        Lichen planus and hepatitis C virus: a multicentre study of patients with oral lesions and a systematic review.
        Br J Dermatol. 2004; 151: 1172-1181
        • Protzer U.
        • Ochsendorf F.R.
        • Leopolder-Ochsendorf A.
        • Holtermuller K.H.
        Exacerbation of lichen planus during interferon alfa-2a therapy for chronic active hepatitis C.
        Gastroenterology. 1993; 104: 903-905
        • Eisen D.
        The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients.
        J Am Acad Dermatol. 2002; 46: 207-214
        • Stojanovic L.
        • Lunder T.
        • Poljak M.
        • Mars T.
        • Mlakar B.
        • Maticic M.
        Lack of evidence for hepatitis C virus infection in association with lichen planus.
        Int J Dermatol. 2008; 47: 1250-1256
        • Gimenez-Garcia R.
        • Perez-Castrillon J.L.
        Lichen planus and hepatitis C virus infection.
        J Eur Acad Dermatol Venereol. 2003; 17: 291-295
        • Lapane K.L.
        • Jakiche A.F.
        • Sugano D.
        • Weng C.S.
        • Carey W.D.
        Hepatitis C infection risk analysis: who should be screened? Comparison of multiple screening strategies based on the National Hepatitis Surveillance Program.
        Am J Gastroenterol. 1998; 93: 591-596
        • Daramola O.O.
        • George A.O.
        • Ogunbiyi A.O.
        • Otegbayo J.A.
        Hepatitis B virus in Nigerians with lichen planus.
        West Afr J Med. 2004; 23: 104-106
        • Mizukawa Y.
        • Horie C.
        • Yamazaki Y.
        • Shiohara T.
        Detection of varicella-zoster virus antigens in lesional skin of zosteriform lichen planus but not in that of linear lichen planus.
        Dermatology. 2012; 225: 22-26
        • Pourshahidi S.
        • Fakhri F.
        • Ebrahimi H.
        • et al.
        Lack of association between Helicobacter pylori infection and oral lichen planus.
        Asian Pac J Cancer Prev. 2012; 13: 1745-1747
        • Rebora A.
        • Rongioletti F.
        • Drago F.
        • Parodi A.
        Lichen planus as a side effect of HBV vaccination.
        Dermatology. 1999; 198: 222
        • Limas C.
        • Limas C.J.
        Lichen planus in children: a possible complication of hepatitis B vaccines.
        Pediatr Dermatol. 2002; 19: 204-209
        • Copeman P.W.
        • Tan R.S.
        • Timlin D.
        • Samman P.D.
        Familial lichen planus. Another disease or a distinct people?.
        Br J Dermatol. 1978; 98: 573-577
        • Sodaify M.
        • Vollum D.I.
        Familial lichen planus. A case report.
        Br J Dermatol. 1978; 98: 579-581
        • Malhotra Y.K.
        • Kanwar A.J.
        Familial lichen planus.
        Arch Dermatol. 1980; 116: 622
        • Kofoed M.L.
        • Wantzin G.L.
        Familial lichen planus. More frequent than previously suggested?.
        J Am Acad Dermatol. 1985; 13: 50-54
        • Lowe N.J.
        • Cudworth A.G.
        • Woodrow J.C.
        HL-A antigens in lichen planus.
        Br J Dermatol. 1976; 95: 169-171
        • Veien N.K.
        • Risum G.
        • Jorgensen H.P.
        • Svejgaard A.
        HLA antigens in patients with lichen planus.
        Acta Derm Venereol. 1979; 59: 205-209
        • Powell F.C.
        • Rogers R.S.
        • Dickson E.R.
        • Moore S.B.
        An association between HLA DRI and lichen planus.
        Br J Dermatol. 1986; 114: 473-478
        • White A.G.
        • Rostom A.I.
        HLA antigens in Arabs with lichen planus.
        Clin Exp Dermatol. 1994; 19: 236-237
        • Carcassi C.
        • Cottoni F.
        • Floris L.
        • et al.
        The HLA-DRB1*0101 allele is responsible for HLA susceptibility to lichen ruber planus.
        Eur J Immunogenet. 1994; 21: 425-429
        • Luis-Montoya P.
        • Yamamoto-Furusho J.K.
        • Vega-Memije E.
        • et al.
        HLA-DRB1*0101 is associated with the genetic susceptibility to develop lichen planus in the Mexican Mestizo population.
        Arch Dermatol Res. 2007; 299: 405-407
        • Saurat J.H.
        • Lemarchand F.
        • Hors J.
        • Nunez-Roldan A.
        • Gluckman E.
        • Dausset J.
        HLA markers and lymphocytotoxins in lichen planus.
        Arch Dermatol. 1977; 113: 1719-1720
        • Halevy S.
        • Zamir R.
        • Gazit E.
        • Feuerman E.J.
        HLA system in relation to carbohydrate metabolism in lichen planus.
        Br J Dermatol. 1979; 100: 683-686
        • Jin X.
        • Wang J.
        • Zhu L.
        • et al.
        Association between -308 G/A polymorphism in TNF-alpha gene and lichen planus: a meta-analysis.
        J Dermatol Sci. 2012; 68: 127-134
        • Liu J.
        • Ye Z.
        • Mayer J.G.
        • et al.
        Phenome-wide association study maps new diseases to the human major histocompatibility complex region.
        J Med Genet. 2016; 53: 681-689
        • Cleynen I.
        • Boucher G.
        • Jostins L.
        • et al.
        Inherited determinants of Crohn’s disease and ulcerative colitis phenotypes: a genetic association study.
        Lancet. 2016; 387: 156-167
        • Vignal C.
        • Bansal A.T.
        • Balding D.J.
        • et al.
        Genetic association of the major histocompatibility complex with rheumatoid arthritis implicates two non-DRB1 loci.
        Arthritis Rheum. 2009; 60: 53-62
        • Prasad P.
        • Kumar A.
        • Gupta R.
        • Juyal R.C.
        • Thelma B.K.
        Caucasian and Asian specific rheumatoid arthritis risk loci reveal limited replication and apparent allelic heterogeneity in north Indians.
        PLoS One. 2012; 7: e31584
        • Yu X.Q.
        • Li M.
        • Zhang H.
        • et al.
        A genome-wide association study in Han Chinese identifies multiple susceptibility loci for IgA nephropathy.
        Nat Genet. 2012; 44: 178-182
        • Feehally J.
        • Farrall M.
        • Boland A.
        • et al.
        HLA has strongest association with IgA nephropathy in genome-wide analysis.
        J Am Soc Nephrol. 2010; 21: 1791-1797
        • Sepic J.
        • Ristic S.
        • Perkovic O.
        • et al.
        A case of lichen ruber planus in a patient with familial multiple sclerosis.
        J Int Med Res. 2010; 38: 1856-1860
        • Mohsin S.F.
        • Ahmed S.A.
        • Fawwad A.
        • Basit A.
        Prevalence of oral mucosal alterations in type 2 diabetes mellitus patients attending a diabetic center.
        Pak J Med Sci. 2014; 30: 716-719
        • Setterfield J.F.
        • Neill S.
        • Shirlaw P.J.
        • et al.
        The vulvovaginal gingival syndrome: a severe subgroup of lichen planus with characteristic clinical features and a novel association with the class II HLA DQB1*0201 allele.
        J Am Acad Dermatol. 2006; 55: 98-113
        • Akay A.
        • Pekcanlar A.
        • Bozdag K.E.
        • Altintas L.
        • Karaman A.
        Assessment of depression in subjects with psoriasis vulgaris and lichen planus.
        J Eur Acad Dermatol Venereol. 2002; 16: 347-352
        • Gavic L.
        • Cigic L.
        • Biocina Lukenda D.
        • Gruden V.
        • Gruden Pokupec J.S.
        The role of anxiety, depression, and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus.
        J Oral Pathol Med. 2014; 43: 410-417
        • Brancaccio R.R.
        • Cockerell C.J.
        • Belsito D.
        • Ostreicher R.
        Allergic contact dermatitis from color film developers: clinical and histologic features.
        J Am Acad Dermatol. 1993; 28: 827-830
        • Kawamura T.
        • Fukuda S.
        • Ohtake N.
        • Furue M.
        • Tamaki K.
        Lichen planus–like contact dermatitis due to methacrylic acid esters.
        Br J Dermatol. 1996; 134: 358-360
        • Guillet G.
        • Coindre M.
        • Levillain P.
        • Guillet M.H.
        Lichenoid dermatitis resulting from sensitization to dimethylfumarate: atypical presentation of “Chinese sofa dermatitis.”.
        Ann Dermatol Venereol. 2009; 135: 279-281
        • Kim J.H.
        • Krivda S.J.
        Lichen planus confined to a radiation therapy site.
        J Am Acad Dermatol. 2002; 46: 604-605

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