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Histopathologic Correlations of Dermoscopic Structures
Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Daniel Morgado-Carrasco, Constanza Riquelme-Mc Loughlin, Ralph P. Braun, Oriol Yélamos
Peripheral dotted/linear vessels together with round, linear, reticular, or annular pearly-whitish structures are characteristic of lichen planus [53] (Figure 3.58). Histopathologically, whitish structures correspond with compact orthokeratosis above zones of wedge-shaped hypergranulosis and acanthosis. This feature is the equivalent of Wickham striae [108].
Papulosquamous Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Melek Aslan Kayıran, Jordan V. Wang, Ayşe Serap Karadağ
Clinical presentation: Generally, the flexural part of the wrists, the dorsum of hands, ankles, and waist are involved, but lesions can also be seen on the hips, trunk, and neck. When the axillae, inguinal, and inframammary areas are involved, it is called inverse LP. Lesions are typically violaceous, flat-topped, polygonal papules, which can have lattice-like white lines, termed Wickham striae (Figure 4.6). Although the disease can be significantly pruritic, itching is not observed in 20% of patients. As lesions resolve, they usually leave behind a gray to brown hyperpigmentation, especially in dark-skinned individuals.
Basic dermatology in children and adolescents
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Kalyani Marathe, Kathleen Ellison
Lichen planus is an inflammatory dermatosis of unknown etiology that classically presents as flat-topped, polymorphic, pink to violaceous papules that can vary in size from 0.2 to 1 cm or more (Figure 10.11). The lesions are usually pruritic and commonly occur symmetrically on the flexural surfaces of the extremities as well as the trunk and genitalia; lichen planus can also present on the mucous membranes as a network of delicate white lines referred to as Wickham striae. Koebnerization may be observed. Atypical presentations include bullous, annular, hypertrophic, and vesicular, among others. While the majority of lichen planus cases occur in adults, children comprise 5%–11% of reported cases.27
Vulvovaginal graft-versus-host disease: a review
Published in Climacteric, 2019
M. Jacobson, J. Wong, A. Li, W. L. Wolfman
Physical examination should consist of thorough vulvar examination, a cotton swab test of the introitus, followed by gentle digital examination for adhesions and vaginal shortening, as well as speculum examination if tolerated. On inspection and examination of the vulva, one may find non-specific signs such as ulceration, sclerosus, loss of architecture, phimosis/agglutination of the clitoris, fissures, or pale white striations (Wickham Striae) (Figure 1). Many of these changes are also seen classically in vulvar lichen sclerosus or lichen planus. In the vaginal epithelium, dryness, pallor, petechiae, and adhesion formation may be appreciated20. Vaginal synechiae can occasionally only be appreciated by digital examination. Thin adhesions can be broken down with pressure from a gloved finger or speculum, and may not be appreciated with a speculum. If severe, vaginal stenosis ± hematometra and hematocolpos may occur. Development of vaginal occlusion may preclude the ability to examine the cervix or screen for cervical malignancy. Assessment for vaginal disease may be difficult in women or adolescents who have never been sexually active. Explanation of the reason for such a one-finger gentle examination and permission to conduct the examination should always be obtained first. The presence of vulvar disease prior to vaginal manifestation has been described as an opportunity to intervene with prophylactic measures, with a median 10-month difference in time of presentation (9 and 19 months, respectively)24,25.
Esophageal lichen planus: towards diagnosis of an underdiagnosed disease
Published in Scandinavian Journal of Gastroenterology, 2019
Franziska Schauer, Carmen Monasterio, Kristin Technau-Hafsi, Johannes Steffen Kern, Adhara Lazaro, Peter Deibert, Peter Hasselblatt, Henning Schwacha, Steffen Heeg, Volker Brass, Armin Küllmer, Arthur Robert Schmidt, Annette Schmitt-Graeff, Wolfgang Kreisel
Twenty-eight patients showed specific macroscopic changes of the esophagus (Figure 1). Mucosal fragility (denudation, sloughing and/or tearing = specific endoscopic sign) was present after taking biopsies in 12 patients, while spontaneous denudation was found in 16 patients. Hyperkeratosis (white, rough mucosal surface) was found in seven of all 34 ELP patients (20.6%). These patients showed a macroscopic plaque like pattern. None of the patients had a lace like pattern (Wickham striae) as it is known in oral LP. Trachealization was found in ten (29.4%) patients. Both latter findings were regarded as possible endoscopic signs, because they were present only in ELP cases of our cohort (Table 1). In two patients with macroscopically severe hyperkeratosis, no esophageal carcinoma was found. Stenoses/strictures were present in 7/52 patients, predominantly in patients with severe esophageal involvement (p < 0.02).
Chemotherapy-Induced Oral Complications and Prophylaxis Strategies
Published in Cancer Investigation, 2023
Aleksandra Śledzińska, Paulina Śledzińska, Marek Bebyn, Oskar Komisarek
Oral mucositis caused by molecularly targeted drugs tends to be of lesser severity and occurs earlier than oral mucositis related to conventional cytotoxic agents (34,36). The clinical presentation is different from that of conventional cytotoxic drugs. It is aphthous-like and well-defined. The appearance of mucositis caused by immune checkpoint inhibitors has a variable presentation. However, lichenoid characteristics are frequently seen. Oral lichenoid reactions manifest typically as reticulate, white streaks (Wickham striae), or erosive lesions (37).