Esophageal Lichen Planus: The Efficacy and Safety of Tacrolimus in Reducing Inflammation and Need for Dilation.

Introduction: Esophageal lichen planus (ELP) is a rare inflammatory disease most seen in middle-aged White women, manifested by sloughing mucosa, thick exudate, and proximal strictures. Most case reports and small series highlight using steroids and other immunosuppressants. To the best of our knowledge, oral tablet tacrolimus has not been studied.

Lupus Erythematosus Tumidus as a Distinct Uncommon Subtype of Cutaneous Lupus Erythematosus: A Case Report and Review.

Lupus erythematosus tumidus (LET) is an uncommon but distinct photosensitive subtype of cutaneous lupus erythematosus (CLE). It differs from discoid and subacute cutaneous lupus erythematosus (SCLE) clinically and pathologically. LET is marked by extreme photosensitivity and carries a much lower risk of progression to systemic disease.

Demystifying Esophageal Lichen Planus: A Comprehensive Review of a Rare Disease You Will See in Practice.

Lichen planus (LP) is a chronic inflammatory disorder that often affects the skin, hair, nails, and mucus membranes. Although esophageal involvement has traditionally been felt to be rare, recent reports suggest that it is often unrecognized or misdiagnosed. The diagnoses of esophageal lichen planus can be challenging and is suspected based on patients' endoscopic and histologic findings and in the context of their clinical history and physical examination.

Safety of efalizumab in patients with moderate to severe chronic plaque psoriasis: review of clinical data. part II.

Background: The efficacy and safety of efalizumab have been evaluated in multiple clinical trials.

Objective: The purpose of this review is to provide an overview of the safety profile of efalizumab during the clinical trials.

Methods: Twelve-week data from four placebo-controlled trials were pooled and analyzed.

Long-term implications of T-cell receptor gene rearrangement analysis by Southern blot in patients with cutaneous T-cell lymphoma.

Background: T-cell clonality analysis by Southern blot (TSB) in skin biopsy specimens suggestive of mycosis fungoides may be helpful in confirming the diagnosis of a cutaneous lymphoma. However, there are no data available regarding the long-term prognostic implication of such results.

Objectives: We sought to determine the long-term prognostic significance of TSB results from skin biopsy specimens of patients with mycosis fungoides.

Implant retained overdentures for two patients with severe lichen planus: a clinical report.

Lichen planus is a common inflammatory mucocutaneous disease that often manifests itself intraorally. Oral lichen planus can appear in many forms; the most significant form for the edentulous patient is the erosive variety. For the patient, wearing a complete denture is quite dramatic because of the friability of the tissue.

Successful Breast Conservation in a Patient with Epidermolysis Bullosa Simplex.

Before breast conservation can be offered to a woman with breast cancer one must understand both the indications and contraindications to such an approach. Factors that play a role in this decision include tumor-related factors and factors related to the expected cosmetic outcome following breast conservation. Here we present a case of a woman with epidermolysis bullosa simplex (EBS), a rare skin disorder that is characterized by blister formation following minor trauma, who underwent successful breast conservation.

Paraneoplastic pemphigus: a review of the literature.

Paraneoplastic pemphigus is a relatively rare but highly significant acquired mucocutaneous disorder. The condition typically presents in patients with previously diagnosed lymphoreticular disease, primarily malignancies (non-Hodgkin's lymphoma; chronic lymphocytic leukemia). Multiple sites of involvement are common, with the skin affected by a polymorphous eruption that includes lichenoid plaques as well as bullae.

Two considerations for patients with psoriasis and their clinicians: what defines mild, moderate, and severe psoriasis? What constitutes a clinically significant improvement when treating psoriasis?

The definitions of psoriasis severity and clinically significant improvement in psoriasis are used to classify treatments, obtain Food and Drug Administration approval, and determine product labeling and reimbursement. The Medical Advisory Board of the National Psoriasis Foundation has addressed these issues because of their importance in the clinical trials that are conducted to gain FDA approval of indications. Narrow indications, which are without a sound rational basis, will-in this era of constant oversight by third party payers-affect physicians' ability to manage patients with psoriasis.

Psoriasis: a clinical update on diagnosis and new therapies.

Psoriasis varies widely in its clinical expression, from a single fingernail pit to widespread disfiguring skin lesions and disabling arthritis. Treatments are divided into five levels, providing a framework for approaching this disease according to severity and recalcitrance to previous treatment. Powerful immunosuppressive drugs are showing some success in treating severe cases.

Cicatrizing conjunctivitis associated with paraneoplastic lichen planus.

Purpose: To report two cases of cicatrizing conjunctivitis associated with paraneoplastic lichen planus.

Methods: Case reports.

Results: Two patients were examined because of redness and discomfort in both eyes.

New and emerging therapies for diseases of the oral cavity.

It is obvious from the review of the literature that most treatments for oral diseases such as lichen planus, pemphigoid, and pemphigus are based on case reports, anecdotes, and small uncontrolled studies. Efforts must be made to perform more controlled studies to evaluate the efficacy of new treatments. Small numbers of patients at each site and multiple-drug therapy make this task difficult.

Selected drug complications and treatment conflicts in the presence of coexistent diseases.

The presence of different coexistent systemic diseases often times complicates the selection of the appropriate treatment of an underlying rheumatologic condition. In this article, some controversial treatment conflicts that are frequently encountered in the daily practice of rheumatology are clarified and guidelines for the best available therapeutic options are provided.

Unresponsive eczematous dermatitis: a case of pancreatic cancer masquerading as cutaneous T cell lymphoma.

Skin diseases may be the presenting sign of malignancy, but strict criteria are required to make the diagnosis of a paraneoplastic syndrome. Common dermatoses may also herald an underlying malignancy without meeting these criteria. We report the case of an elderly man with an unresponsive eczematous dermatitis whose evaluation eventually revealed a pancreatic carcinoma.

Lupus erythematosus associated with erythema multiforme: does Rowell's syndrome exist?

We describe a patient with lupus erythematosus who experienced an unusual erythema multiforme-like eruption suggestive of Rowell's syndrome. We compare our case and 9 other reports of lupus erythematosus associated with erythema multiforme to the 4 cases reported by Rowell. Our findings indicate that Rowell's original criteria are not well preserved.

Contact hypersensitivity to mercury in amalgam restorations may mimic oral lichen planus.

Oral lichenoid lesions caused by hypersensitivity to mercury in amalgam fillings may mimic oral lichen planus on clinical and histologic examination. A positive patch test reaction to more than one mercurial allergen increases confidence in the diagnosis and justifies the removal and replacement of all amalgam fillings with those made of other materials. A complete remission may be expected about 3 months after the last amalgam filling is removed.

Allergic contact dermatitis from transdermal clonidine in a patient with mycosis fungoides.

Although therapy with transdermal clonidine is considered an effective method of hypertension control, this mode of delivery has been associated with localized dermal reactions in numerous patients. We present a patient with coexistent mycosis fungoides and allergic contact dermatitis from transdermal clonidine. The association of these two dermatologic processes has not been previously reported.

Squamous cell carcinoma of the tongue arising in lichen planus: a case report and review of the literature.

Lichen planus is a relatively common inflammatory disorder of unknown cause that affects the skin and mucosal surfaces. The relationship of oral lichen planus to oral squamous cell carcinoma is a matter of concern and debate. We present a case of squamous cell carcinoma of the dorsal surface of the tongue that arose in a previously biopsy-confirmed area of lichen planus.

Treatment of pemphigus.

A general review of the treatment of autoimmune diseases classified as pemphigus is presented and includes pemphigus vulgaris, pemphigus vegetans, pemphigus foliaceous, pemphigus erythematosus, druginduced pemphigus, IgA pemphigus, and paraneoplastic pemphigus. The nurse plays an essential role in educating patients and their families about local skin and oral care related to these diseases.

Paraneoplastic pemphigus occurring in a patient with B-cell non-Hodgkin's lymphoma.

We present the case of a 71-year-old white male with paraneoplastic pemphigus associated with a B-cell non-Hodgkin's lymphoma. Diagnosis of paraneoplastic pemphigus was made by the characteristic findings on immunoprecipitation performed on a serum specimen. Paraneoplastic pemphigus is a severe autoimmune disease comprised of polymorphous mucocutaneous lesions, characteristic laboratory findings, association with one of several types of neoplasms, and a very poor prognosis.