Challenges and pitfalls between lichen planus pemphigoides and bullous lichen planus

ABSTRACT Lichen planus pemphigoides (LPP) and bullous lichen planus (BLP) are rare dermatoses, which are characterised by blisters and lichenoid lesions. Their clinical presentation is heterogenous, displaying overlapping features or mimicking other dermatological diseases. Therefore, diagnosis can...

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Published inAustralasian journal of dermatology Vol. 63; no. 2; pp. 165 - 171
Main Authors Papara, Cristian, Danescu, Sorina, Sitaru, Cassian, Baican, Adrian
Format Journal Article
LanguageEnglish
Published Australia Wiley Subscription Services, Inc 01.05.2022
Subjects
Antigens
Autoantibodies
Autoimmune Diseases
Blister - diagnosis
BP180
BP230
bullous
Collagen
Degeneration
Diagnosis
Epidermis
Humans
Immunological tolerance
Inhibitor drugs
Lichen planus
Lichen Planus - diagnosis
Lichen Planus - drug therapy
Lichen Planus - pathology
lichen planus pemphigoides
Mimicry
Mucosa
Pathophysiology
Pemphigoid, Bullous - diagnosis
Pemphigoid, Bullous - drug therapy
Skin diseases
bullous
BP180
lichen planus pemphigoides
lichen planus
BP230
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Summary:ABSTRACT Lichen planus pemphigoides (LPP) and bullous lichen planus (BLP) are rare dermatoses, which are characterised by blisters and lichenoid lesions. Their clinical presentation is heterogenous, displaying overlapping features or mimicking other dermatological diseases. Therefore, diagnosis can often be challenging, requiring a thorough dermatological examination along with distinctive histological and immunopathological characteristics. Lichenoid degeneration of the basal epidermis exposes various antigens of the dermal–epidermal junction in LPP, resulting in the breakdown of immune tolerance, hence, the production of autoantibodies against type XVII collagen. Conversely, no pathogenic autoantibodies are detected in BLP. However, some cases of mucosal lichen planus might display immunopathological features suggestive of autoimmune blistering diseases. Therefore, a better understanding of the pathophysiology of these two distinct dermatoses is imperative. The aim of this review was to provide a summary of the current knowledge on the clinical hallmarks, diagnosis and available therapeutic options in LPP and BLP.
Bibliography:Consent for publication: The patients were informed that deidentified data would be used in the scientific research and publications and an informed consent for publication was obtained from them.
Funding source: The current paper did not receive any external funding.
Author contributions: C.P., S.D. and A.B. involved in the conception and design of the study; C.P., S.D. and C.S. involved in the acquisition, analysis and interpretation of data; C.P. and S.D. involved in the drafting of the manuscript; C.P., C.S. and A.B. involved in the critical revision of the manuscript. All authors have read and agreed to the final version of the manuscript.
Conflict of interest: The authors have no conflicts of interest to declare.
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ISSN:0004-8380
1440-0960
DOI:10.1111/ajd.13808