Related Experiment Videos
Lichen planus and cicatrizing conjunctivitis: characterization of five cases
Jennifer E Thorne1, Douglas A Jabs, Olga V Nikolskaia
1Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. jthorne@jhmi.edu
American Journal of Ophthalmology
|July 31, 2003
Summary
Cicatrizing conjunctivitis can be caused by lichen planus. Early diagnosis and treatment with immunosuppressive therapy, such as oral cyclosporine, are crucial for managing this condition.
Area of Science:
- Ophthalmology
- Immunodermatology
- Autoimmune Diseases
Background:
- Cicatrizing conjunctivitis presents a diagnostic challenge, often mimicking other autoimmune conditions like mucous membrane pemphigoid.
- Lichen planus is a chronic inflammatory condition that can affect various tissues, including the conjunctiva.
Observation:
- A retrospective case series of six patients with cicatrizing conjunctivitis evaluated in an ocular pemphigoid clinic.
- Clinical, immunopathologic, and serologic features were assessed, alongside therapeutic responses.
Findings:
- All six patients exhibited conjunctival scarring; five had concurrent oral/gingival lichen planus, and one had skin involvement.
- Histopathology revealed thickened epithelium and a lymphocytic infiltrate. Electron microscopy showed basement membrane abnormalities in three patients.
- Direct immunofluorescence confirmed lichen planus by demonstrating fibrinogen deposition along the basement membrane zone.
Implications:
- Lichen planus must be considered in the differential diagnosis of cicatrizing conjunctivitis.
- Accurate diagnosis is critical to differentiate from other autoimmune diseases and guide appropriate management.
- Oral cyclosporine demonstrated efficacy in controlling conjunctival lichen planus in a majority of cases.