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Lichen planus bullosusL43.10

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 03.08.2023

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Synonym(s)

Bullöser LIchen planus; bullous lichen planus; Bull's eye lichen ruber planus; lichen planus vesiculosus; lichen vesiculosus

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HistoryThis section has been translated automatically.

Kaposi, 1892

DefinitionThis section has been translated automatically.

Rare variant of lichen planus with blistered transformation of lichen planus nodules (Liakopoulou A et al. 2017)

EtiopathogenesisThis section has been translated automatically.

Autoimmunological disease; etiology usually unknown.

ManifestationThis section has been translated automatically.

Occurring at any age. Also in children. The oral lichen planus occurs as a blistered variant in about 2-3% of those affected.

LocalizationThis section has been translated automatically.

Extremities, also oral mucosa.

HistologyThis section has been translated automatically.

Image of the typical lichen planus with subepidermal blistering in the subepithelial fissures already preformed by the Josephs spaces. This form is to be distinguished from the lichen planus pemphigoides, which is considered a coincidental disease entity of lichen planus and bullous pemphigoid.

Direct ImmunofluorescenceThis section has been translated automatically.

No proof of BP180-AK; no proof of BP 230-AK. Detection of fibrinogen deposited in the form of a band.

Differential diagnosisThis section has been translated automatically.

Lichen planus pemphigoides: Coincidence of lichen planus and bullous pemphigoid (bP). Detection of bP-AK in non-lesional skin.

Bullous pemphigoid: Urticular papules, subepithelial blisters; no evidence of typical lichen planus efflorescences. Detection of bP-AK.

Dermatitis herpetiformis: Disseminated, intensely pruritic/burning or prickly-painful, 0.1-0.2 cm, grouped, reddened papules, also vesicles that erode rapidly. This multicolored efflorescent spot can be seen mainly on the elbows and buttocks.

TherapyThis section has been translated automatically.

Depending on the extent of bubble formation.

External therapyThis section has been translated automatically.

In case of low blister formation potent glucocorticoid ointments(e.g. Dermoxin, Ecural), otherwise bland caring local therapy (e.g. with Ungt. emulsif. aquos. or Asche® Basis Creme).

Internal therapyThis section has been translated automatically.

According to the Lichen planus. Successful therapies combining glucocorticoids with dapsone (e.g. Dapson-Fatol) are reported.

Note(s)This section has been translated automatically.

An association with chronic hepatitis B seems to be detectable above average.

LiteratureThis section has been translated automatically.

  1. Budimir V et al (2014) Oral lichen planus - retrospective study of 563 Croatian patients. Med Oral Patol Oral Cir Bucal 19:e255-60
  2. Camisa C et al (1986) Bullous lichen planus: diagnosis by indirect immunofluorescence and treatment with dapsone. J Am Acad Dermatol 14: 464-469.

  3. Güneş AT et al (2006) Naproxen-induced lichen planus: report of 55 cases. Int J Dermatol 45:709-712.

  4. Jang SH et al (2014) Lichen planus pemphigoides associated with chronic hepatitis B virus infection. Clin Exp Dermatol doi:10.1111/ced.12530.
  5. Kaposi M (1892) Lichen ruber pemphigoides. Arch Derm Syph 24: 340-341
  6. Kolb-Maurer A et al (2003) Treatment of lichen planus pemphigoides with acitretin and pulsed corticosteroids. Dermatologist 54: 268-273
  7. Laureano A et al (2013) Lichen planus pemphigoides possibly induced by hormone therapy. Eur J Dermatol 23:903-904
  8. Liakopoulou A et al (2017) Bullous lichen planus - a review. J Dermatol Case Rep 11:1-4.
  9. Unsal B et al (2003) Bullous oral lichen planus: report of two cases. Chin Med J (Engl) 116: 1594-1545.
  10. Zaraa I et al (2013) Lichen planus pemphigoides: four new cases and a review of the literature. Int J Dermatol 52:406-412

Authors

Last updated on: 03.08.2023

Author: Prof. Dr. med. Peter Altmeyer