Welz-Kubiak Kalina, Reich Adam
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Ulica Chalubinskiego 1, 50-368 Wroclaw, Poland.
Autoimmune Dis. 2013;2013:941431. doi: 10.1155/2013/941431. Epub 2013 Jul 21.
Lichen planus (LP) is an inflammatory mucocutaneous disease, showing a wide variety of clinical subtypes. The classic presentation of LP involves the appearance of polygonal, flat-topped, violaceous papules and plaques with reticulated white lines, termed "Wickham's striae". Cutaneous lesions tend to be extremely pruritic, and this symptom does not subside after common antipruritic treatment. Moreover, based on our previous pilot study, it could be stated, that itch is the most unpleasant and bothersome symptom of LP for majority of patients suffering from this disease. However, the underlying mechanisms of itch in lichen planus remain still unknown. In addition, there is no study on mediators of this sensation, but taking into account pathogenesis of LP there are some possible mediators implicated to transmit or modulate itch. In pathogenesis of LP important are such mechanisms as apoptosis, autoimmune reaction, and role of stress. With these pathways some, previously described in other diseases, itch mediators such as cytokines, proteases, and opioid system are connected. Whether these mechanisms are involved in pruritus accompanying LP requires further investigation. Limited knowledge of pruritus origin in lichen planus is responsible for the lack of the effective antipruritic treatments. Here, we describe possible mechanisms participating the pathogenesis of pruritus in lichen planus.
扁平苔藓（LP）是一种炎症性黏膜皮肤疾病，表现出多种临床亚型。LP的典型表现包括出现多边形、平顶、紫红色丘疹和斑块，并伴有网状白线，称为“威克姆纹”。皮肤病变往往极度瘙痒，且这种症状在普通止痒治疗后不会消退。此外，根据我们之前的初步研究，可以说，对于大多数患有这种疾病的患者来说，瘙痒是LP最令人不适和困扰的症状。然而，扁平苔藓瘙痒的潜在机制仍然未知。此外，目前尚无关于这种感觉介质的研究，但考虑到LP的发病机制，有一些可能的介质参与传递或调节瘙痒。在LP的发病机制中，细胞凋亡、自身免疫反应和应激作用等机制很重要。通过这些途径，一些先前在其他疾病中描述过的瘙痒介质，如细胞因子、蛋白酶和阿片系统，相互关联。这些机制是否参与LP伴发的瘙痒尚需进一步研究。对扁平苔藓瘙痒起源的了解有限导致缺乏有效的止痒治疗方法。在此，我们描述了可能参与扁平苔藓瘙痒发病机制的机制。
