Niebel Dennis, Wilsmann-Theis Dagmar, Wenzel Joerg
Clinic for Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany.
J Dermatol. 2020 Apr;47(4):397-401. doi: 10.1111/1346-8138.15222. Epub 2020 Jan 6.
Psoriasis vulgaris and lichen planus are distinct T-cell-driven inflammatory skin diseases. Both present in a variety of clinical subtypes. Mucosal or nail involvement may be present. Here, we report the rare concomitant clinical presentation of psoriatic arthritis and annular atrophic lichen planus on the trunk of a 52-year-old male patient. Treatment with sulfasalazine failed to control inflammatory activity; methotrexate and leflunomide were ceased due to side-effects. After confirmation of both diagnoses, we initiated a tumor necrosis factor (TNF)-α-directed therapy with the fusion protein etanercept resulting in significant improvement of both conditions. This case report aims to highlight the rare colocalization of psoriasis and lichen planus, the rare entity of annular atrophic lichen planus, and to discuss a possible beneficial impact of certain TNF-α inhibitors on subtypes of lichen planus.
寻常型银屑病和扁平苔藓是由T细胞驱动的不同炎症性皮肤病。两者均有多种临床亚型。可能出现黏膜或指甲受累。在此,我们报告一例52岁男性患者躯干上罕见的银屑病关节炎与环状萎缩性扁平苔藓同时出现的临床表现。柳氮磺胺吡啶治疗未能控制炎症活动;甲氨蝶呤和来氟米特因副作用停药。在确诊两种疾病后,我们开始使用融合蛋白依那西普进行肿瘤坏死因子(TNF)-α靶向治疗,使两种病情均得到显著改善。本病例报告旨在强调银屑病和扁平苔藓罕见的共定位情况、环状萎缩性扁平苔藓这一罕见实体,并探讨某些TNF-α抑制剂对扁平苔藓亚型可能产生的有益影响。