Perez Alexandre, Lazzarotto Benjamin, Carrel Jean-Pierre, Lombardi Tommaso
Unit of Oral Medicine and Pathology, Division of Oral Maxillofacial Surgery, Department of Surgery, University Hospitals of Geneva, 1205 Geneva, Switzerland.
Dermatopathology (Basel). 2020 Aug 12;7(2):18-25. doi: 10.3390/dermatopathology7020004.
: Lichen planus is a chronic mucocutaneous inflammatory disease. Oral manifestations are common, and may remain exclusive to the oral mucosa without involvement of the skin or other mucosae. A differential diagnosis includes oral lichenoid drug reactions. Allopurinol, which is the first line hypo-uricemic treatment, is often quoted as being a possible offending drug, though oral reactions have rarely been reported. : We describe a 59-year-old male gout patient, successfully treated with allopurinol, who developed acute onset of oral lichenoid lesions, involving bilaterally the buccal mucosa, the tongue and the labial mucosa. Histopathology was consistent with a lichen planus or a drug-induced lichenoid reaction. Improvement of the patient's condition after withdrawal of allopurinol confirmed the lichenoid nature of the lesion. Remission was complete after a few weeks. : Although unusual, allopurinol may induce a lichenoid drug reaction. These reactions may mimic clinically and histopathologically idiopathic lichen planus. Improvement or complete regression of the lesions may be attempted to confirm the diagnosis. According to the latest WHO recommendations, these lesions have a potential for malignant transformation.
扁平苔藓是一种慢性黏膜皮肤炎症性疾病。口腔表现很常见，且可能仅局限于口腔黏膜，而不累及皮肤或其他黏膜。鉴别诊断包括口腔苔藓样药物反应。别嘌醇是一线降尿酸治疗药物，虽很少有口服反应的报道，但常被认为是一种可能的致病药物。我们描述了一名59岁的男性痛风患者，他接受别嘌醇治疗成功，但出现了急性发作的口腔苔藓样病变，双侧颊黏膜、舌和唇黏膜均受累。组织病理学与扁平苔藓或药物性苔藓样反应一致。停用别嘌醇后患者病情改善，证实了病变的苔藓样性质。几周后完全缓解。虽然不常见，但别嘌醇可能诱发苔藓样药物反应。这些反应在临床和组织病理学上可能与特发性扁平苔藓相似。可尝试使病变改善或完全消退以确诊。根据世界卫生组织的最新建议，这些病变有恶变的可能。
