Boch Katharina, Langan Ewan A, Kridin Khalaf, Zillikens Detlef, Ludwig Ralf J, Bieber Katja
Department of Dermatology, University of Lübeck, Lübeck, Germany.
Dermatological Sciences, University of Manchester, Manchester, United Kingdom.
Front Med (Lausanne). 2021 Nov 1;8:737813. doi: 10.3389/fmed.2021.737813. eCollection 2021.
Lichen planus (LP) is a T cell-mediated disease affecting the stratified squamous epithelia of the skin and/or mucus membrane. Histologically, the disease is characterized by a lichenoid inflammatory infiltrate and vacuolar degeneration of the basal layer of the epidermis. LP has three major subtypes: Cutaneous, mucosal and appendageal LP. Rarely, it may affect the nails in the absence of skin and/or mucosal changes. LP may also be induced by several drugs, typically anti-hypertensive medication or be associated with infections, particularly viral hepatitis. The diagnosis is based on the clinical presentation and characteristic histological findings. Although the disease is often self-limiting, the intractable pruritus and painful mucosal erosions result in significant morbidity. The current first-line treatment are topical and/or systemic corticosteroids. In addition, immunosuppressants may be used as corticosteroid-sparing agents. These, however are often not sufficient to control disease. Janus kinase inhibitors and biologics (anti-IL-12/23, anti-IL17) have emerged as novel future treatment options. Thus, one may expect a dramatic change of the treatment landscape of LP in the near future.
扁平苔藓（LP）是一种由T细胞介导的疾病，可累及皮肤和/或黏膜的复层鳞状上皮。在组织学上，该疾病的特征为苔藓样炎性浸润以及表皮基底层的空泡变性。LP有三种主要亚型：皮肤型、黏膜型和附属器型LP。极少数情况下，它可在无皮肤和/或黏膜改变时累及指甲。LP也可能由多种药物诱发，通常为抗高血压药物，或与感染有关，尤其是病毒性肝炎。诊断基于临床表现和特征性组织学表现。尽管该疾病通常具有自限性，但难治性瘙痒和疼痛性黏膜糜烂会导致明显的发病率。目前的一线治疗是局部和/或全身使用皮质类固醇。此外，免疫抑制剂可用作皮质类固醇节省剂。然而，这些通常不足以控制疾病。 Janus激酶抑制剂和生物制剂（抗IL-12/23、抗IL17）已成为未来新的治疗选择。因此，人们可能预计在不久的将来LP的治疗格局会发生巨大变化。
