Disabling pansclerotic morphea involves all layers of the skin, extending through the dermis and subcutaneous tissues to involvemuscle, tendon, and bone. It is distinguished from generalized scleroderma by its lack of...Disabling pansclerotic morphea involves all layers of the skin, extending through the dermis and subcutaneous tissues to involvemuscle, tendon, and bone. It is distinguished from generalized scleroderma by its lack of systemic involvement. Onset usually occurs before the age of 14 years. We describe adultonset disabling pansclerotic morphea in two previously healthy young men. In both cases, the onset of disease was explosive, with rapid progression,widespread cutaneous involvement, and severe disablement caused by mutilating contracture deformities. Increased susceptibility of sclerodermatous tissue to recalcitrant ulceration and malignant transformation with development of nonmelanoma skin cancers was also observed. Treatment of this disease continues to present a therapeutic dilemma with only sporadic remission despite multimodality therapy.展开更多
Background:Topical tacrolimus has been reported to be effective for the treatme nt of oral lichen planus. This article describes our experience with topical tac rolimus in patients treated for symptomatic oral lichen ...Background:Topical tacrolimus has been reported to be effective for the treatme nt of oral lichen planus. This article describes our experience with topical tac rolimus in patients treated for symptomatic oral lichen planus. Observations:A survey was mailed to 40 patients with symptomatic oral lichen planus treated wit h topical tacrolimus. Surveys were completed by 37 patients (93%) a mean of 1.3 years after initiation of treatment. Thirty-three (89%) of the 37 patients re ported symptomatic improvement, and 31 (84%) reported partial to complete lesio n clearance while using topical tacrolimus. On average, patients noted improveme nt in 1 month. Twelve patients(32%) reported adverse effects consistent with th ose reported previously (ie, burning, irritation, and tingling). Among the 28 pa tients still using the medication, 15 patients (54%) apply it at least once dai ly. Of the 9 patients who discontinued using the medication, 5 experienced recur rence. Conclusions:Topical tacrolimus is effective for the treatment of oral li chen planus. Most patients experienced symptomatic improvement in less than 1 mo nth. However, the effect is temporary; when topical tacrolimus is discontinued, oral lichen planus may flare again.展开更多
文摘Disabling pansclerotic morphea involves all layers of the skin, extending through the dermis and subcutaneous tissues to involvemuscle, tendon, and bone. It is distinguished from generalized scleroderma by its lack of systemic involvement. Onset usually occurs before the age of 14 years. We describe adultonset disabling pansclerotic morphea in two previously healthy young men. In both cases, the onset of disease was explosive, with rapid progression,widespread cutaneous involvement, and severe disablement caused by mutilating contracture deformities. Increased susceptibility of sclerodermatous tissue to recalcitrant ulceration and malignant transformation with development of nonmelanoma skin cancers was also observed. Treatment of this disease continues to present a therapeutic dilemma with only sporadic remission despite multimodality therapy.
文摘Background:Topical tacrolimus has been reported to be effective for the treatme nt of oral lichen planus. This article describes our experience with topical tac rolimus in patients treated for symptomatic oral lichen planus. Observations:A survey was mailed to 40 patients with symptomatic oral lichen planus treated wit h topical tacrolimus. Surveys were completed by 37 patients (93%) a mean of 1.3 years after initiation of treatment. Thirty-three (89%) of the 37 patients re ported symptomatic improvement, and 31 (84%) reported partial to complete lesio n clearance while using topical tacrolimus. On average, patients noted improveme nt in 1 month. Twelve patients(32%) reported adverse effects consistent with th ose reported previously (ie, burning, irritation, and tingling). Among the 28 pa tients still using the medication, 15 patients (54%) apply it at least once dai ly. Of the 9 patients who discontinued using the medication, 5 experienced recur rence. Conclusions:Topical tacrolimus is effective for the treatment of oral li chen planus. Most patients experienced symptomatic improvement in less than 1 mo nth. However, the effect is temporary; when topical tacrolimus is discontinued, oral lichen planus may flare again.
