Successful treatment of lichen amyloidosis coexisting with atopic dermatitis by dupilumab:Four case reports

BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated with atopic dermatitis(AD),and in this setting,the treatment options may be more limited.Herein,we report four cases of LA associated with AD successfully treated by dupilumab.CASE SUMMARY In this article,we describe four cases of patients who presented with recurrent skin rash accompanied by severe generalized intractable pruritus,diagnosed with refractory LA coexisting with chronic AD.Previous treatments had not produced any apparent improvement.Thus,we administered dupilumab injection subcutaneously at a dose of 600 mg for the first time and 300 mg every 2 wk thereafter.Their lesions all markedly improved.CONCLUSION Dupilumab may be a new useful treatment for LA coexisting with AD.

Saxicolous lichen communities in three basins associated with mining activity in northwestern Argentina

Mining activity affects the vegetation and soils of the ecosystems.However,the effects of mining activity on saxicolous lichen communities are less concerned.Thus,the aim of this study was to characterize saxicolous lichen communities in three basins(Vis-Vis River basin,Poteros River basin,and Capillitas River basin)surrounding metalliferous mining projects of different types of operation and at different stages of exploitation.A large-scale mine(Bajo de la Alumbrera)with more than 25 a of open-pit mining located in the Vis-Vis River basin(CRV).A pre-exploitation mine(Agua Rica)located in the Poteros River basin(CRP),and a small-scale mine(Minas Capillitas)with more than 160 a of underground mining located in the Capillitas River basin(CAC).In each basin,species richness,cover,and frequency of lichen communities were measured on 40 rock outcrops.Also,explanatory variables were recorded,i.e.,altitude,slope,aspect,vegetation cover,rock,and soil cover around the rocky area sampled.Richness and total cover of lichen communities were analysed using linear models,and species composition was explored using multivariate ordination analysis.Results showed that a total of 118 lichen species were identified.The species richness differed among basins and the lichen composition present in areas close to mining sites responded mainly to basins,altitude,and microsite variables.The lichen cover showed no difference among basins,but it changed under different rock and vegetation cover.It was not possible to quantify the effects of mining activity on species richness and composition.However,the low richness values found in the downstream of Minera Alumbrera could be associated with the negative impact of open-pit mining.Moreover,the effects of large-scale mining activity on lichen communities needs more investigation.

Predicting the Activity of Oral Lichen Planus with Glycolysis-related Molecules:A Scikit-learn-based Function

Objective Oral lichen planus(OLP)is one of the most common oral mucosa diseases,and is mainly mediated by T lymphocytes.The metabolic reprogramming of activated T cells has been shown to transform from oxidative phosphorylation to aerobic glycolysis.The present study investigated the serum levels of glycolysis-related molecules(lactate dehydrogenase,LDH;pyruvic acid,PA;lactic acid,LAC)in OLP,and the correlation with OLP activity was assessed using the reticular,atrophic and erosive lesion(RAE)scoring system.Methods Univariate and multivariate linear regression functions based on scikit-learn were designed to predict the RAE scores in OLP patients,and the performance of these two machine learning functions was compared.Results The results revealed that the serum levels of PA and LAC were upregulated in erosive OLP(EOLP)patients,when compared to healthy volunteers.Furthermore,the LDH and LAC levels were significantly higher in the EOLP group than in the nonerosive OLP(NEOLP)group.All glycolysis-related molecules were positively correlated to the RAE scores.Among these,LAC had a strong correlation.The univariate function that involved the LAC level and the multivariate function that involved all glycolysis-related molecules presented comparable prediction accuracy and stability,but the latter was more time-consuming.Conclusion It can be concluded that the serum LAC level can be a user-friendly biomarker to monitor the OLP activity,based on the univariate function developed in the present study.The intervention of the glycolytic pathway may provide a potential therapeutic strategy.

Prediction of potential targets and molecular mechanisms of Tripterygium hypoglaucum for oral lichen planus based on network pharmacology and molecular docking

Objective:To explore the potential targets and molecular mechanisms of tripterygium hypoglaucum for oral lichen planus(OLP)by applying network pharmacology and molecular docking technology.Methods:The active ingredients and targets of tripterygium hypoglaucum were screened.OLP-related targets were predicted.The Protein-Protein Interaction(PPI)network was constructed for the intersection targets of tripterygium hypoglaucum and OLP.The“OLP-target-molecule-Tripterygium hypoglaucum”network was constructed and visualized.The intersection genes were screened for gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses.Molecular docking analysis and visualization were performed.Results:15 active ingredients and 78 targets of tripterygium hypoglaucum were obtained.9109 OLP-related targets were screened,and 54 intersection genes of tripterygium hypoglaucum with OLP were obtained.The top 10 key targets were screened from the constructed PPI network.The top 10 active ingredients of tripterygium hypoglaucum were screened from the constructed“OLP-targets of actionactive ingredients-tripterygium hypoglaucum”network.The GO and KEGG analyses of the 54 intersection targets indicated that tripterygium hypoglaucum may play a therapeutic role by regulating one carbon pool by folate,pathways in cancer,et al.Molecular docking analysis showed that dihydrofolate reductase(DHFR),phosphoribosylglycinamide formyltransferase(GART),estrogen receptor 1(ESR1),et al are the key targets for the treatment of OLP in tripterygium hypoglaucum.Conclusion:The potential key targets and molecular mechanisms of tripterygium hypoglaucum in treating OLP provide a theoretical basis for new drug development and clinical applications.

Rock-weathering by lichens in Antarctic: patterns and mechanisms

Saxicolous species of lichens are able to induce and accelerate weathering of their rock substrate, and effects of lichens on substrate can be attributed to both physical and chemical causes. This paper is focused on biotic weathering actions of epilithic and endolithic species on the different rock types (sandstones and volcanogenic rocks) in Antarctica. The patterns, mechanisms, processes and neoformations of rock-weathering resulting from lichen colonization are expounded in detail. Furthermore, it is pointed out that, for a better understanding of the impacts of lichens on environments, the studies on the rate of biotic weathering and the comprehensive involvement of the lichen effects on weathering of natural rocks remain to be carried out in Antarctica.

Production of chitosan from endolichenic fungi isolated from mangrove environment and its antagonistic activity

Objective:To screen the chitosan producing ability of endolichenic fungi and its antibacterial activity.Methods:Lichen collected from mangroves was screened for endophytes and the chitosan producing ability of endolichenic fungi by submerged fermentation was also determined.Antibacterial activity was carried out against different pathogens.Results:Totally4 different groups of fungi were isolated from the lichen Roccella montagnei.Among the four genera,Aspergillus niger(A.niger)is potential to produce chitosan(1.3 g/L)on the twelfth day of incubation.Glucose plays an important role in the pnjductivity of chitosan and the yield was maximum at 10%(1.93 g/L).Antibacterial activity revealed that Vibrio cholerae was sensitive to chitosan followed by Escherichia coli.Conclusions:In conclusion,our findings suggest that A.niger is a potential candidate to produce more chitosan than the other strains and glucose plays an important role in the production of chitosan which proves to have a good antibacterial activity.

Unilateral lichen planus with Blaschko line distribution: A case report

BACKGROUND Lichen planus(LP)with distribution of lesions along Blaschko’s lines is a rare entity,accounting for 0.24%-0.62%of all patients.Unilateral distribution of lesions in arm,leg,trunk,and waist is even less common.Approximately 10%of patients with LP manifest nail lesions.CASE SUMMARY A 20-year-old woman presented to our department with polygonal,purpuric,flattopped papules over the right arm,right leg,and right side of trunk and waist for the last 5 mo.The patient initially developed nail deformation in the left middle finger with no obvious cause,followed by development of blue-purple and red maculopapular rash with pruritus.During the disease course,the skin lesions aggravated and spread to several segments due to scratching.The lesions showed unilateral distribution along the Blaschko’s lines.The diagnosis of LP along Blaschko’s lines was established based on dermoscopy and skin biopsy.Her cutaneous lesions considerably improved after 4-wk treatment with intramuscular glucocorticoid,oral acitretin,topical glucocorticoid,and retinoids.CONCLUSION Cases of LP involving multiple segments of the body along the Blaschko’s lines with nail damage are rare.

Taxonomy and Ecology of the Lichens of the Ohaliksai River Basin

The article presents information about the taxonomy and ecology of lichens in the Ohaliksai River basin. According to the conducted studies, 11 families of the Lecanoromycetes class (Parmeliaceae, Lecanoraceae, Ramalinaceae, Megasporaceae, Physciaceae, Teloschistaceae, Peltigeraceae, Collemataceae, Candelariaceae, Umbilicariaceae, Physciaceae), 1 family of the Eurotiomycetes class (Verrucariaceae) and 1 family Lichinaceae of the class Lichinomycetes were identified, 18 groups and 23 species were noted as widespread. The taxonomic analysis and ecological characteristics of the identified species are presented.

Histopathological and Immunohistochemical Study of the Distinction between Oral Lichen Planus and Oral Lichenoid Lesions

Background: Oral potentially malignant disorders, which include oral lichen planus (OLP), are clinical presentations that carry a risk of development to cancer in the oral cavity. Oral lichenoid lesions (OLLs) are also termed interface/lichenoid mucositis. Malignant transformation of them remains controversial, but distinct clinical and histological criteria for how to differentiate OLP from OLLs have not been developed. Objectives: The purpose of this study was to elucidate findings that can allow histopathological differentiation of OLP and OLLs using histomorphological and immunohistochemical analyses. Materials and Methods: Analyses were performed in 10 cases diagnosed with OLP and 9 cases diagnosed with OLLs. Cytokeratin 19 (CK19), Ki-67 and CD3 were used as primary antibodies to detect basal cells, proliferative activity and T-cell distribution, respectively, and Perlecan and COX-2 to evaluate epithelial intracellular arrangements and interstitial distributions of proteoglycans and enzymes. Results: For CK19, positive cells were significantly found in OLLs at both the prominent area and site adjacent to the lesion comparison with those of OLP’s. The number of COX-2 positive cells was significantly higher in spinous and basal layers in OLLs of the prominent area. Additionally, OLLs showed mild to moderate expression for perlecan in the basal to spinous layers and in subepithelial tissue. Conclusion: Almost no basal cells were noted in the prominent area in OLP. COX-2 and perlecan were found in the basal to spinous layers in OLLs. Although there are restrictions, these suggested the possibility of helping to distinguish between OLP and OLLs.

Lichens of the Sirumalai hills,Eastern Ghats with one genus and six species new to India

Lichens of Sirumalai hills are reported here for the first time.Lichen biota comprised of 95 species.The genus Japewiella is reported for the first time in India and is represented by J.tavaresiana(H.Magn.)Printzen.Furthermore,the following six taxa including one variety are new to India viz.Arthonia atra(Pers.)A.Schneid.,Graphis brevicarpa M.Nakan.,Kashiw.&K.H.Moon,Micarea erratica(Körb.)Hertel,Rambold&Pietschm.,Pertusaria cicatricosa var.deficiens A.W.Archer,Elix&Streimam,Porina subargillacea Müll Arg.,and Pyxine schmidtii Vain.Brief accounts for all the new records to India are provided to facilitate their identification.Arthonia redingeri Grube and Lepraria caesiella R.C.Harris are reported for the first time from south India.Besides all above,29 species are recorded for the first time from the state of Tamil Nadu.The lichen biota of the area is primarily corticolous in habitats and dominated by crustose form.

First report of lichens from St.Mary’s Islands,the south west coast,India

The paper presents the first ever report on lichens of St.Mary’s Island with a total of 20 species belonging to 13 genera.Two species,Pertusaria dehiscens var.sekikaica A.W.Archer&Elix and Porina howeana P.M.McCarthy are reported as new records for India.Rhizocarpon obscuratum(Ach.)A.Massal.is recorded after a gap of 52 years.

Periodontopathogen profile of healthy and oral lichen planus patients with gingivitis or periodontitis

Oral lichen planus （OLP） is a chronic inflammatory disease that is frequently detected in oral tissues. The aim of our study was to identify the prevalence of the detection of periodontopathogenic microorganisms （Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola in OLP patients and to compare with this prevalence of periodontopathogenic microorganisms in healthy non-OLP patients. Our study included 27 （18 chronic periodontitis （OLPP） and 9 gingivitis （OLPG）） patients diagnosed with OLP along with 26 （13 chronic periodontitis （HP） and 13 gingivitis （HG）） healthy non-OLP patients. The multiplex polymerase chain reaction （PCR）with subsequent reverse hybridization method （micro-IDent） was used for identifying periodontopathogenic microorganisms present in subgingival plaque samples. The percentages of detection for A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia and T. denticola in subgingival plaque samples taken from OLP patients （OLPG and OLPP） were 18.5%, 85.1%, 81.4%, 88.8% and 74%, respectively. Meanwhile, in the non-OLP patients （HG and HP）, these values were 7.6%, 50%, 46.1%, 73% and 57.7%, respectively. Thus, comparing the non-OLP groups with the OLP groups, the periodontopathogens＇ percentages of detection in the OLP groups were higher than those in the non-OLP groups. According to our study results, OLP patients have higher levels of infection with A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia and T. denticola than non-OLP patients. We argue that the high percentages in patients with OLP may help identify the importance of periodontopathoRenic microorganisms in the progress of periodontal diseases of OLP.

Reform of Carbonate Rock Subsurface by Crustose Lichens and Its Environmental Significance

Crustose lichens are distributed extensively in karst areas in Southern China. They can be found on the surface of carbonate rocks. Through biophysical and biochemical processes, crustose lichens reform the subsurface of carbonate rocks and in the meanwhile change their physical and chemical properties: (1) the mechanical strength decreases by 17.04° on average (up to 33.2°); (2) the chemical solution surface area increases from 28.26% to 75.36% (lichen microholes considered only); and (3) the water-holding capacity is greatly improved. Comparative field experiments between biokarst samples underneath crustose lichens and fresh rock samples with the same composition and texture show that the corrosional rate of carbonate rocks of the former is 1.264–1.643 times higher than that of the latter. Crustose lichens are considered as an activator of the surface corrosion of carbonate rocks.

Interferon-c and interleukin-4 detected in serum and saliva from patients with oral lichen planus

Our previous salivary study had demonstrated an apparent T helper 2 （Th2）-predominance in saliva of oral lichen planus （OLP） patients and suggested a potential of salivary interleukin-4 （IL-4） as a biomarker for monitoring disease severity. To further determine the consistency of Th1/Th2 bias of OLP, this study investigated the expression profile of interferon-γ （IFN-γ） and IL-4 in serum and the relationship of the serum levels of these cytokines with their saliva partners. Sixty ethnic Chinese patients with OLP （40 of the erythematous/ulcerative form and 20 of the reticular form） were recruited for this study, with 40 age-sex-matched healthy volunteers as control group. IFN-γ and IL-4 levels in serum and paired saliva samples were screened by enzyme-linked immunosorbent assay. OLP patient showed a low-level IFN-γ but high-level IL-4 expression profile in both serum and saliva, with a lower IFN-γ/IL-4 ratio. Serum IL-4 level in the erythematous/ulcerative group was significantly higher than that in the reticular group. Serum levels of IFN-γ and IL-4 were significantly and positively correlated with their saliva partners. These results provided more evidence for Th2 cytokine- predominant immune imbalance in OLP, as well as the potential of IL-4 as the biomarker for monitoring severity of OLP.

COX-2, MMP-7 expression in oral lichen planus and oral squamous cell carcinoma

Objective: To observe cyclooxygenase (COX)-2 expression in normal oral mucosa (NOM), oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC) and explore its significance in the incidence of oral cancer. Methods: The immunohistochemical method and RT-PCR method were applied to detect the expression of COX-2 and MMP-7 in 10 cases with NOM, 33 cases of with OLP and 38 cases with OSCC. Results: The expression of COX-2 mRNA in OSCC tissues (68.4%, 26/38) was significantly higher than in the OLP (24.2%, 8/33) and NOM (0.0%, 0/10) ( P<0.01). The expression of MMP-7 mRNA in OSCC tissues (65.8%, 25/38) was significantly higher than in the OLP (30.3%, 10/33) and NOM (0.0%, 0/10) ( P<0.01). The expression of MMP-7 in OLP was significantly higher than in the NOM ( P<0.05). There was no significant expression of COX-2 protein in NOM, and the positive rate was 42.4% (14/33) and 89.5% (34/38) in OLP and OSCC group, respectively. The COX-2 expression in cancer tissues was significantly higher than in NOM and OLP ( P<0.05). The MMP-7 protein expression in cancer tissues (84.2%, 32/38) was significantly higher than in NOM (10.0%, 1/10) and in OLP (42.4%, 14/33), and the positive rate in OLP was significantly higher than in NOM ( P<0.01). The COX-2 expression was associated with clinical stage ( P<0.05), the MMP-7 expression was associated with clinical stage and lymph node metastasis ( P<0.05). The expressions of COX-2 and MMP-7 mRNA were positively correlated with OSCC. Conclusions: The abnormal expressions of COX-2 and MMP-7 are closely related to the biological behavior of OSCC, the MMP-7 may be induced by COX-2, and further lead to the invasion and metastasis of OSCC.

Three antibacterial naphthoquinone analogues from cultured mycobiont of lichen Astrothelium sp

A new naphthoquinone compound named 7-hydroxyl-8-methoxyltrypethelone 3 together with two known compounds trypethelone 1 and trypethelone methyl ether 2 was isolated from cultured mycobiont of Astrothelium sp.The structures were elucidated by 1D and 2D NMR spectroscopic analysis as well as comparison with those reported in literatures.Compound 1 displayed significant antibacterial activity against Bacillus subtilis（ATCC 6633）,and showed modest antibacterial activity against Staphylococcus aureus col（MRSA）（CGMCC 1.2465）,while compounds 2 and 3 showed modest antibacterial activity against Enterococcus faecalis 850E（CGMCC 1.2135） and S.aureus col（MRSA）（CGMCC 1.2465）.

Loss of Aβ-nerve endings associated with the Merkel cell-neurite complex in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis

The Merkel cell-neurite complex initiates the perception of touch and mediates Ap slowly adapting type I responses. Lichen planus is a chronic inflammatory autoimmune disease with T-cell-mediated inflammation, whereas hyperkeratosis is characterized with or without epithelial dysplasia in the oral mucosa. To determine the effects of lichen planus and hyperkeratosis on the Merkel cell-neurite complex, healthy oral mucosal epithelium and lesional oral mucosal epithelium of lichen planus and hyperkeratosis patients were stained by immunohistochemistry （the avidin-biotin-peroxidase complex and double immunofluorescence methods）using pan cytokeratin, cytokeratin 20 （K20, a Merkel cell marker）, and neurofilament 200 （NF200, a myelinated Aβ- and Aδ-nerve fibre marker） antibodies. N F200-immunoreactive （ir） nerve fibres in healthy tissues and in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis were counted and statistically analysed. In the healthy oral mucosa, K20-positive Merkel cells with and without close association to the intraepithelial NF200-ir nerve fibres were detected. In the lesional oral mucosa of lichen planus and hyperkeratosis patients, extremely rare NF200-ir nerve fibres were detected only in the lamina propria. Compared with healthy tissues, lichen planus and hyperkeratosis tissues had significantly decreased numbers of NF200-ir nerve fibres in the oral mucosal epithelium. Lichen planus and hyperkeratosis were associated with the absence of Aβ-nerve endings in the oral mucosal epithelium. Thus, we conclude that mechanosensation mediated by the Merkel cell-neurite complex in the oral mucosal epithelium is impaired in lichen planus and hvperkeratosis.

The Prevalence of Hepatitis C Virus Infection in Oral Lichen Planus in an Ethnic Chinese Cohort of 232 Patients

Aim Oral lichen planush （OLP） is a chronic inflammatory disease, and has been reported to have a correlation with hepatitis Cvirus （HCV） infection in some regional investigations. In this study, we investigated the prevalence of HCV in patients with oral lichen planus in an ethnic Chinese cohort. Methodology The antibody of HCV infection was detected by using enzymelinked immunosorbent assay. Moreover, the clinical characteristics of whole the cohort have also been studied, such as the gender, age, clinical type, habits and social factors. Results Of all 232 patients, the antibody of HCV infection was detected positive in 4 patients （1.72%） using enzyme-linked immunosorbent assay. It was lower than that in control group of 2.5%, but not significant （P=0.309）. The positive rate of HCV antibody in the erosive type ones （4.2%） was higher than that in the reticular type ones （1.0%）, but this difference was proved to be not significant （P=0.389）. The clinical characteristics of whole cohort, such as the gender, age, clinical type, habits and social factors, showed the outcome obtained in the present study were similar to thao of our previous study. Conclusion HCV may play no etiological role in oral lichen planus in ethnic Chinese OLP patients.

Case report and review of esophageal lichen planus treated with fluticasone

Lichen planus is a fairly common chronic idiopathic disorder of the skin,nails and mucosal surfaces.Esophageal involvement of this disease on the other hand is rare and only about 50 cases have been reported in literature.Given its rarity,it can be difficult to diagnose and may be easily misdiagnosed as reflux esophagitis.Currently,there are no clear recommendations on the optimal management of this disease and little is known about the best treatment approach.Systemic steroids are usually the first line treatment and offer a favorable response.In this report,we would like to present a novel approach in the management of esophageal lichen planus in a middle-aged woman treated successfully with swallowed fluticasone propionate 220 mcg twice a day for 6 wk,as evidenced by objective clinical findings.Based on our review of related literature and experience in this patient,we feel that a trial of swallowed fluticasone may be a prudent approach in the management of these patients since it has a more favorable side effect profile than systemic treatment.

Esophageal lichen planus:A case report and review of the literature

Esophageal involvement by lichen planus(ELP),previously thought to be quite rare,is a disease much more common in women and frequently the initial manifestation of mucocutaneous lichen planus(LP).Considering that the symptoms of ELP do not present in a predictable manner,ELP is perhaps more under-recognized than rare.To date,four cases of squamous cell carcinoma in association with ELP have been reported,suggesting that timely and accurate diagnosis of ELP is of importance for appropriate follow-up.In this case report,a 69-year-old female presented with dysphagia and odynophagia.She reported a history of oral LP but had no active oral or skin lesions.Endoscopic examination revealed severe strictures and web-like areas in the esophagus.Histologic examination demonstratedextensive denudation of the squamous epithelium,scattered intraepithelial lymphocytes,rare eosinophils and dyskeratotic cells.Direct immunofluorescence showed rare cytoid bodies and was used to exclude other primary immunobullous disorders.By using clinical,endoscopic,and histologic data,a broad list of differential diagnoses can be narrowed,and the accurate diagnosis of ELP can be made,which is essential for proper treatment and subsequent follow-up.