Lichen planus pemphigoides: another paraneoplastic bullous disease?

Background Despite a long-standing controversy regarding the classification of lichen planus associated with blistering, it seems likely today that bullous lichen planus and lichen planus pemphigoides are separate entities. Patients In this presentation two patients are described: a 56-year-old female with bullous lichen planus developed on persisting lesions over a period of 1 year and an 83-year-old female who developed lichen planus pemphigoides during the course of thyroid-gland carcinoma. Conclusion Each of these two entities has its own clinical, histological, immunohistological, and immunobiochemical features. Also, the outcomes seem to be different since lesions of bullous lichen planus usually resolve after a rather short period of time; persistent lesions may possibly develop into squamous cell carcinoma. In contrast, lichen planus pemphigoides is likely to be a paraneoplastic disorder. (C) 1997 Elsevier Science B.V

Secondary Reactive Conditions in Pruritic Skin

The definition of itch as an unpleasant sensation that elicits an urge or desire to scratch describes the close relationship between the feeling and the response. The physiological role of scratching in response to acute itch is to remove harmful agents from the skin. In the short term, mild scratching relieves itching. With more fierce and prolonged scratching in chronic pruritus, the skin becomes damaged and the changes induced intensify itch, setting up a vicious circle. In pruritus due to an underlying internal disease, these reactive skin conditions occur in normal skin, whereas in inflammatory skin disease they may be superimposed on the primary skin lesions. This chapter will summarize elicitation of scratching as well as different clinical patterns it induces, such as excoriations, lichen simplex chronicus, lichen amyloidosus and prurigo