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A Vaginal Prosthetic Device as an Aid in Treating Ulcerative Lichen Planus of the Mucous Membrane: Successful Combination Therapy With a Corticosteroid-Bioadhesive Compound and Iontophoresis

A Vaginal Prosthetic Device as an Aid in Treating Ulcerative Lichen Planus of the Mucous... Abstract REPORT OF A CASE A 36-year-old woman presented with an 11-year history of chronic, painful biopsy-proven oral, vaginal, and vulvar erosive lichen planus (LP) complicated by vaginal stenosis and labial adhesions. She reported no remissions despite therapeutic trials of high-potency topical, oral, and intralesional steroids, isotretinoin, etretinate, and griseofulvin. Surgical procedures to release the labia and repeated vaginal dilatations were only temporarily successful. Pain, bleeding, and decreased vaginal orifice size prohibited sexual intercourse for 1 year. Her mother has suffered from biopsy-proven oral, vaginal, and vulvar erosive LP for 20 years. The patient's sister, brother, and grandmother also suffer from persistent oral ulcerative disease.Intense erythema of the attached upper and lower facial and lingual gingiva was present. Irregular 2- to 3-cm erosions on the buccal mucosa were present with white reticulated plaques noted on the left lower side. Pelvic examination revealed a narrow vaginal orifice. The mucosal lining of References 1. Lee MS, Wakefield PE, Konzelman JL, James WD. Oral insertable prosthetic device as an aid in treating oral ulcers . Arch Dermatol. 1991;127:479-480.Crossref 2. Altman J, Perry HO. The variations and course of lichen planus . Arch Dermatol. 1961;84:179-191.Crossref 3. Silverman S, Gorsky MA, Lozado-Nur F. A prospective follow-up study of 570 patients with oral lichen planus: persistence, remission, and malignant association . Oral Surg. 1985;60:30-34.Crossref 4. Crotty CF, Su WPD, Winkelmann RK. Ulcerative lichen planus: follow-up of surgical excision and grafting . Arch Dermatol. 1980;116:1252-1256.Crossref 5. Pelisse M. The vulvo-vaginal-gingival syndrome . Int J Dermatol. 1989;28:381-384.Crossref 6. Mahood JM. Familial lichen planus: a report of nine cases from four families with a brief review of the literature . Arch Dermatol. 1983;119:292-294.Crossref 7. Itin P, Surber C, Buchner S. Lack of effect after local treatment with a new cyclosporin formulation in recalcitrant erosive oral lichen planus . Dermatology . 1992;185:262-265.Crossref 8. Eisen D, Ellis CN, Duell EA, Griffiths CEM, Voorhees JJ. Effect of topical cyclosporine rinse on oral lichen planus: a double blind analysis . N Engl J Med. 1990;323:290-294.Crossref 9. Pelisse M, Boisnic S, Moyal-Barracco M, Szpiglas H, Reigneau O, Frances C. Treatment of vulvo-vaginal erosive lichen planus with topical cyclosporin . In: Program and abstracts of the International Society for the Study of Vulvar Disease, 11th World Congress; September 1991; Oxford, England. 10. Smith KJ, Konzelman JL, Lombardo FA, et al. Iontophoresis of vinblastine into normal skin and for treatment of Kaposi's sarcoma in human immunodeficiency virus—positive patients . Arch Dermatol. 1992;128:1365-1370.Crossref 11. Sloan JB, Keyoumars S. Iontophoresis in dermatology . J Am Acad Dermatol. 1986;15:671-684.Crossref 12. Singh J, Roberts MS. Transdermal delivery of drugs by iontophoresis: a review . Drug Des Deliv. 1989;4:1-12.Crossref 13. Robinson JR, Longer MA, Veillard M. Bioadhesive polymers for controlled drug delivery . Ann N Y Acad Sci. 1987;507:307-314.Crossref 14. Bachmann GA, Notelovitz M, Gonzalez SJ, Thompson C, Morecraft BA. Vaginal dryness in menopausal women: clinical characteristics and nonhormonal treatment . Clin Prac Sex . 1992;7:1-8. 15. Ziny MA, Shiao-Yu L. Double-blind study of the comparative effects of two gels on the vaginal pH in postmenopausal women . Today Ther Trend . 1991; 8:65-72. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

A Vaginal Prosthetic Device as an Aid in Treating Ulcerative Lichen Planus of the Mucous Membrane: Successful Combination Therapy With a Corticosteroid-Bioadhesive Compound and Iontophoresis

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1995.01690150029007
Publisher site
See Article on Publisher Site

Abstract

Abstract REPORT OF A CASE A 36-year-old woman presented with an 11-year history of chronic, painful biopsy-proven oral, vaginal, and vulvar erosive lichen planus (LP) complicated by vaginal stenosis and labial adhesions. She reported no remissions despite therapeutic trials of high-potency topical, oral, and intralesional steroids, isotretinoin, etretinate, and griseofulvin. Surgical procedures to release the labia and repeated vaginal dilatations were only temporarily successful. Pain, bleeding, and decreased vaginal orifice size prohibited sexual intercourse for 1 year. Her mother has suffered from biopsy-proven oral, vaginal, and vulvar erosive LP for 20 years. The patient's sister, brother, and grandmother also suffer from persistent oral ulcerative disease.Intense erythema of the attached upper and lower facial and lingual gingiva was present. Irregular 2- to 3-cm erosions on the buccal mucosa were present with white reticulated plaques noted on the left lower side. Pelvic examination revealed a narrow vaginal orifice. The mucosal lining of References 1. Lee MS, Wakefield PE, Konzelman JL, James WD. Oral insertable prosthetic device as an aid in treating oral ulcers . Arch Dermatol. 1991;127:479-480.Crossref 2. Altman J, Perry HO. The variations and course of lichen planus . Arch Dermatol. 1961;84:179-191.Crossref 3. Silverman S, Gorsky MA, Lozado-Nur F. A prospective follow-up study of 570 patients with oral lichen planus: persistence, remission, and malignant association . Oral Surg. 1985;60:30-34.Crossref 4. Crotty CF, Su WPD, Winkelmann RK. Ulcerative lichen planus: follow-up of surgical excision and grafting . Arch Dermatol. 1980;116:1252-1256.Crossref 5. Pelisse M. The vulvo-vaginal-gingival syndrome . Int J Dermatol. 1989;28:381-384.Crossref 6. Mahood JM. Familial lichen planus: a report of nine cases from four families with a brief review of the literature . Arch Dermatol. 1983;119:292-294.Crossref 7. Itin P, Surber C, Buchner S. Lack of effect after local treatment with a new cyclosporin formulation in recalcitrant erosive oral lichen planus . Dermatology . 1992;185:262-265.Crossref 8. Eisen D, Ellis CN, Duell EA, Griffiths CEM, Voorhees JJ. Effect of topical cyclosporine rinse on oral lichen planus: a double blind analysis . N Engl J Med. 1990;323:290-294.Crossref 9. Pelisse M, Boisnic S, Moyal-Barracco M, Szpiglas H, Reigneau O, Frances C. Treatment of vulvo-vaginal erosive lichen planus with topical cyclosporin . In: Program and abstracts of the International Society for the Study of Vulvar Disease, 11th World Congress; September 1991; Oxford, England. 10. Smith KJ, Konzelman JL, Lombardo FA, et al. Iontophoresis of vinblastine into normal skin and for treatment of Kaposi's sarcoma in human immunodeficiency virus—positive patients . Arch Dermatol. 1992;128:1365-1370.Crossref 11. Sloan JB, Keyoumars S. Iontophoresis in dermatology . J Am Acad Dermatol. 1986;15:671-684.Crossref 12. Singh J, Roberts MS. Transdermal delivery of drugs by iontophoresis: a review . Drug Des Deliv. 1989;4:1-12.Crossref 13. Robinson JR, Longer MA, Veillard M. Bioadhesive polymers for controlled drug delivery . Ann N Y Acad Sci. 1987;507:307-314.Crossref 14. Bachmann GA, Notelovitz M, Gonzalez SJ, Thompson C, Morecraft BA. Vaginal dryness in menopausal women: clinical characteristics and nonhormonal treatment . Clin Prac Sex . 1992;7:1-8. 15. Ziny MA, Shiao-Yu L. Double-blind study of the comparative effects of two gels on the vaginal pH in postmenopausal women . Today Ther Trend . 1991; 8:65-72.

Journal

Archives of Dermatology – American Medical Association

Published: Mar 1, 1995

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