PDF(Pubmed)
Abstract：
Lichen planus (LP) is a common T-cell-mediated autoimmune skin disease, and its exact etiology is unknown. Typically, it affects the trunk, flexural surfaces, and the mucosa.We report a rare finding of LP involving both eyelids in a 67-year-old female. A 67-year-old Saudi female with a medical history of diabetes mellitus, hypothyroidism and rheumatoid arthritis presented with a three-month history of pruritic skin eruptions in both eyelids. She had no associated musculoskeletal symptoms or fatigue and no medical or family history of atopy. The patient had violaceous, thin, scaly plaques confined to both eyelids. Oral mucosa, genitalia, scalp, and nails were not affected. Histopathology from the right lower eyelid confirmed the diagnosis of LP. Hepatitis C virus serology was negative. Patient was examined by ophthalmology to rule out conjunctival involvement of LP. She had dry eyes only. She was initially managed by topical tacrolimus 0.1% ointment and didn\'t tolerate it due to severe reaction. She tolerated mometasone propionate 0.1% cream, which relieved the itch and partially improved the lesions. Although rare, LP of the eyelids must be considered among differential diagnoses of eyelid dermatitis. It can be confined, or it may concomitantly involve other parts of the body. LP of the eyelid may also extend to the conjunctiva, so it\'s important to screen patients by ophthalmology to rule out possible ocular involvement. This is the first case report of a Saudi patient with LP confined to the eyelid. The management of LP involving the eyelids is challenging. Treatment options include topical steroids, tacrolimus ointment, phototherapy and oral retinoids (etretinate).
摘要：
扁平苔藓(LP)是一种常见的T细胞介导的自身免疫性皮肤病,其确切病因尚不清楚。通常,它会影响后备箱，挠曲表面,和粘膜。我们报告了一名67岁女性中罕见的涉及两个眼睑的LP发现。一位67岁的沙特女性，有糖尿病病史，甲状腺功能减退症和类风湿性关节炎均有3个月的双眼皮瘙痒性皮疹病史。她没有相关的肌肉骨骼症状或疲劳，也没有过敏症的病史或家族史。病人有暴力倾向,薄,鳞状斑块局限于两个眼睑。口腔粘膜,生殖器,头皮,指甲没有受到影响。右下眼睑的组织病理学证实了LP的诊断。丙型肝炎病毒血清学检查阴性。通过眼科检查患者以排除LP的结膜受累。她只有干涩的眼睛。她最初使用0.1%他克莫司外用软膏治疗，但由于严重反应而无法耐受。她耐受0.1%丙酸莫米松乳膏,缓解瘙痒，部分改善病变。虽然罕见，在眼睑皮炎的鉴别诊断中必须考虑眼睑的LP。它可以被限制，或者它可能同时涉及身体的其他部位。眼睑的LP也可以延伸到结膜，因此，通过眼科筛查患者以排除可能的眼部受累是很重要的。这是沙特患者LP局限于眼睑的首例病例报告。涉及眼睑的LP的管理具有挑战性。治疗选择包括局部类固醇，他克莫司软膏,光疗和口服类维生素A（依定）。
