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Mimetismo antigênico seguido de espalhamento de epítopos: agente desencadeador patogênico da morfologia clínica do líquen plano e de sua transi??o para a Síndrome de Graham-Little-Piccardi-Lassueur e para a ceratose líquenóide cr?nica - Hipótese médica ou realidade?

DOI: 10.1590/S0365-05962009000600019

Keywords: apoptosis, epitopes, immunity, infection, lichen planus, molecular mimicry.

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literature data analysis, providing an exact explanation of the lichen planus pathogenesis, as well as its transition into other rare forms such as keratosis lichenoides chronica or graham lassueur piccardi little syndrome are scant, or totally missing. the chronological course of the disease, known in the literature as lichen planus, varies. some patients develop lichen planus or lichen nitidus and there is no logical explanation why. it is also not clear why single patients initially develop ulcerative lesions in the area of the mucosa and only in a few of them these lesions affect the skin. antigen mimicry and epitope spreading could be the possible pathogenic inductor in cases of lichenoid dermatoses, as well as the cause for their transition into ulcerative, exanthematous or other rare forms. the epitope spreading is probably not the leading pathogenetic factor in lichen planus but a phenomenon which occurs later. this manuscript analyzes some basic pathogenic aspects and presents some possible medical hypotheses regarding the heterogenic clinical picture and pathogenesis of lichen planus and lichenoid like pathologies of the skin which, in the near future should be analyzed in details in order to clarify several dilemmas the clinical dermatologist has to face.


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