Tags

Type your tag names separated by a space and hit enter

Bicanalicular obstruction in lichen planus: a characteristic pattern of disease.
Ophthalmology. 2008 Feb; 115(2):386-9.O

Abstract

PURPOSE

Lichen planus, an idiopathic mucocutaneous inflammatory disease, has only once been reported to cause lacrimal drainage obstruction. The authors present a series of patients with epiphora resulting from systemic lichen planus and describe the characteristic pattern of lacrimal canalicular blockage.

DESIGN

Retrospective noninterventional case series.

PARTICIPANTS

Eight patients (5 women, 3 men) with a median presenting age of 49 years (range, 39-60 years).

METHODS

A retrospective review of case notes for patients attending the lacrimal clinic between 1998 and 2005 was performed to identify patients with nontraumatic lacrimal canalicular obstruction. In addition to demographic information, the data collected included a history of periocular herpetic infection, administration of systemic 5-fluorouracil, other causes of canalicular obstruction, the extent of proximal and distal canalicular obstruction (noted during surgery), the type of surgery, and the surgical outcomes.

MAIN OUTCOME MEASURES

Identification of patients with biopsy-proven systemic lichen planus who had conjunctival and canalicular disease and documentation of the extent and severity of canalicular obstruction.

RESULTS

Of the 184 patients with canalicular obstruction identified during the study period, 8 had lichen planus. Bilateral, bicanalicular involvement was present in 7 of 8 lichen planus patients, with 3 of 8 patients having completely obstructed canaliculi. Primary dacryocystorhinostomy (DCR) with retrograde canaliculostomy was performed in 4 of 8 patients, but all required secondary placement of Lester Jones canalicular bypass tubes. The other 4 patients had either primary DCR alone (both eyes in 1 patient, with solely canalicular stenosis) or DCR with primary placement of Jones tubes (6 eyes in 3 patients). Histologic examination of pericanalicular tissues in 2 patients showed features consistent with lichen planus.

CONCLUSIONS

Lacrimal involvement in lichen planus is characterized by severe bilateral bicanalicular occlusion involving most of the length of affected canaliculi, and placement of a Jones canalicular bypass tube is generally required to control symptoms.

Authors+Show Affiliations

Moorfields Eye Hospital, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18243906

Citation

Durrani, Omar M., et al. "Bicanalicular Obstruction in Lichen Planus: a Characteristic Pattern of Disease." Ophthalmology, vol. 115, no. 2, 2008, pp. 386-9.
Durrani OM, Verity DH, Meligonis G, et al. Bicanalicular obstruction in lichen planus: a characteristic pattern of disease. Ophthalmology. 2008;115(2):386-9.
Durrani, O. M., Verity, D. H., Meligonis, G., & Rose, G. E. (2008). Bicanalicular obstruction in lichen planus: a characteristic pattern of disease. Ophthalmology, 115(2), 386-9. https://doi.org/10.1016/j.ophtha.2007.03.081
Durrani OM, et al. Bicanalicular Obstruction in Lichen Planus: a Characteristic Pattern of Disease. Ophthalmology. 2008;115(2):386-9. PubMed PMID: 18243906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bicanalicular obstruction in lichen planus: a characteristic pattern of disease. AU - Durrani,Omar M, AU - Verity,David H, AU - Meligonis,George, AU - Rose,Geoffrey E, PY - 2006/03/21/received PY - 2007/03/08/revised PY - 2007/03/10/accepted PY - 2008/2/5/pubmed PY - 2008/2/12/medline PY - 2008/2/5/entrez SP - 386 EP - 9 JF - Ophthalmology JO - Ophthalmology VL - 115 IS - 2 N2 - PURPOSE: Lichen planus, an idiopathic mucocutaneous inflammatory disease, has only once been reported to cause lacrimal drainage obstruction. The authors present a series of patients with epiphora resulting from systemic lichen planus and describe the characteristic pattern of lacrimal canalicular blockage. DESIGN: Retrospective noninterventional case series. PARTICIPANTS: Eight patients (5 women, 3 men) with a median presenting age of 49 years (range, 39-60 years). METHODS: A retrospective review of case notes for patients attending the lacrimal clinic between 1998 and 2005 was performed to identify patients with nontraumatic lacrimal canalicular obstruction. In addition to demographic information, the data collected included a history of periocular herpetic infection, administration of systemic 5-fluorouracil, other causes of canalicular obstruction, the extent of proximal and distal canalicular obstruction (noted during surgery), the type of surgery, and the surgical outcomes. MAIN OUTCOME MEASURES: Identification of patients with biopsy-proven systemic lichen planus who had conjunctival and canalicular disease and documentation of the extent and severity of canalicular obstruction. RESULTS: Of the 184 patients with canalicular obstruction identified during the study period, 8 had lichen planus. Bilateral, bicanalicular involvement was present in 7 of 8 lichen planus patients, with 3 of 8 patients having completely obstructed canaliculi. Primary dacryocystorhinostomy (DCR) with retrograde canaliculostomy was performed in 4 of 8 patients, but all required secondary placement of Lester Jones canalicular bypass tubes. The other 4 patients had either primary DCR alone (both eyes in 1 patient, with solely canalicular stenosis) or DCR with primary placement of Jones tubes (6 eyes in 3 patients). Histologic examination of pericanalicular tissues in 2 patients showed features consistent with lichen planus. CONCLUSIONS: Lacrimal involvement in lichen planus is characterized by severe bilateral bicanalicular occlusion involving most of the length of affected canaliculi, and placement of a Jones canalicular bypass tube is generally required to control symptoms. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/18243906/Bicanalicular_obstruction_in_lichen_planus:_a_characteristic_pattern_of_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(07)00465-4 DB - PRIME DP - Unbound Medicine ER -