Calcineurinantagonisten bei Lichen sclerosus

Zusammenfassung

Der Lichen sclerosus et atrophicus ist eine chronisch-entzündliche Erkrankung, die bevorzugt das weibliche Geschlecht befällt. Es zeigen sich zwei Erkrankungsgipfel im prämenarchialen Alter sowie in der 5. Dekade. Der Lichen sclerosus manifestiert sich überwiegend in der Anogenitalregion, seltener auch extragenital oder mukosal. Neuere Befunde weisen auf eine autoantikörper-vermittelte Genese der chronisch-entzündlichen Dermatose hin. Bei 80 % der untersuchten Patienten finden sich Autoantikörper gegen das extrazelluläre Membranprotein-1. Neben der bewährten Therapie mit lokalen Kortikosteroiden führen Calcineurinantagonisten zu viel versprechenden Resultaten in der Behandlung des Lichen sclerosus. Eine konsequente Betreuung und ein interdisziplinäres Management können die Lebensqualität und die Klinik von Lichen-sclerosus-Patienten günstig beeinflussen.

Abstract

Lichen sclerosus et atrophicus is a chronic inflammatory disorder of the skin that mainly affects women with a bimodal peak in incidence in prepubertal children and post-menopausal women. Besides the anogenital region, lichen sclerosus may be localized extragenitally or mucosally. Recently, it was proposed that autoantibodies against the extracellular membrane protein-1 (ECM1) are pathogenetic for this chronic inflammatory dermatosis. Immunoreactivity to ECM1 was present in up to 80 % of affected patients. Besides the widely accepted therapy with potent corticosteroids, promising results have been presented using calcineurin antagonists for the treatment of lichen sclerosus. An interdisciplinary management and a continuous care of patients with lichen sclerosus will improve quality of life and the clinical manifestations.

Schlüsselwörter

Lichen sclerosus et atrophicus - Autoimmunerkrankung - anogenitale Lokalisation - extrazelluläres Membranprotein-1 - Glukokortikosteroide - Calcineurinantagonisten

Key words

Lichen sclerosus et atrophicus - autoimmune disease - anogenital localization - extracellular membrane protein-1 - glucocorticosteroids - calcineurin antagonists

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