Cases reported "Facial Dermatoses"

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1/22. Photolocalized tinea facialis.

    The case of a 34-year-old white woman with tinea facialis that persisted for nine months prior to diagnosis is presented. The confluent plaquelike erythematous eruption of the face with eyelid lichenification that flared outdoors was thought to represent polymorphic light eruption and was refractory to antibiotics, corticosteroids (topical and systemic), and antimalarials. A KOH preparation was positive when the dermatosis spilled onto the mandibular region, and restaining of the initial skin biopsy revealed fungal hyphae. Complete resolution was accomplished with griseofulvin and MicTin. tinea cab be added to the list of infectious agents that have a photosensitivity component. The fungus possibly "photolocalizes" to sun-damaged areas, ie, areas of increased capillary permeability. This case illustrates the importance of including tinea in considering diagnoses of sun-exposed lesions of the face.
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ranking = 1
keywords = lichen
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2/22. Lichenoid tissue reaction in porphyria cutanea tarda.

    We report a patient presenting with lichenoid plaques on exposed skin who had the metabolic features of porphyria cutanea tarda (PCT). histology of lesional skin demonstrated a lichenoid inflammatory cell infiltrate in the upper dermis, while direct immunofluorescence revealed immunoreactive colloid bodies. Monochromator irradiation testing demonstrated photosensitivity in the visible spectrum consistent with porphyria. Solar-simulated irradiation induced a papular reaction with lichenoid histological changes. We propose that this atypical presentation of PCT may reflect a lichenoid tissue response to a porphyrin-mediated photochemical reaction.
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ranking = 4
keywords = lichen
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3/22. Delayed and immediate hypersensitivity reactions associated with the use of amalgam.

    hypersensitivity to the constituents of dental amalgam is uncommon. When it occurs it typically manifests itself as a lichenoid reaction involving a delayed, type IV, cell-mediated hypersensitivity response. Rarely, a more acute and generalised response can occur involving both the oral mucosa and skin. We describe two cases that illustrate the presentation and management of these two types of reaction.
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ranking = 1
keywords = lichen
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4/22. Allergy to lichen acids in a fragrance.

    A 48-year-old clerical officer with a recurrent facial eruption had positive patch test reactions to nickel, fragrance mix and lichen acid mix. On testing to individual ingredients of fragrance mix and lichen acid mix, she had 2 reactions to oak moss, which is thought to be the main allergen in fragrance mix, and to usnic acid, which is one of a number of lichen acids comprising oak moss. Avoidance of fragrance use resulted in clearing of the eruption but, subsequently, an acute vesicular flare on her face and hands occurred after exposure to lichen on garden shrubs.
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ranking = 8
keywords = lichen
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5/22. keratosis lichenoides chronica: marked response to calcipotriol ointment.

    keratosis lichenoides chronica (KCL) is a rare dermatosis characterized by a distinctive seborrheic dermatitis-like facial eruption, together with violaceous, papular, and nodular lesions on the extremities and trunk, typically arranged in a linear and reticulate pattern. KLC is resistant to therapy, although spontaneous remission has been reported. We describe a 35-year-old woman with KLC who had the typical features of widespread violaceous, reticulate, and striae-like eruptions with a prominent keratotic component over a nine-year period and who responded well to treatment with calcipotriol ointment. The immunohistochemical profiles are presented in addition to typical histopathologic features.
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ranking = 5
keywords = lichen
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6/22. Linear eruptions of the nose in childhood: a form of lichen striatus?

    We report four children with linear eruptions on the nose, with overlapping features of lichen striatus and linear cutaneous lupus erythematosus. However, linear lupus erythematosus has rarely been reported, and lichen striatus, although classically linear, rarely affects the face. The linear distribution of lesions from the glabella to the ala nasi may represent distribution following Blaschko's lines.
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ranking = 6
keywords = lichen
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7/22. Linear oro-facial lichen sclerosus.

    Lichen sclerosus is a depigmenting mucocutaneous disorder that most frequently affects the female genitalia. Lichen sclerosus affecting the oral mucosa is extremely rare. Oral lesions are asymptomatic but cosmetically unacceptable. We report here a case of lichen sclerosus presenting with a linear lesion over the nose that extended to involve the philtrum and the upper lip with intraoral extension up to the gingiva. Treatment with a short course of oral and intralesional corticosteroids resulted in partial resolution of the lesions.
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ranking = 5
keywords = lichen
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8/22. Facial lichen striatus: successful treatment with tacrolimus ointment.

    We report a 22-year-old Japanese woman with facial lichen striatus (LS). The distribution of the lesions corresponded to that of Blaschko's lines. histology of the lesional skin showed an inflammatory cell infiltrate around hair follicles and eccrine glands. Treatment of the linear lesions with tacrolimus ointment once or twice daily resulted in a dramatical improvement in a short time. LS is a T-cell-mediated inflammatory disease and tacrolimus ointment may be an effective alternative treatment for this disease especially when the lesions are located on the face.
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ranking = 5
keywords = lichen
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9/22. Dermatological side effects of brimonidine: a report of three cases.

    Brimonidine is a potential first line therapy for primary open angle glaucoma (OAG) and ocular hypertension (OHT). It is known to cause various ocular and systemic side effects. Being a newer drug, the whole spectrum of its adverse effects is not known. The dermatological side effects caused by brimonidine have rarely been reported before. We present three OAG patients who presented to us with contact dermatitis of periorbital skin and lichen planus of nail following the use of topical brimonidine (0.2% twice a day) for more than six months. These side effects slowly disappeared on discontinuing the drug but reappeared on reintroducing topical formulation. Such side effects from the use of brimonidine have not been reported before.
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ranking = 1
keywords = lichen
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10/22. lichen planus follicularis tumidus with cysts and comedones.

    The lichen planus follicularis tumidus was described by Belaich et al. in 1977, and we have found 13 cases published so far. We report two cases we have recently seen, one of them with multiple lesions on the head, and the other with a temporo-frontal lesion.
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ranking = 1
keywords = lichen
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