1/9. Keratosis lichenoides chronica: report of a case developing after erythroderma.A 66-year-old male presented with keratosis lichenoides chronica after a presumed drug-induced erythroderma. After resolution of the erythroderma, slightly scaly erythematous and violaceous papules in a reticular arrangement over the trunk and limbs developed in association with hoarseness, palmoplantar keratoderma, onycholysis and subungual keratosis. histology from a lichenoid lesion showed pseudo-epitheliomatous hyperplasia, hyperorthokeratosis, parakeratosis, dyskeratosis, neutrophil exocytosis and focal vacuolar degeneration of the basal layer of the epidermis. There was a band-like chronic inflammatory infiltrate in the upper dermis. The skin improved with prednisone 40 mg/day for 15 days, leaving atrophic hypopigmented scars. A diagnosis of keratosis lichenoides chronica was made.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
2/9. Paraneoplastic pemphigus in association with a retroperitoneal Castleman's disease presenting with a lichen planus pemphigoides-like eruption. A case report and review of literature.A 50-year-old man presented with severe mucosal erosions of the lips, oral cavity and perianal area, a lichen planus-like eruption on the trunk and extremities and scaly plaques of the palms and soles. The clinical impression was of Stevens--Johnson syndrome, or paraneoplastic pemphigus (PNP). Histopathology revealed vacuolar interface and lichenoid dermatitis with dyskeratosis and suprabasal acantholytic vesiculation. Direct immunofluorescence showed deposition of IgG in the intercellular space and linear deposition of C3 along the basal membrane zone. Indirect immunofluorescence revealed circulating IgG with intercellular staining of the epithelium of rat urinary bladder. Western blotting demonstrated bands of 250- and 230-kDa antigens. The clinical, histological and immunological features were consistent with the lichen planus pemphigoides variant of PNP. A retroperitoneal hyaline-vascular Castleman's disease was detected and excised. The skin lesions worsened initially after tumour resection but improved gradually, leaving extensive melanosis after cyclosporin and mycophenolate mofetil treatment.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
3/9. lichen sclerosus et atrophicus affecting the wrists and left ankle and clinically simulating lichen planus.lichen sclerosus et atrophicus (LSA) is a disease of unknown etiology, although hereditary, endocrine, and autoimmune factors are known to be involved. Although the anal and genital regions are predominantly affected, 2.5% of patients only present with extragenital lesions--particularly of the trunk, neck, and upper limbs. The wrists, palmoplantar regions, nipples, and face are less commonly involved. The possible relationship between LSA and both lichen planus and localized scleroderma (morphea) has not been clearly established, although in a number of cases, several of these conditions have been found simultaneously. We report the case of a 61-year-old woman with LSA lesions affecting only the wrists and left ankle. The unusual character of this presentation is pointed out, along with its clinical similarity to lichen planus.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
4/9. Palmoplantar lichen planus presenting with vesicle-like papules.Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. Although several morphological patterns may be seen, plaques or small papules with compact hyperkeratosis are usually observed. We present a 25-year-old woman with a one-month history of slightly pruritic, red papules on her palms and soles. Dermatologic examination revealed numerous, asymptomatic, unscaly, red papules on her palms and soles, some of them resembling vesicles and white reticulate plaques on both sides of the buccal mucosa. The diagnosis was established by the typical histopathological features of lichen planus. Although resistant to topical corticosteroids, she responded well to systemic corticosteroid therapy, and no recurrence was observed during the follow-up period of one year.- - - - - - - - - - ranking = 2keywords = palm (Clic here for more details about this article) |
5/9. Cutaneous ulcerative lichen planus exhibiting pathergy, response to acitretin.While ulcerative lichen planus is a common diagnosis when involving the mucosa, it is uncommonly found on the cutaneous surface. Cutaneous ulcerative lichen planus is usually found on the palmar or plantar surfaces and has only rarely been described elsewhere. We describe a case of cutaneous ulcerative lichen planus involving the pretibia and exhibiting pathergy, which to our knowledge has not been previously reported. We also describe successful treatment with oral acitretin in conjunction with topical and intralesional corticosteroids.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
6/9. Management of erosive lichen planus with topical tacrolimus and recurrence secondary to metoprolol.metoprolol, a widely prescribed beta-adrenergic receptor blocker, has occasionally been associated with a diversity of cutaneous reactions. We present a 79-year-old male patient with erosive lichen planus (LP) on the feet and hands who was successfully treated with topical tacrolimus. Six months after the lesions had been cured the patient received the beta-receptor blocker metoprolol for the treatment of hypertonus. Within only 2 weeks of metoprolol intake the erosive lesions on the palms and feet recurred. After discontinuation of the drug and repetitive topical treatment with tacrolimus a complete remission of the lesions could be achieved. The recurrence of erosive LP probably secondary to metoprolol and the therapeutic success of topical tacrolimus in the treatment of LP are discussed.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
7/9. Paraneoplastic pemphigus with clinical features of lichen planus associated with low-grade B cell lymphoma.BACKGROUND: Neoplasia-induced lichen planus is described as a cell-mediated reaction to unknown epithelial antigens. Paraneoplastic pemphigus (PNP), characterized by the presence of a specific array of autoantibodies, probably represents a different form of presentation of the same autoimmune syndrome where the mucocutaneous expression depends on the dominant pathologic mechanism. methods: The authors report a case of PNP with predominant lichen planus-like lesions and review the relevant literature. We observed a 74-year-old female with vesico-bullous, erosive, target-shaped and flat papular lichenoid lesions on the lower legs, palms and soles, evolving for 3 weeks. Histopathology revealed a lichenoid dermatitis. Direct immunofluorescence showed C3 deposition around keratinocytes and epidermal IgG intranuclear deposition. Indirect immunofluorescence revealed circulating IgG with intercellular staining on rat bladder substrate. immunoblotting demonstrated bands of 130, 190, 210 and 250 kDa antigens. A pararenal B cell lymphoma was found. RESULTS: Oral corticotherapy with 40 mg prednisolone daily was initiated with a good cutaneous response. Four months later, cyclophosphamide (50 mg/day) was introduced because of a discrete enlargement of the pararenal mass. The patient died on the seventh month of follow up as a result of respiratory insufficiency. CONCLUSION: PNP has different forms of presentation and the lack of a consensus about diagnostic criteria may contribute to underdiagnosed cases. Advances on the knowledge of the sensitivity and specificity of diagnostic criteria have allowed a better accuracy of diagnosis.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
8/9. Coexistence of palmoplantar lichen planus and lupus erythematosus with response to treatment using acitretin.lichen planus and lupus erythematosus may occur as an overlap syndrome. Here we report the clinical characteristics of a 49-year-old man with palmoplantar lichen planus and lupus erythematosus. He showed a remarkable clinical response to treatment with acitretin, which resulted in prolonged remission of the disorder.- - - - - - - - - - ranking = 5keywords = palm (Clic here for more details about this article) |
9/9. Eccrine syringofibroadenoma in a patient with erosive palmoplantar lichen planus.We report the case of an 82-year-old woman with a 6-year history of erosive palmoplantar lichen planus associated with eccrine syringofibroadenoma (ESFA). Examination revealed a well-demarcated patche writish of reticulated whitish papular lesions in skin of otherwise normal appearance at the border of erosive lichen planus plaques. These lesions had the histological appearance of ESFA. We suggest that these lesions are induced by the inflammatory remodelling associated with erosive lichen planus and propose to consider ESFA in the context of skin tissue remodelling as a new subtype of ESFA.- - - - - - - - - - ranking = 5keywords = palm (Clic here for more details about this article) |