1/15. Gianotti-Crosti syndrome presenting as lichenoid dermatitis.Papular acrodermatitis of childhood (Gianotti-Crosti syndrome) is an uncommon, self-limited disease characterized by an erythematous papular eruption symmetrically distributed on the face and limbs and mild lymphadenopathy, thought to be of viral origin. The histopathologic findings are nonspecific and include focal parakeratosis, mild spongiosis, superficial perivascular infiltrate, papillary dermal edema, and extravasated red blood cells. Interface changes with some basal vacuolization may be present, but are not a conspicuous feature. We present a 2 1/2-year-old boy with multiple papules and plaques on the face and extremities and cervical lymphadenopathy. Histopathologic analysis showed compact orthokeratosis, focal parakeratosis, hypergranulosis, psoriasiform epidermal hyperplasia, and a dense lichenoid lymphohistiocytic infiltrate with extensive exocytosis of mononuclear cells. Immunoperoxidase staining with CD 1 a revealed clusters of langerhans cells in the epidermis and in the papillary dermis. In view of the clinical findings, a diagnosis of Gianotti-Crosti syndrome was made. Although there are a few reports describing a lichenoid pattern of infiltration in Gianotti-Crosti syndrome, this histologic pattern is not widely known. This case is presented to illustrate the fact that Gianotti-Crosti syndrome can present as lichenoid dermatitis, and, especially in children, should be added to the differential diagnoses of lichenoid infiltrates.- - - - - - - - - - ranking = 1keywords = keratosis (Clic here for more details about this article) |
2/15. Keratosis lichenoides chronica: report of a new case, with success of puva therapy.Keratosis lichenoides chronica is a rare disorder. It consists of the progressive development of asymptomatic verrucosities on the limbs and the trunk, with a partially linear distribution. We report the case of a 78-year-old woman who presented with keratotic plaques and papules of the trunk and the limbs for several years. A diagnosis of keratosis lichenoides chronica was clinically and histologically evident. PUVA-therapy was started, with excellent results.- - - - - - - - - - ranking = 0.33333333333333keywords = keratosis (Clic here for more details about this article) |
3/15. adolescent-onset ichthyosiform-like erythroderma with lichenoid tissue reaction: a new entity?A patient with severe ichthyosiform erythroderma and lichenoid histological changes is presented. We discuss the clinical and histological differential diagnosis, including lupus erythematosus, lichenoid drug eruption, lichen planus, graft-versus-host disease, lymphoma, keratosis lichenoides chronica, Netherton's syndrome and ichthyosiform erythroderma. None of these is consistent with the features in our case, which may represent either a hitherto unreported form of ichthyosiform erythroderma or possibly a new entity.- - - - - - - - - - ranking = 0.33333333333333keywords = keratosis (Clic here for more details about this article) |
4/15. Vascular variant of keratosis lichenoides chronica associated with hypothyroidism and response to tacalcitol and acitretin.Keratosis lichenoides chronica (KLC) is a rare chronic progressive cutaneous disease that is part of the heterogeneous group of lichenoid dermatoses. The typical clinical presentation is characterized by lichenoid hyperkeratotic papules and nodules arranged in a linear and reticular pattern on the trunk and extremities. Our case confirms the existence of a vascular variant of KLC. There is no consensus about its treatment, since it is refractory to many different treatment modalities. We report the effectiveness of acitretin in KLC in combination with tacalcitol. KLC is of unknown aetiology, but is perhaps associated with systemic diseases, most importantly glomerulonephritis and lymphoma. This is the second case associated with hypothyroidism.- - - - - - - - - - ranking = 1.3333333333333keywords = keratosis (Clic here for more details about this article) |
5/15. Keratosis lichenoides chronica and eruptive keratoacanthoma-like lesions in a patient with multiple myeloma.We describe a 72-year-old woman with a 13-year history of a lichenoid dermatitis, who developed multiple, papular keratoacanthoma (KA)-like lesions and few crater-like nodules on the extremities over a period of 6 months before our observation. Her medical history also recorded multiple myeloma diagnosed a few years before. The long-standing dermatosis was diagnosed, clinically, as keratosis lichenoides chronica (KLC), although, histologically, a lichenoid tissue reaction pattern was not evident. On the other hand, histology from papular and nodular lesions of recent onset was consistent with a possible early phase of KA and spinocellular carcinoma, respectively. Oral acitretin induced regression of KA-like lesions and improvement of KLC but had no effects on crater-like nodules, which required surgical excision. KLC is a chronic disorder of keratinization characterized by lichenoid hyperkeratotic papules arranged in a linear pattern, erythematosquamous plaques and seborrhoea-like dermatitis. We emphasize in our case the association between KLC and multiple possible KAs, never previously reported, and speculate that these two rare conditions may represent here a 'continuum' from a pathogenetic point of view.- - - - - - - - - - ranking = 0.33333333333333keywords = keratosis (Clic here for more details about this article) |
6/15. Oral lichenoid eruption secondary to imatinib (Glivec).BACKGROUND: Oral lichenoid drug eruption (OLE) is a self-restricted inflammatory condition usually secondary to a variety of drugs and dental materials (mercury, gold), and rarely to immunomodulators and new antineoplastic agents such as imatinib mesylate (Glivec). OLE clinical features are reminiscent of lichen planus and include symmetric and asymptomatic, erythematous, reticulated and painful ulcerated plaques. Histological examination reveals perivascular lymphocytic infiltrate and the presence of eosinophils that obscures the dermal-epidermal junction, with acanthosis and mild hyperkeratosis. methods: A 62-year-old man was treated with Glivec for metastatic gastrointestinal stromal tumour (GIST). RESULTS: The patient presented with grey-violaceous plaques on both cheek mucosal surfaces and the lateral sides of the tongue and labial mucosa, with a reticular pattern resembling oral lichen planus. These lesions appeared approximately 1 year after therapy and partially subsided in about 10 weeks, to clear after topical corticosteroids and oral omeprazole. The diagnosis of OLE induced by imatinib was confirmed by histological biopsy evaluation; immunohistochemical analysis revealed intense immunoreactivity with only cytokeratins 5/6 and 14 in the epithelium of affected mucosa. All laboratory investigations proved asiderotic anaemia but excluded infectious causes. CONCLUSION: It is believed that this patient developed imatinib-induced OLE; this relationship with therapy rather than the underlying disease rules out a paraneoplastic reaction, and negative immunofluorescence excluded autoimmune dermatosis. In addition, we propose that these lesions are correlated with abnormal expression of some cytokeratins directly caused by this drug.- - - - - - - - - - ranking = 0.33333333333333keywords = keratosis (Clic here for more details about this article) |
7/15. Keratosis lichenoides chronica: a diagnostic and therapeutic challenge.A 45-year-old man presented with a 7-year history of keratosis lichenoides chronica (KLC), a mucocutaneous lichenoid disorder of keratinization with no known aetiology, without significant systemic associations. Our patient also had type I diabetes mellitus, mild hypertension and lipid abnormalities. The diagnosis and treatment of KLC is often challenging.- - - - - - - - - - ranking = 0.33333333333333keywords = keratosis (Clic here for more details about this article) |
8/15. Hyperkeratotic lichenified skin lesion of gluteal region.Elderly people may develop typical skin lesions on the superior part and both sides of the anal cleft. Although such skin changes have recently been reported as anosacral cutaneous amyloidosis in primary cutaneous amyloidosis, in our histopathological examinations no amyloid deposition has been detected at the sites of these lesions. Because hyperkeratosis, acanthosis and follicular plugging were seen in all of the cases histopathologically, we think that these skin manifestations are essentially a type of keratinization abnormality instead. We consider this disease to be a type of senile skin change that develops in response to prolonged mechanical irritation.- - - - - - - - - - ranking = 0.33333333333333keywords = keratosis (Clic here for more details about this article) |
9/15. child syndrome: analysis of abnormal keratinization and ultrastructure.A new patient with child syndrome (congenital hemidysplasia, ichthyosiform erythroderma, and limb defects), the thirtieth in the literature, was observed for over three years. Initially, the right-sided lesion spared the breast area. At 10 months of age the trunk lesion extended to cover the entire area of the right chest. At age 20 months the patient developed linear, bandlike, keratotic, brown-black lesions on her left thigh that subsided within six weeks, leaving a slight hyperpigmentation. This patient was studied by routine histologic methods as well as with markers of keratinization and electron microscopy. In hematoxylin and eosinstained sections, parakeratosis and orthokeratosis alternated. In some parakeratotic areas, large granular cells, and in others, ghost granular cells, were present. The latter showed basophilic cytoplasm, and palestaining or vacuolated nucleus and were seen either above the normal granular layer or without it. Although regional variations existed, basal cell-type keratins as recognized by AE1 continued to be expressed in suprabasal layers. Filaggrin- and involucrin-positive layers were expanded, particularly the latter, down to the lower prickle cell layer. Ultrastructurally, numerous lamellar or membranous structures were found in upper layers of the epidermis, both intracellulary and intercellularly. Normal cementsomes coexisted with these abnormal lamellar structures, and it was thought that the latter represent modified cementsomes because the discharge of those from the cell periphery was often detected.- - - - - - - - - - ranking = 0.66666666666667keywords = keratosis (Clic here for more details about this article) |
10/15. Keratosis lichenoides chronica in a child.A young boy developed childhood keratosis lichenoides chronica. The eruption cleared spontaneously after 13 years. This is a rare condition, regarded by some as a variant of lichen planus. The great preponderance of cases occur in adults, whereas the disease in childhood is uncommon.- - - - - - - - - - ranking = 0.33333333333333keywords = keratosis (Clic here for more details about this article) |
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