1/18. purpura of the ears: a distinctive vasculopathy with circulating autoantibodies complicating long-term treatment with levamisole in children.The cutaneous side-effects of levamisole include non-specific and lichenoid eruptions, fixed drug eruption and, very rarely, cutaneous vasculitis. We describe a distinctive clinical and histological vasculopathy with immunological abnormalities in children with paediatric nephrotic syndrome receiving long-term levamisole treatment. Four boys and one girl were identified. Their average age was 10 years. levamisole had been used for an average of 24 months. purpura of the ears was the most common finding corresponding histologically to a vasculopathic reaction pattern ranging from a leucocytoclastic and thrombotic vasculitis to a vascular occlusive disease without true vasculitis but with associated antinuclear, antiphospholipid and anticytoplasmic antibodies. The eruption resolved in all patients 2-3 weeks after the discontinuation of levamisole, but serum autoantibodies persisted for 2-14 months.- - - - - - - - - - ranking = 1keywords = lichen (Clic here for more details about this article) |
2/18. A case of lichenoid purpura possibly caused by diltiazem hydrochloride.A 65-year-old Japanese man presented with itchy purpuric lichenoid papules of six months' duration on his legs and buttock. A topical glucocorticoid ointment was not effective. The biopsy specimen histologically showed a dense lichenoid infiltration of lymphocytes and histiocytes into the dermoepidermal junction; red blood cells were seen in the infiltration. Based on the clinical and pathological findings, we diagnosed this case as lichenoid purpura of Gougerot-Blum. The lesions disappeared when the diltiazem hydrochloride that he had been taking was discontinued.- - - - - - - - - - ranking = 7keywords = lichen (Clic here for more details about this article) |
3/18. puva therapy in lichen aureus.Lichen aureus is one of the subtypes of a rare group of diseases, pigmented purpuric dermatoses. The natural course of the disease is slow evolution and slow resolution. Treatment is generally limited. We report a case of lichen aureus that responded dramatically to photochemotherapy (PUVA).- - - - - - - - - - ranking = 5keywords = lichen (Clic here for more details about this article) |
4/18. Two cases of unilateral pigmented purpuric dermatosis.Two cases of pigmented purpuric dermatosis showing unusual distribution are reported. Case 1: 35-year-old female. A group of three asymptomatic purpuric macules developed on the ulnar side of the elbow flexure of the left forear 3-6 months before presentation. Histopathological analysis revealed a band-like inflammatory infiltrate in the Uppermost dermis and extravasation of red blood cells just beneath the epidermis, but there was no evidence of lichefaction degeneration in the basal layer of the epidermis. Case 2: 26-year-old female. Asymptomatic purpuric pigmentations developed on the flexure side of the right lower extremity in a linear arrangement 2-3 months before presentation. Histopathological analysis revealed focally perivascular inflammatatory infiltrates consisting mainly of lymphocytes and conspicuous extravasation of red blood cells into the papillary dermis. There was no histological evidence of vasculitis in either case. hemosiderin deposits were more limited than expected in both patients. Both cases are compatible with diagnoses of pigmented purpuric dermatosis. Case 1 on the left arm was compatible with lichen purpuricus. Case 2 occurred in a linear arrangement on the right leg and had a history of aspirin use for chronic headache. We therefore suspected that medication had been an etiological or contributing factor.- - - - - - - - - - ranking = 1keywords = lichen (Clic here for more details about this article) |
5/18. Monoclonal rearrangement of the T cell receptor gamma-chain in lichenoid pigmented purpuric dermatitis of gougerot-blum responding to topical corticosteroid therapy.Lichenoid pigmented purpuric dermatitis of Gougerot-Blum belongs to a group of closely related disorders which are termed pigmented purpuric dermatoses. It clinically manifests itself with grouped lichenoid papules in association with purpuric lesions. We report a case of lichenoid pigmented purpuric dermatitis of Gougerot-Blum with a heavy band-like CD4-positive lymphocytic infiltrate and clonal rearrangements of the gamma-chain of the T cell receptors as detected by polymerase chain reaction/denaturing gradient gel electrophoresis. Monoclonal expansion of T cells in combination with certain histological features of mycosis fungoides (MF) might support a biological relationship between lichenoid pigmented purpuric dermatitis of Gougerot-Blum and MF. However, prompt clinical response to topical steroid therapy supports the benign clinical nature of our case.- - - - - - - - - - ranking = 7keywords = lichen (Clic here for more details about this article) |
6/18. Localized morphoea preceded by a pigmented purpuric dermatosis.Localized morphoea uncommonly occurs in a linear distribution and may present following trauma, although most cases are idiopathic. Pigmented purpuric dermatoses such as lichen aureus may also rarely occur in a linear distribution and have been associated with trauma. A middle-aged man is described who initially presented with lesions typical of lichen aureus in a linear distribution at a site exposed to chronic low-grade trauma. This eruption was transient and clinically underwent spontaneous complete resolution. Several months later he developed localized morphoea in an identical distribution. To our knowledge this is the first reported case of a pigmented purpuric dermatosis, presumably precipitated by trauma, evolving into linear morphoea.- - - - - - - - - - ranking = 2keywords = lichen (Clic here for more details about this article) |
7/18. Chronic vulvar purpura: persistent pigmented purpuric dermatitis (lichen aureus) of the vulva or plasma cell (Zoon's) vulvitis?BACKGROUND: Lichen aureus is localized variant of persistent pigmented purpuric dermatitis that typically affects the legs and can be associated with delayed hypersensitivity reactions or vascular abnormalities. plasma cell vulvitis (Zoon's vulvitis) is a rare condition that frequently contains hemosiderin deposits and is suspected to be a mucosal reaction pattern due to variety of insults, most often local irritation or trauma. CASE REPORT: A 50-year-old female with longstanding complaints of spotting, vulvar dryness, irritation, and dyspareunia presented with circumscribed, purpuric, erythematous vulvar patches. Past estrogen cream treatment evoked symptoms of discomfort. On biopsy, siderophages and extravasated red blood cells were found in conjunction with a lichenoid, lymphocyte and plasma cell infiltrate, and dilated dermal and intraepithelial vessels. CONCLUSIONS: Reported herein is an unusual vulvar dermatosis that is best classified as a localized variant of persistent pigmented dermatosis (lichen aureus) but overlaps clinically and histologically with Zoon's vulvitis. This constellation of findings may represent a site-specific mucosal reaction to an erosive process that could either be inflammatory (hypersensitivity reaction) and/or traumatic in nature.- - - - - - - - - - ranking = 6keywords = lichen (Clic here for more details about this article) |
8/18. Pigmented purpuric stomatitis.The pigmented purpuric dermatoses are a group of disorders in which there is chronic capillaritis, with pigmented purpuric lesions predominantly on the lower limbs. We report a case with chronic oral lesions that had histologic features most in keeping with the purpuric lichenoid dermatitis of Gougerot and Blum syndrome.- - - - - - - - - - ranking = 1keywords = lichen (Clic here for more details about this article) |
9/18. Purpuric generalized lichen nitidus: an unusual eruption simulating pigmented purpuric dermatosis.BACKGROUND: Generalized haemorrhagic lichen nitidus is rare. To our knowledge, this form of presentation has only been reported once. OBJECTIVE: To describe a new case of generalized haemorrhagic lichen nitidus simulating a pigmented purpuric dermatosis. methods AND RESULTS: We document a 24-year-old man who presented with an 8-month history of a progressive non-pruritic, red-brown papular eruption on the dorsa of the feet, ankles and distal third of the legs. A diagnosis of Schamberg's progressive pigmentary dermatosis was made, and no treatment was prescribed. Two months later, the lesions had extended to the abdomen, groins, forearms, elbows and wrists. biopsy of the skin of the right foot revealed lesions typical of lichen nitidus with subepidermal extravasation of red cells and capillary wall hyalinization. macrophages and T lymphocytes were abundant in the infiltrate. CONCLUSION: Purpuric generalized lichen nitidus should be included in the differential diagnosis of pigmented purpuric dermatoses.- - - - - - - - - - ranking = 1549.4019841547keywords = lichen nitidus, nitidus, lichen (Clic here for more details about this article) |
10/18. Vascular abnormalities in lichen aureus.Lichen aureus is an infrequently reported subset of the pigmented purpuric dermatoses. A review of the English literature suggests the golden to purple colored lesions are asymptomatic or mildly pruritic with no regression once established. A case report of a 56-year-old man with lichen aureus of the thighs is presented. This case is unusual in that the patient had persistent pain at the lesion site. Furthermore, increased capillary fragility and koebnerization were both demonstrated. Treatment of an asymptomatic urinary tract infection resulted in temporary subjective and objective improvement.- - - - - - - - - - ranking = 5keywords = lichen (Clic here for more details about this article) |
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