Liquen plano linealblashkoide, reporte de 2 casos / Linear lichen planus along the lines of Blaschko, report of 2 cases

RESUMEN El liquen plano es una dermatosis inflamatoria autolimitada, de etiología desconocida, relativamente común. Existen múltiples variedades clínicas,que se basan en la disposición, morfología y localización de las lesiones, siendo el liquen plano lineal a lo largo de las líneas de Blaschko una presentación de distribución rara. Se presentan dos casos en pacientes de sexo masculino de 22 y 21 años de edad, con confirmación histológica y buena respuesta clínica al tratamiento tópico.

SUMMARY Lichen planus is a self-limited inflammatory dermatosis, relatively common, with a unknown cause. There are multiple clinical varieties, based on the disposition, morphology and location of the lesions, being the linear lichen planar along the lines of Blaschko a rare distribution presentation. We report two cases in male patients of 22 and 21 years of age, with histological confirmation and a good clinical response to topical treatment.

Liquen plano blaschkoide facial como expresión de mosaicismo cutáneo, a propósito de un caso / Lichen planus blaschkoide facial as expression of cutaneous mosaicism, on a case by case

El liquen plano es un trastorno inflamatorio adquirido de etiología desconocida que, excepcionalmente, puede presentarse de forma lineal, debido a la predisposición genética de un clon que se produce durante el desarrollo embrionario. El liquen plano lineal o Blaschkoide de localización facial, es aún más infrecuente, y traduce una mutación genética postcigótica, que así como en otras patologías inflamatorias dermatológicas, aumenta la susceptibilidad de los individuos a desarrollarla.

Lichen planus is an acquired inflammatory disorder of unknown etiology that in exceptional cases can occur linearly. This is due to the genetic predisposition of a clone that occurs during embryonic development. Facial localization of the lichen planus is even more infrequent, and translates to a postcigotic genetic mutation. This mutation increases individual susceptibility, just as in other dermatological inflammatory pathologies.

Linear Lichen Planus in Hypereosinophilic Syndrome / 대한피부과학회지

Hypereosinophilic syndrome (HES) is characterized by chronically increased peripheral blood eosinophil levels and organ damages related to eosinophilic infiltration. Cutaneous manifestations are common (>50%) and non-specific. It is generally manifested as erythematous pruritic eczema. Linear lichen planus has not been reported in HES. A 35-year-old woman was presented with linear brownish papules and plaques on her left arm. She had been diagnosed with HES three years earlier. Initially, the skin lesions were manifested as linear pruritic erythematous plaques, but they gradually transformed into shiny brownish plaques. Skin biopsy specimens showed irregular acanthosis of the epidermis and band-like infiltrations of lymphocytes and eosinophils with necrotic keratinocytes in the papillary dermis. We proposed that the eosinophil infiltration was caused by HES, and that the patient's histological and clinical manifestations should account for linear lichen planus.

Treatment of Linear Lichen Planus with Oral Methylprednisolone / 대한피부과학회지

BACKGROUND: Lichen planus is a chronic papulosquamous disease characterized by various clinical manifestations of the skin, mucosa, hair, and nails. Various drugs or physical treatments for lichen planus have been proposed, but the efficacies are often disappointing and controversial. Linear lichen planus is a rare variant of lichen planus, which accounts for 0.2~0.6% of all patients with lichen planus. Systemic corticosteroids remain the most widely used treatment for lichen planus. However, there have been no clinical studies on the effectiveness of this therapy on linear lichen planus despite the fact that linear lichen planus usually lasts for more than 1 year and occasionally results in cosmetic problems. OBJECTIVE: This study evaluated the efficacy and safety of oral methylprednisolone therapy for linear lichen planus. METHODS: Retrospective study was performed by reviewing the medical records and clinical photographs of 12 linear lichen planus patients treated with oral methylprednisolone. The analyses of treatment response to oral methylprednisolone therapy, adverse effects, and recurrence were performed. RESULTS: All the 12 patients who completed the oral methylprednisolone therapy achieved complete response. Most patients showed a marked improvement 1 to 2 weeks after starting oral methylprednisolone therapy. Three of the 12 patients showed recurrence at 9 to 14 weeks after cessation of the treatment. Oral methylprednisolone therapy was generally well-tolerated and no serious adverse effects were observed. CONCLUSION: Oral methylprednisolone therapy is an efficacious, safe, and tolerable treatment modality for linear lichen planus.

A Case of Adult-onset Lichen Striatus / 대한피부과학회지

Lichen striatus and linear lichen planus are rare disorders that can be confused because they share similar clinical and histopathologic findings. We report a case of lichen striatus on the left wrist and fingers in a 54-year-old woman, who was initially diagnosed with linear lichen planus. She had overlapping clinico-histopathologic features of both lichen striatus and linear lichen planus. To discriminate between the two disorders, careful histological and clinical evaluations are needed, especially when a lichen striatus-like eruption occurs in adults.

A Case of Linear Lichen Planus Associated with Cicatrical Alopecia and Vitiligo / 대한피부과학회지

Lichen planus is a papulosquamous disorder that has numerous clinical variants. Linear lichen-planus (LLP), a variant of lichen planus, consists of itchy linearly distributed, violaceous papules on the extremities. In lichen planopilaris (LPP), involvement of the hair follicles can induce a form of cicatrical alopecia. Half of the LPP cases have or develop characteristic skin or mucosal involvement of lichen planus. Vitiligo is a chronic disorder characterized by a marked absence of melanocytes and melanin in the epidermis. The coexistence of vitiligo and lichen planus is rare. However, this association is of interest because a cell-mediated immune reaction is thought to play a central role in the pathogenesis of both diseases. We report on a 32-year-old woman affected with LLP, accompanied by cicatrical alopecia and vitiligo.

A Case of Multiple Linear Lichen Planus along the Lines of Blaschko / 대한피부과학회지

Linear lichen planus (LLP) is a rare variant found in only 0.24~0.62% of all lichen planus patients. It is mostly located on the extremities and found more often in children than adults. It has been reported that LLP lesions usually occur in solitary strips, but they occasionally occur on different segments of skin or in multiple lines, which are zosteriform in distribution or follow the lines of Blaschko. LLP following Blaschko's line is extremely rare and, in most cases, the linear streaks are solitary. We present a case of multiple linear lichen planus along the lines of Blaschko in a 15-year-old female.

A Case of Multiple Linear Lichen Planus along the Lines of Blaschko / 대한피부과학회지

Linear lichen planus (LLP) is a rare variant of lichen planus, which accounts for 0.24-0.62% of all patients with lichen planus. Blaschko lines are the pattern assumed by many different nevoid and acquired skin diseases on the human skin, which present with a characteristic S-shape on the abdomen, a V-shape near the posterior midline, a linear pattern on the lower trunk and limbs, and whorls on the scalp and abdomen. Multiple LLP along the lines of Blaschko has been rarely reported. Differential diagnosis of LLP includes lichen striatus, epidermal nevi, linear psoriasis, inflammatory linear verrucous epidermal nevus (ILVEN), linear Darier disease, linear lupus erythematosus, and linear lichen nitidus. We herein describe a 49-year-old female who showed multiple linear erythematous, brownish papules on her right trunk, shoulder, arm, and groin with typical histopathologic findings of lichen planus.

A Case of Linear Lichen Planus / 대한피부과학회지

Linear lichen planus, a rare variant of lichen planus, accounts for 0.24-0.62% of all patients with lichen planus. Clinically, it consists of itchy linear-distributed violaceous papules, usually last for more than 1 year and the mucous membranes may also be affected. This disorder shows the same histologic findings of lichen planus, which is characterized by a band-like dermal inflammatory infiltration with hyperkeratosis, focal hypergranulosis, acanthosis, exocytosis and the presence of Civatte body. We report a 46-year-old woman showing typical clinical and histological features of linear lichen planus without pruritus.

Histopathologic Evaluation of Linear Lichen Planus and Lichen Striatus

BACKGROUND: Linear lichen planus (LLP) and Lichen striatus (LS) are rare disorder that can be confused because they can share similar clinical and histopathologic features. OBJECTIVE: The purpose of this study was to evaluate the characteristic differences and common features between the two disorders histopathologically. METHODS: We reviewed the clinical records of patients who had been diagnosed as LLP or LS in our dermatology clinic during the 15-year period between 1985 and 1999. We classified twenty seven cases, which were differentiated from other possible linear dermatoses, into LLP and LS on the basis of clinical features, and then compared them histopathologically, and appreciated the characteristic differences or common features of the two disorders. RESULTS: In cases diagnosed as LLP clinically, epidermal changes were mainly composed of hyperkeratosis (78%), acanthosis (78%), basal degeneration (78%), granular layer thickening (67%) and saw-toothed appearance of rete ridges (44%). In dermis, colloid bodies (78%), band-like inflammatory cell infiltration with pigmentary incontinence (78%) were strik-,ting findings. In cases with clinical features of LS, parakeratosis (50%), dyskeratotic cells scattered in the epidermis (61%) and intercellular edema (39%) were noted in the epidermis. Dermal cellular deposits were focally band-like infiltration(89%), more frequently perivascular in-filtration (83%) and often involved deep dermis (50%), hair follicles (44%) and eccrine glands (22%) in contrast to LLP. CONCLUSION: This study presents a comparative histopathologic features of LLP and LS. Three cases of LLP with overlapping histopathologic features suggest the possibility that there may be an intermediate form between either end of a spectrum, LLP and LS.