Successful removal of hyperkeratotic-lichenoid reaction to red ink tattoo with preservation of the whole tattoo using a skin grafting knife.

With the increasing popularity of tattoo body decorations, reports of medical complications with tattoos have increased in parallel. Although tattoo reactions can resolve spontaneously, they often last for months or even years, despite the various treatment methods. In our case, we present the successful removal of hyperkeratotic-lichenoid reaction to red ink using a simple and cheap skin grafting knife. The entire tattoo was preserved with a good aesthetic result with minimal scarring.

Pseudolymphomatous and lichenoid reaction to a red tattoo: a case report.

A pseudolymphomatous reaction is an unusual immune response that can be caused by a tattoo, most commonly by red ink. We present the case of a 40-year-old woman with discolored and pruritic plaques in the areas of red ink tattooed on her right ankle that developed shortly after tattoo application. The patient had 2 other tattoos with red ink for more than 20 years without any disfigurement. Histopathology, immunohistochemistry, and polymerase chain reaction analysis from biopsy of the affected area showed polyclonal pseudolymphomatous and lichenoid reaction, confirming the diagnosis of pseudolymphoma secondary to a tattoo. Total excision of the lesion was performed.

Successful treatment of scleromyxedema with autologous peripheral blood stem cell transplantation.

BACKGROUND: Scleromyxedema is a rare chronic fibromucinous disorder that can have devastating clinical manifestations, including sclerosis of the skin with progressive pharyngeal and upper airway involvement, resulting in high mortality due to respiratory complications. Herein we describe a novel therapeutic approach. Because autologous hematopoietic stem cell transplantation is effective in other plasma cell proliferative disorders, it may be effective in this setting. OBSERVATIONS: We retrospectively evaluated 6 patients who were offered high-dose chemotherapy with stem cell rescue as treatment for scleromyxedema. One heavily pretreated patient was unable to mobilize stem cells. The remaining 5 patients mobilized stem cells and underwent successful transplantation. There was no treatment-related mortality. Hematologic responses were seen in 4 patients, including 2 complete remissions and 2 partial remissions, and all 4 had improvement in extracutaneous manifestations. All 4 patients subsequently had relapse of the monoclonal protein, and 3 developed skin relapses at 14, 37, and 45 months. CONCLUSIONS: High-dose chemotherapy with stem cell rescue is feasible for patients with scleromyxedema and, although not curative, offers durable remission in most patients. This therapy should be considered before treatment with alkylating agents or other treatments that could adversely affect the ability to collect stem cells.

Liquen «nitidus» / Lichen nitidus

El liquen nitidus es una erupción liquenoide que se manifiesta en forma de pápulas brillantes de pequeño tamaño, del color de la piel normal, con carácter asintomático, de forma localizada o generalizada. La confirmación se realiza mediante estudio histopatológico, que presenta un infiltrado linfohistiocitario en dermis superficial con crestas interpapilares elongadas en los bordes abarcando dicho infiltrado. Por su tendencia a la resolución espontánea y la ausencia de síntomas, generalmente no precisa tratamiento

Lichen nitidus is a lichenoid eruption characterized by small, shiny, skin-colored papules. It is asymptomatic and can be localized or generalized. The diagnosis is confirmed by means of histopathological study, which reveals the presence of a lymphohistiocytic infiltrate in the superficial dermis, with elongated interpapillary crests on the borders encircling the infiltrate. Given that it tends to resolve spontaneously and the absence of symptoms, it generally does not require treatment

Localized longitudinal erythronychia: diagnostic significance and physical explanation.

BACKGROUND: Longitudinal erythronychia (LE) is a term for red streaks in the nail. We describe the range of diseases manifested by localized (single or bifid) LE and explain the underlying physical changes. OBSERVATIONS: Longitudinal erythronychia can be multiple or localized. Multiple lesions typically indicate an inflammatory disease such as lichen planus. When localized, they may be a single or bifid streak arising through a benign or malignant neoplasm, scarring of the dermis or epidermis, or the first stage of an inflammatory process that may evolve into multiple LE. Excision of a localized LE may provide a diagnosis and cure. Incisional matrix biopsy of multiple LE may provide a diagnosis. Clinical manifestation of LE arises through reduced compression of the nail bed due to loss of bulk of the nail plate with a groove on the undersurface. A streak of thinned nail then allows an enhanced view of a corresponding streak of engorged nail bed. The reduction in nail thickness renders it more fragile with a tendency to split distally. CONCLUSIONS: Understanding LE can assist in diagnosis and explanation to the patient. Localized LE may represent a focal tumor or dysplastic process.

Erbium:Yag laser therapy of lichenoid red tattoo reaction.

Delayed reactions caused by red tattoo pigments are often difficult to treat. We report a 31-year-old female patient with a lichenoid reaction to a red tattoo on the right ankle who was successfully treated with five sessions of a surgical Erbium:Yag laser, using several passes in each session. Our work leads us to consider that Er:Yag laser therapy may be an effective and safe treatment for these therapeutically challenging reactions.

The treatment of lichen amyloidosis. A review and a new technique.

BACKGROUND: A number of treatments for lichen amyloidosis have been described and the results are frequently unsatisfactory. OBJECTIVE: To describe a new surgical technique that uses a scalpel to scrape the upper layer of the skin. METHODS: A scalpel (No. 15) is pressed firmly and perpendicularly against the skin and scraped exactly parallel with the surface of the skin. This can be repeated until the subpapillary dermal layer. RESULTS: Scraping with the scalpel removes the epidermis and deposits of amyloid in the dermis. All nine patients healed without complications with acceptable to good aesthetic results. CONCLUSION: The technique is quick, effective, simple to perform, inexpensive, and safe. This is another option in the surgical treatment of selected cases of lichen amyloidosis.

Lichen sclerosus et atrophicus causing phimosis in boys: a prospective study with 5-year followup after complete circumcision.

We prospectively investigated 100 pediatric patients suffering from phimosis and found a 10% incidence of lichen sclerosus et atrophicus. This condition usually can be diagnosed preoperatively because of its classic manifestation of severe phimosis due to a sclerotic, whitish ring at the tip of the prepuce, which in our cases was accompanied by sclerogenous glanular lesions. To our knowledge our study represents the first evidence that the development of secondary phimosis with no apparent reason in school-age boys is highly suggestive for lichen sclerosus et atrophicus. Complete circumcision is the therapy of choice because it completely removes all affected tissue and it allows spontaneous regression or resolution of glanular lesions. There has been no recurrence after 5 years of followup.

Carbon dioxide laser treatment of lichen sclerosus et atrophicus.

We followed 62 men treated with the carbon dioxide laser for lichen sclerosus et atrophicus for an average of 30 months (3 months to 7 years). Of the patients 47 (76%) became asymptomatic and 10 (16%) had minor residual symptoms. In 26 patients (40%) concomitant superficial meatal stenosis was simultaneously treated with laser meatotomy. The cosmetic and functional results of treatment were highly encouraging. Provided that radicality is achieved at the primary application, the carbon dioxide laser is an excellent therapeutic modality for lichen sclerosus et atrophicus.