Evaluation of linear dermatoses by reflectance confocal microscopy in children.

Lichen striatus (LS), linear psoriasis (LPs), linear cutaneous lupus erythematosus (LCLE) and linear lichen planus (LLP) often have similar clinical manifestations, which makes clinical diagnosis with the naked eye difficult; therefore, they are easily misdiagnosed. The purpose of this study was to determine whether reflectance confocal microscopy (RCM) is helpful in differentiating between these four linear dermatoses in children. This retrospective study included 14 patients with LS, nine with LPs, eight with LCLE and 12 with LLP. All patients were analysed using RCM, and biopsies were collected from lesions previously imaged by RCM. For LS, the dermal papillary rings were partially absent, but when present, manifested with small, homogeneously round, bright cells and occasionally highly refractive plump cellular structures, aggregated in clusters. LPs exhibited dark cyst-like structures with small, bright, round cells aggregated at the epidermal level; at the dermal-epidermal junction, homogeneously distributed, enlarged, faint dermal papillary rings and numerous enlarged low-refractive canalicular structures were observed in the superficial dermis. LCLE and LLP exhibited similar manifestations, including epidermal disarray, almost total absence of dermal papillary rings, and various sized refractive structures densely distributed in the dermis. The key distinguishing features of LCLE were the different sized structures mainly clustered around hair follicles, while LLP demonstrated dense structures with a scattered distribution. RCM may be used to distinguish between the key features of LS, LPs, LCLE and LLP in children.

Two Cases of Linear Lichen Planus Pigmentosus of the Chin in Korean Women Treated by Fractional Lasers and Polydeoxyribonucleotide Injection.

Linear lichen planus pigmentosus is a rare subtype of lichen planus pigmentosus that follows Blaschko's lines, leaving long-standing residual atrophy and pigmentation, especially in dark-skinned populations. Conventional treatments have several limitations regarding the alleviation of pigmentation and atrophy. We report two cases of Korean women with linear lichen planus pigmentosus on their faces who were successfully treated with fractional lasers and intralesional injection of polydeoxyribonucleotide.

A Case of Unilateral Blaschko-Linear Lichen Planus Pigmentosus in a Seven-Year-Old Female: A Rare Presentation.

Lichen planus pigmentosus (LPP) is a rare form of lichen planus that typically affects middle-aged people with darker-pigmented skin. LPP is associated with a longer clinical course than classical lichen planus, which distinguishes it clinically. Its occurrence in children is uncommon, with few reported cases in this population in the literature. We report a rare presentation of unilateral blaschkoid LPP in a seven-year-old Saudi Arabian female patient.

Blaschko-Linear Lichen Planus Pigmentosus: An Unusual Presentation.

Lichen planus pigmentosus (LPP), an uncommon variant of lichen planus (LP), is characterized by diffuse hyperpigmented dark brown macules in sun-exposed areas. We report an unusual case of LPP with a blaschkoid distribution in an area of radiotherapy for breast cancer. This description is rarely reported. Its pathogeny is poorly understood and suggests an embryological origin by genetic mosaicism and also discusses the immunomodulatory role of radiotherapy in the disease.

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.

Adult-onset lichen striatus versus adult blaschkitis: a clinicopathological review of 40 cases of acquired blaschkolinear inflammatory dermatosis.

BACKGROUND: Since the first description of adult blaschkitis (AB), the existence of this entity has been a matter of great debate. OBJECTIVES: To compare clinicopathological features of lichen striatus (LS) and AB cases. MATERIALS AND METHODS: We retrospectively reviewed the clinicopathological features of patients who clinically showed linear inflammatory dermatosis along Blaschko's lines based on a skin biopsy registry. RESULTS: Through a process of clinicopathological differential diagnosis, 27 cases of LS, three of AB, eight of linear lichen planus, and two of linear psoriasis were identified. Clinicopathological differences between LS and AB were mostly insignificant except for age at onset and multiple site involvement. In these cases, females were affected more frequently than males. The mean age at onset was 31.6 years, and the most common involved site was the leg. The lesions lasted approximately 8.3 months with few relapses. The most common histopathological finding was perivascular infiltration followed by peri-appendageal infiltration. CONCLUSION: Distinction between LS and AB appears to be unnecessary given their overlapping features.

Coexistence of Linear and Inversus Variants of Lichen Planus Pigmentosus: A Rare Occurrence.

Lichen planus pigmentosus (LPP) is a rare disorder affecting primarily the people with ethnic skin. It results in hyperpigmentation of sun-exposed sites along with the involvement of flexures. In accordance with clinical patterns, different variants such as diffuse, blotchy, reticulate, and perifollicular have been described. Rare variants such as flexural (inversus), mucosal, linear, and zosteriform have been reported scarcely. Inversus LPP refers to the involvement of major flexures such as inframammary area, axillae, and groins in the absence of involvement of photo-exposed sites. We present an unusual case presenting with coexisting linear and inversus variants of LPP.

Linear Lichen Planus: Continuum From Skin to Mucosa.

Lichen planus (LP) is a chronic inflammatory disorder that most commonly affects middle-aged individuals. LP involves the skin and/or mucous membranes, including oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. Linear LP, a rare distinct variant of LP, is characterised by pruritic eruption of lichenoid and violaceous papules in a linear distribution. We report an unusual presentation of linear LP in a 14-year-old child that extended from the left anterior nares to upper lip and into the oral mucosa up to the upper gum margin.

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 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 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 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.