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Extra genital lichen sclerosus et atrophicus with cutaneous distribution and morphology simulating lichen planus.

Patel B, Gupta R, Vora VR - Indian J Dermatol (2015 Jan-Feb)

Bottom Line: LP and LSA share similar clinical and pathological features.There have been a few reported cases in the literature of the coexistence of LP and LSA.We reported a case of 39-years-old female having LSA with cutaneous distribution and morphologically simulating LP.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and VD, Pramukhswami Medical College, Karamsad, Gujarat, India.

ABSTRACT
Lichen sclerosus et atrophicus (LSA) also known as Csillag's disease, characterized by small, porcelain white, sclerotic areas occur at any site on the skin including mucosa. There is strong association of autoimmune disorders with LSA. Lichen planus (LP) is an inflammatory, papulosquamous disorder characterized by erythematous to violaceous, flat topped, polygonal, pruritic papules distributed mainly on flexural aspects like wrist, around ankles, lumbar region, trunk and neck and also involves mucous membranes, hair, and nail. LP and LSA share similar clinical and pathological features. There have been a few reported cases in the literature of the coexistence of LP and LSA. We reported a case of 39-years-old female having LSA with cutaneous distribution and morphologically simulating LP.

No MeSH data available.


Related in: MedlinePlus

Violaceous to hyperpigmented maculo-papular lesions over both the thigh region
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Figure 2: Violaceous to hyperpigmented maculo-papular lesions over both the thigh region

Mentions: A 39-years-old female presented with multiple bilateral symmetrical lesions over extremities, thighs and buttocks since 5 months. Lesions started from lower legs then gradually progressed to involve flexural aspect of forearm, thighs and buttocks. On examination, there were multiple discrete bilateral symmetrical violaceous to hyperpigmented maculo-papular lesions over the above mentioned sites [Figures 1 and 2]. Skin lesions were associated with itching. There was no involvement of the oral and genital mucosa. No evident koebnerization was seen at trauma sites. Skin biopsy was not taken initially because of typical morphology of LP. Clinical diagnosis of lichen planus was made and she was treated with topical application of moderate potent steroid. Within 1 month of treatment new hypo to depigmented macular lesions developed over both dorsum of feet, around ankle, and lower legs [Figure 3]. Wood's lamp examination from the lesions did not show any accentuation. Differential diagnosis LSA, idiopathic guttate hypomelanosis, and pre-vitiligo were kept and skin biopsies were taken from both hyperpigmented as well as hypopigmented lesions. Both biopsy showed an atrophic epidermis, homogenization of the upper dermis and a mid-dermal lymphocytic infiltrate, with flattening of rete ridges which was consistent with lichen sclerosus et atrophicus [Figures 4 and 5].


Extra genital lichen sclerosus et atrophicus with cutaneous distribution and morphology simulating lichen planus.

Patel B, Gupta R, Vora VR - Indian J Dermatol (2015 Jan-Feb)

Violaceous to hyperpigmented maculo-papular lesions over both the thigh region
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318040&req=5

Figure 2: Violaceous to hyperpigmented maculo-papular lesions over both the thigh region
Mentions: A 39-years-old female presented with multiple bilateral symmetrical lesions over extremities, thighs and buttocks since 5 months. Lesions started from lower legs then gradually progressed to involve flexural aspect of forearm, thighs and buttocks. On examination, there were multiple discrete bilateral symmetrical violaceous to hyperpigmented maculo-papular lesions over the above mentioned sites [Figures 1 and 2]. Skin lesions were associated with itching. There was no involvement of the oral and genital mucosa. No evident koebnerization was seen at trauma sites. Skin biopsy was not taken initially because of typical morphology of LP. Clinical diagnosis of lichen planus was made and she was treated with topical application of moderate potent steroid. Within 1 month of treatment new hypo to depigmented macular lesions developed over both dorsum of feet, around ankle, and lower legs [Figure 3]. Wood's lamp examination from the lesions did not show any accentuation. Differential diagnosis LSA, idiopathic guttate hypomelanosis, and pre-vitiligo were kept and skin biopsies were taken from both hyperpigmented as well as hypopigmented lesions. Both biopsy showed an atrophic epidermis, homogenization of the upper dermis and a mid-dermal lymphocytic infiltrate, with flattening of rete ridges which was consistent with lichen sclerosus et atrophicus [Figures 4 and 5].

Bottom Line: LP and LSA share similar clinical and pathological features.There have been a few reported cases in the literature of the coexistence of LP and LSA.We reported a case of 39-years-old female having LSA with cutaneous distribution and morphologically simulating LP.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and VD, Pramukhswami Medical College, Karamsad, Gujarat, India.

ABSTRACT
Lichen sclerosus et atrophicus (LSA) also known as Csillag's disease, characterized by small, porcelain white, sclerotic areas occur at any site on the skin including mucosa. There is strong association of autoimmune disorders with LSA. Lichen planus (LP) is an inflammatory, papulosquamous disorder characterized by erythematous to violaceous, flat topped, polygonal, pruritic papules distributed mainly on flexural aspects like wrist, around ankles, lumbar region, trunk and neck and also involves mucous membranes, hair, and nail. LP and LSA share similar clinical and pathological features. There have been a few reported cases in the literature of the coexistence of LP and LSA. We reported a case of 39-years-old female having LSA with cutaneous distribution and morphologically simulating LP.

No MeSH data available.


Related in: MedlinePlus