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Solitary violaceous plaque over the abdomen.

Sonthalia S, Khetan P, Sarkar R, Sharma S, Arora R - Indian J Dermatol (2015 Jan-Feb)

View Article: PubMed Central - PubMed

Affiliation: Skinnocence: The Skin Clinic, Gurgaon, Haryana, India.

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A 60-year-old man presented with a 2-year history of a single, nonpruritic, light-brown colored plaque over the lower abdomen... Histopathological features on hematoxylin and eosin (H and E) staining from a biopsy specimen are shown in Figures 2 and 3... Treatment with 0.05% clobetasol propionate cream twice-a-day for 3 weeks resulted in complete resolution with no recurrence till 6 months of follow-up... Solitary benign lichenoid keratosis (SBLK), first described in 1966 by Shapiro and Ackerman as ‘lichen planus-like keratosis’ (LPLK) and by Lumpkin and Helwig as ‘solitary lichen planus’, consists of a nonpruritic papule or slightly indurated plaque predominantly occurring in adults (between the 5 and 7 decade), with female preponderance... The most important differentials include lichen planus (LP), lichenoid actinic keratosis (LAK), seborrheic keratosis (SK), lupus erythematosus, regressing melanocytic lesions, basal cell carcinoma, and Bowen's disease... Histopathological differentiation from LP is not straightforward, because LPLK also shows epidermal acanthosis, lichenoid infiltrate at the dermoepidermal junction, and colloid bodies... Though many authors consider it to represent a lymphocyte-mediated regression of a preexisting solar lentigo, an end-stage evolution of a reticulated SK, or even other suspected precursor lesions like warts or actinic keratosis; recent detailed histological and immmunohistochemical staining-based studies have doubted this concept and suggest it to be a specific disorder... Though it is known that SBLK tends to regress spontaneously, treatment with potent topical steroids results in early resolution... Prophylactic surgical removal and submission of the entire specimen for histopathology is recommended if a malignant melanocytic lesion is suspected... SBLK or LPLK is clinically characterized by a solitary (sometimes multiple) violaceous to brownish plaque(s) predominantly affecting adults with female preponderance It may represent the end-stage evolution of a reticulated SK or regression of a preexisting solar lentigo-specific disorder, but may be a specific disorder in itself Differentiation from LP and LAK is difficult due to overlapping clinical and histopathological features... Presence of focal parakeratosis favors its diagnosis, but not in all cases Dermoscopic features of pigmented granular pattern are helpful in diagnosis Spontaneous resolution is well-known, though topical steroids also induce resolution... Surgical excision is ideal for any suspicious lesion.

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Dense lymphohistiocytic inflammation at dermoepidermal junction with numerous melanophages in the upper dermis. Vacuolar degeneration of basal layer and colloid bodies (arrow) are also visible (H and E, ×400)
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Figure 3: Dense lymphohistiocytic inflammation at dermoepidermal junction with numerous melanophages in the upper dermis. Vacuolar degeneration of basal layer and colloid bodies (arrow) are also visible (H and E, ×400)

Mentions: A 60-year-old man presented with a 2-year history of a single, nonpruritic, light-brown colored plaque over the lower abdomen. There was no history of similar eruption in the past, prior drug intake, trauma, or insect bite. Past medical and family history was noncontributory. Dermatologic examination revealed a solitary, oval-shaped, 3 × 4 cm sized sharply-demarcated annular plaque over the lower right side of anterior abdomen. The plaque was violaceous to brown-colored in the center with raised erythematous borders [Figure 1]. The surface had a wrinkled appearance with mild scaling. On palpation, it was mildly indurated with intact sensations. Examination of the mucosae and rest of the physical examination were normal. Histopathological features on hematoxylin and eosin (H and E) staining from a biopsy specimen are shown in Figures 2 and 3. Treatment with 0.05% clobetasol propionate cream twice-a-day for 3 weeks resulted in complete resolution with no recurrence till 6 months of follow-up.


Solitary violaceous plaque over the abdomen.

Sonthalia S, Khetan P, Sarkar R, Sharma S, Arora R - Indian J Dermatol (2015 Jan-Feb)

Dense lymphohistiocytic inflammation at dermoepidermal junction with numerous melanophages in the upper dermis. Vacuolar degeneration of basal layer and colloid bodies (arrow) are also visible (H and E, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318055&req=5

Figure 3: Dense lymphohistiocytic inflammation at dermoepidermal junction with numerous melanophages in the upper dermis. Vacuolar degeneration of basal layer and colloid bodies (arrow) are also visible (H and E, ×400)
Mentions: A 60-year-old man presented with a 2-year history of a single, nonpruritic, light-brown colored plaque over the lower abdomen. There was no history of similar eruption in the past, prior drug intake, trauma, or insect bite. Past medical and family history was noncontributory. Dermatologic examination revealed a solitary, oval-shaped, 3 × 4 cm sized sharply-demarcated annular plaque over the lower right side of anterior abdomen. The plaque was violaceous to brown-colored in the center with raised erythematous borders [Figure 1]. The surface had a wrinkled appearance with mild scaling. On palpation, it was mildly indurated with intact sensations. Examination of the mucosae and rest of the physical examination were normal. Histopathological features on hematoxylin and eosin (H and E) staining from a biopsy specimen are shown in Figures 2 and 3. Treatment with 0.05% clobetasol propionate cream twice-a-day for 3 weeks resulted in complete resolution with no recurrence till 6 months of follow-up.

View Article: PubMed Central - PubMed

Affiliation: Skinnocence: The Skin Clinic, Gurgaon, Haryana, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

A 60-year-old man presented with a 2-year history of a single, nonpruritic, light-brown colored plaque over the lower abdomen... Histopathological features on hematoxylin and eosin (H and E) staining from a biopsy specimen are shown in Figures 2 and 3... Treatment with 0.05% clobetasol propionate cream twice-a-day for 3 weeks resulted in complete resolution with no recurrence till 6 months of follow-up... Solitary benign lichenoid keratosis (SBLK), first described in 1966 by Shapiro and Ackerman as ‘lichen planus-like keratosis’ (LPLK) and by Lumpkin and Helwig as ‘solitary lichen planus’, consists of a nonpruritic papule or slightly indurated plaque predominantly occurring in adults (between the 5 and 7 decade), with female preponderance... The most important differentials include lichen planus (LP), lichenoid actinic keratosis (LAK), seborrheic keratosis (SK), lupus erythematosus, regressing melanocytic lesions, basal cell carcinoma, and Bowen's disease... Histopathological differentiation from LP is not straightforward, because LPLK also shows epidermal acanthosis, lichenoid infiltrate at the dermoepidermal junction, and colloid bodies... Though many authors consider it to represent a lymphocyte-mediated regression of a preexisting solar lentigo, an end-stage evolution of a reticulated SK, or even other suspected precursor lesions like warts or actinic keratosis; recent detailed histological and immmunohistochemical staining-based studies have doubted this concept and suggest it to be a specific disorder... Though it is known that SBLK tends to regress spontaneously, treatment with potent topical steroids results in early resolution... Prophylactic surgical removal and submission of the entire specimen for histopathology is recommended if a malignant melanocytic lesion is suspected... SBLK or LPLK is clinically characterized by a solitary (sometimes multiple) violaceous to brownish plaque(s) predominantly affecting adults with female preponderance It may represent the end-stage evolution of a reticulated SK or regression of a preexisting solar lentigo-specific disorder, but may be a specific disorder in itself Differentiation from LP and LAK is difficult due to overlapping clinical and histopathological features... Presence of focal parakeratosis favors its diagnosis, but not in all cases Dermoscopic features of pigmented granular pattern are helpful in diagnosis Spontaneous resolution is well-known, though topical steroids also induce resolution... Surgical excision is ideal for any suspicious lesion.

No MeSH data available.


Related in: MedlinePlus