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Merio L, Tounkara TM, Battesti G, Cordoliani F, Arsouze A, Bagot M, Battistella M, Petit A. Blaschko-linear lichen planus of the face: A retrospective study of 6 cases and a literature review. Ann Dermatol Venereol 2021; 149:112-118. [PMID: 34538651 DOI: 10.1016/j.annder.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/07/2021] [Accepted: 08/02/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND METHODS Different clinical and histological variants of lichen planus (LP) exist, such as lichen planopilaris, pigmentosus, linear, or atrophic LP. Recently, some cases came to our attention of hyperpigmented and atrophic linear lesions of the face with lichenoid histology, suggesting a combination of these different variants. We carried out a single-center, retrospective descriptive study of 6 similar cases selected from our database and compared them with a literature review. RESULTS There were 4 males and 2 females of mean age 42 years. Each had linear lesions located on one side of the face. All lesions were initially itchy; they appeared hyperpigmented in all patients and atrophic in 5 cases. Biopsies indicated lichen planopilaris in 5 patients, with deep peri-eccrine involvement in 4 of them. Only 2 of the 6 patients had extra-facial lesions. DISCUSSION AND LITERATURE REVIEW We found 24 cases in the literature having similar clinical and histological aspects. Men aged around 37 years seemed particularly affected. An atrophic course was noticed in 10 patients. Such a clinicopathological picture may suggest differential diagnoses like lichen striatus, lupus erythematosus, lichen sclerosus atrophicus, or Moulin's linear atrophoderma. Early histopathological examination could be of precious assistance in allowing the initiation of effective treatment immediately as of the initial inflammatory phase, thereby limiting the risk of cosmetic sequelae such as atrophy or residual pigmentation. CONCLUSION We describe a form of facial lichen planus that is highly particular in terms of its follicular tropism, its blaschkoid distribution, its pigmented character, and its atrophic progression.
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Affiliation(s)
- L Merio
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - T-M Tounkara
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France; Gamal-Abdel-Nasser University of Conakry, Conakry, Guinea
| | - G Battesti
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - F Cordoliani
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - A Arsouze
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - M Bagot
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - M Battistella
- Department of Pathology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - A Petit
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
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Turegano MM, Sperling LC. Lichenoid folliculitis: A unifying concept. J Cutan Pathol 2017; 44:647-654. [PMID: 28345255 DOI: 10.1111/cup.12938] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/13/2017] [Accepted: 03/21/2017] [Indexed: 12/19/2022]
Abstract
Skin diseases presenting with keratotic papules, atrophy, cicatricial alopecia and/or "lichenoid" histopathologic changes have been described under at least 30 names. This family of diseases contains 2 subgroups, largely based on clinical features: keratosis pilaris atrophicans (KPA; including keratosis pilaris atrophicans faciei/ulerythema ophryogenes, atrophoderma vermiculatum, and keratosis follicularis spinulosa decalvans); and the lichen planopilaris (LPP) subgroup (including LPP, frontal fibrosing alopecia, Graham-Little-Piccardi-Lassueur Syndrome and fibrosing alopecia in a pattern distribution). An interface dermatitis with lichenoid inflammation is characteristic of the LPP group of disorders, but the literature provides scant information about the histopathology of the KPA group. Our experience has been that the 2 subgroups show a unifying histologic similarity as well as considerable clinical overlap. Because these conditions overlap clinically and histologically, we propose that the term lichenoid folliculitis (LF) be used to refer to this group of diseases, thus simplifying cumbersome nomenclature and highlighting the possibility of shared pathogenesis and treatment options.
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Affiliation(s)
- Mamina M Turegano
- Department of Pathology and Laboratory Medicine, Division of Dermatopathology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Maryland
| | - Leonard C Sperling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Los Angeles, Maryland
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Bolduc C, Sperling LC, Shapiro J. Primary cicatricial alopecia: Lymphocytic primary cicatricial alopecias, including chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, and Graham-Little syndrome. J Am Acad Dermatol 2017; 75:1081-1099. [PMID: 27846944 DOI: 10.1016/j.jaad.2014.09.058] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 09/14/2014] [Accepted: 09/15/2014] [Indexed: 12/19/2022]
Abstract
Both primary and secondary forms of cicatricial alopecia have been described. The hair follicles are the specific target of inflammation in primary cicatricial alopecias. Hair follicles are destroyed randomly with surrounding structures in secondary cicatricial alopecia. This 2-part continuing medical education article will review primary cicatricial alopecias according to the working classification suggested by the North American Hair Research Society. In this classification, the different entities are classified into 3 different groups according to their prominent inflammatory infiltrate (ie, lymphocytic, neutrophilic, and mixed). Part I discusses the following lymphocytic primary cicatricial alopecias: chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, and Graham-Little syndrome.
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Affiliation(s)
- Chantal Bolduc
- Department of Dermatology, University of Montreal, Montreal, Quebec, Canada.
| | - Leonard C Sperling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Jerry Shapiro
- Department of Dermatology, University of British Columbia, Vancouver, British Columbia, Canada; Department of Dermatology, New York University, New York, New York
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Asz-Sigall D, González-de-Cossio-Hernández AC, Rodríguez-Lobato E, Ortega-Springall MF, Vega-Memije ME, Arenas Guzmán R. Linear Lichen Planopilaris of the Face: Case Report and Review. Skin Appendage Disord 2016; 2:72-75. [PMID: 27843930 DOI: 10.1159/000446967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/18/2016] [Indexed: 01/05/2023] Open
Abstract
We describe the case of a 45-year-old man who presented with a 5-month history of unilateral pruritic linear erythematous papules and atrophy on the chin and mandibular area. Dermoscopy showed areas of cicatricial alopecia with absence of follicular openings, perifollicular erythema and pigment. Lichen planopilaris of the face is a rare variant with only 13 cases reported in the literature.
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Affiliation(s)
- Daniel Asz-Sigall
- Dermato-Oncology and Trichology Clinic, National University of Mexico, México City, Mexico
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5
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Abstract
Background: Lichen planopilaris (LPP) is believed to be a follicular variant of lichen planus that affects pilosebaceous units, mainly of the scalp. An extremely rare variant of LPP is a linear form, which follows the lines of Blaschko. Of the five previously documented cases of linear LPP, all were limited to the face. Objective: We report the case of a 34-year-old male who presented with a nonpruritic eruption on the trunk consisting of erythematous, keratotic, folliculocentric papules following Blaschko's lines. Results: Biopsy revealed lichenoid and interface dermatitis involving the basilar epidermis and hair follicles, as well as apoptotic keratinocytes, consistent with LPP. Conclusion: This represents the first documented case of LPP, following the Blaschko's lines, in a nonfacial distribution.
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Affiliation(s)
- Kristi Baker
- Department of Pathology, Division of Dermatology, SMBD-Jewish General Hospital, McGill University, Montreal, QC
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Kluger N, Jegou MH, Assouly P. [Beard and moustache dermatosis and alopecia]. Ann Dermatol Venereol 2014; 141:624-32; quiz 623, 633. [PMID: 25288068 DOI: 10.1016/j.annder.2014.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/02/2014] [Accepted: 05/23/2014] [Indexed: 10/24/2022]
Affiliation(s)
- N Kluger
- Departments of dermatology, allergology and venereology, Institute of Clinical Medicine, University of Helsinki, Skin and Allergies Hospital, Helsinki University Central Hospital, Meilahdentie 2, PO Box 160, 00029 HUS, Finlande.
| | - M-H Jegou
- Cabinet de dermatologie, 8, rue Jules-Ferry, 33290 Blanquefort, France
| | - P Assouly
- Centre Sabouraud, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Tandon YK, Somani N, Cevasco NC, Bergfeld WF. A histologic review of 27 patients with lichen planopilaris. J Am Acad Dermatol 2008; 59:91-8. [DOI: 10.1016/j.jaad.2008.03.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 02/29/2008] [Accepted: 03/09/2008] [Indexed: 11/15/2022]
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Giménez-García R, Lázaro-Cantalejo TE, Sánchez-Ramón S, Velasco Fernandez C. Linear lichen planopilaris of the face. J Eur Acad Dermatol Venereol 2005; 19:770-2. [PMID: 16268895 DOI: 10.1111/j.1468-3083.2005.01260.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
We describe three adolescents with eruptive linear lesions of the back, abdomen, and extremities distributed along the lines of Blaschko. Clinically one of these lesions resembled an epidermal nevus in its morphology and distribution. A biopsy specimen demonstrated the typical histology of lichen planus (LP). There have been fewer than 20 reported cases of childhood linear LP. Our patients demonstrate that linear LP sometimes may closely resemble an epidermal nevus and may auger the onset of more generalized LP or more involvement along the lines of Blaschko, that is, "Blaschkoian" disease. Previous studies have referred to this variant as zosteriform. Our cases are the fourth, fifth, and sixth cases of childhood LP reported to occur along the lines of Blaschko. Based on the clinical findings in our patients and a review of the English-language literature, we believe that linear LP is usually distributed along the lines of Blaschko and should be renamed lichen planus, Blaschko subtype.
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Affiliation(s)
- Christina Kabbash
- Department of Dermatology, St Luke's-Roosevelt Hospital Center, New York, New York 10025, USA
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Abstract
The lines of Blaschko describe distribution patterns which may represent embryologic developmental pathways. This distribution may occasionally be followed by some congenital and acquired skin disorders. We describe a child with linear cutaneous lupus erythematosus (LCLE) following Blaschko lines on the face.
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Affiliation(s)
- M W Lee
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
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Affiliation(s)
- V N Sehgal
- Dermato-Venereology (Skin/VD) Centre, Sehgal Nursing Home, a/6 Panchwati, Opp, Azadpur, Subzi Mandi, Delhi 110 033, India.
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Affiliation(s)
- M J Gerritsen
- Department of Dermatology, University Hospital Nijmegen, The Netherlands
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13
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Abstract
The lines of Blaschko represent a pattern followed by many skin disorders. We review the clinical and histologic features of X-linked, congenital/nevoid, and acquired skin diseases that follow these lines. We also include cutaneous disorders that have a linear distribution but do not follow Blaschko's lines. Finally, we differentiate Blaschko's lines from other patterns on the skin such as dermatomes and Langer's lines.
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Affiliation(s)
- J L Bolognia
- Department of Dermatology, Yale University School of Medicine, New Haven, CT
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Taieb A, el Youbi A, Grosshans E, Maleville J. Lichen striatus: a Blaschko linear acquired inflammatory skin eruption. J Am Acad Dermatol 1991; 25:637-42. [PMID: 1791221 DOI: 10.1016/0190-9622(91)70245-w] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
An illustrative case report and a series of 18 well-documented cases of lichen striatus are presented. The mean age at diagnosis was 3 years (6 months to 14 years; median 2 years). The lesions were predominantly distributed on the trunk in 33% of cases and on the limbs in the remaining two thirds (upper limb: 48%; lower limb: 19%). Pruritus was noted in only 1 of 18 cases. Six cases were associated with clinical features of atopy and/or minor signs of atopic dermatitis (e.g., pityriasis alba). Two cases were considered to be clinically associated with lesions consistent with psoriasis. The mean duration was 9.5 months (4 weeks to 3 years; median 6 months). In one patient, two relapses occurred in 4 years. Hypochromic sequelae were noted in 50% of cases. Lichen striatus is the most common acquired self-limited linear eruption in childhood that follows Blaschko's lines. A new acronym is proposed to emphasize the developmental background of the disease: BLAISE for Blaschko linear acquired inflammatory skin eruption.
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Affiliation(s)
- A Taieb
- Hôpital des Enfants, Bordeaux, France
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