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Blicharz L, Czuwara J, Rudnicka L, Torrelo A. Autoinflammatory Keratinization Diseases-The Concept, Pathophysiology, and Clinical Implications. Clin Rev Allergy Immunol 2023; 65:377-402. [PMID: 38103162 PMCID: PMC10847199 DOI: 10.1007/s12016-023-08971-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 12/17/2023]
Abstract
Recent advances in medical genetics elucidated the background of diseases characterized by superficial dermal and epidermal inflammation with resultant aberrant keratosis. This led to introducing the term autoinflammatory keratinization diseases encompassing entities in which monogenic mutations cause spontaneous activation of the innate immunity and subsequent disruption of the keratinization process. Originally, autoinflammatory keratinization diseases were attributed to pathogenic variants of CARD14 (generalized pustular psoriasis with concomitant psoriasis vulgaris, palmoplantar pustulosis, type V pityriasis rubra pilaris), IL36RN (generalized pustular psoriasis without concomitant psoriasis vulgaris, impetigo herpetiformis, acrodermatitis continua of Hallopeau), NLRP1 (familial forms of keratosis lichenoides chronica), and genes of the mevalonate pathway, i.e., MVK, PMVK, MVD, and FDPS (porokeratosis). Since then, endotypes underlying novel entities matching the concept of autoinflammatory keratinization diseases have been discovered (mutations of JAK1, POMP, and EGFR). This review describes the concept and pathophysiology of autoinflammatory keratinization diseases and outlines the characteristic clinical features of the associated entities. Furthermore, a novel term for NLRP1-associated autoinflammatory disease with epithelial dyskeratosis (NADED) describing the spectrum of autoinflammatory keratinization diseases secondary to NLRP1 mutations is proposed.
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Affiliation(s)
- Leszek Blicharz
- Department of Dermatology, Medical University of Warsaw, 02-008, Warsaw, Poland
| | - Joanna Czuwara
- Department of Dermatology, Medical University of Warsaw, 02-008, Warsaw, Poland.
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, 02-008, Warsaw, Poland
| | - Antonio Torrelo
- Department of Dermatology, University Children's Hospital Niño Jesús, 28009, Madrid, Spain.
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2
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Ozturk A, Acar A, Yaman B, Karaarslan I. Keratosis Lichenoides Chronica (Nekam's Disease): Dermoscopic and in Vivo Reflectance Confocal Microscopy Findings. Dermatol Pract Concept 2023; 13:dpc.1304a232. [PMID: 37992370 PMCID: PMC10656124 DOI: 10.5826/dpc.1304a232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 11/24/2023] Open
Affiliation(s)
- Ayris Ozturk
- Department of Dermatology, Medical Faculty, Ege University, Izmir, Turkey
| | - Ayda Acar
- Department of Dermatology, Medical Faculty, Ege University, Izmir, Turkey
| | - Banu Yaman
- Department of Pathology, Medical Faculty, Ege University, Izmir, Turkey
| | - Isil Karaarslan
- Department of Dermatology, Medical Faculty, Ege University, Izmir, Turkey
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3
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Banjar TA, Abdulwahab RA, Al Hawsawi KA. Confluent and Reticulated Papillomatosis of Gougerot and Carteaud: A Case Report and Review of the Literature. Cureus 2022; 14:e24557. [PMID: 35651451 PMCID: PMC9138193 DOI: 10.7759/cureus.24557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Confluent and reticulated papillomatosis (CARP) of Gougerot and Carteaud is a rare chronic disease with exacerbation and remissions typically affecting young people. Classic clinical characteristics include asymptomatic scaly hyperpigmented macules, patches, and papules in the trunk's confluent and reticular pattern. A 12-year-old girl, otherwise healthy, presented with itchy, persistent skin lesions all over her body for one year. Skin examination revealed generalized scaly brownish patches, thin papules, and plaques all over her body, including her face, neck, middle of the chest, abdomen, back, upper extremities, elbows, lower extremities, and knees. Wood's lamp examination of her skin lesions was unrevealing. Skin biopsy showed papillomatosis, hyperkeratosis, acanthosis, and hypergranulosis. The dermis showed perivascular inflammatory cellular infiltrate. Based on the above clinicopathological findings, the patient was diagnosed with CARP. In our case, a generalized form was reported. CARP is diagnosed based on clinical and histopathological features. Oral antibiotics are the cornerstone of treatment. Our patient responded well to oral minocycline 85 mg one tablet daily, tacrolimus 0.1% ointment twice daily, and selenium sulfide shampoo twice weekly for two months. The classic clinical characteristics of CARP include asymptomatic scaly hyperpigmented macules, patches, and papules in a confluent and reticular pattern on the trunk. A generalized form, as in our case, has been reported. CARP is diagnosed based on clinical and histopathological features. Oral antibiotics are the cornerstone of treatment.
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4
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Borst C, Symmank D, Drach M, Weninger W. Cutaneous signs and mechanisms of inflammasomopathies. Ann Rheum Dis 2022; 81:454-465. [PMID: 35039323 DOI: 10.1136/annrheumdis-2021-220977] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/20/2021] [Indexed: 11/03/2022]
Abstract
The emerging group of autoinflammatory diseases (AIDs) is caused by a dysregulation of the innate immune system while lacking the typical footprint of adaptive immunity. A prominent subgroup of AIDs are inflammasomopathies, which are characterised by periodic flares of cutaneous signs as well as systemic organ involvement and fever. The range of possible skin lesions is vast, ranging from urticarial, erysipelas-like and pustular rashes to erythematous patches, violaceous plaques and eventual necrosis and ulceration. This review provides a structured overview of the pathogenesis and the clinical picture with a focus on dermatological aspects of inflammasomopathies. Current treatment options for these conditions are also discussed.
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Affiliation(s)
- Carina Borst
- Department of Dermatology, Medical University of Vienna, Wien, Austria
| | - Dörte Symmank
- Department of Dermatology, Medical University of Vienna, Wien, Austria
| | - Mathias Drach
- Department of Dermatology, Medical University of Vienna, Wien, Austria
| | - Wolfgang Weninger
- Department of Dermatology, Medical University of Vienna, Wien, Austria
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5
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Akiyama M. Autoinflammatory keratinization diseases: The concept, diseases involved, and pathogeneses. DERMATOL SIN 2022. [DOI: 10.4103/1027-8117.365590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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6
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Aromolo IF, Giacalone S, Genovese G, Maronese CA, Marzano AV. Keratosis lichenoides chronica: A case report and focused overview of the literature. Australas J Dermatol 2021; 63:e99-e102. [PMID: 34514586 PMCID: PMC9291015 DOI: 10.1111/ajd.13713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Italo Francesco Aromolo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Serena Giacalone
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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7
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Adnexotropic Variants of the Interface Dermatitides: A Review. Dermatopathology (Basel) 2021; 8:135-146. [PMID: 34063840 PMCID: PMC8161827 DOI: 10.3390/dermatopathology8020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/15/2021] [Accepted: 05/19/2021] [Indexed: 11/25/2022] Open
Abstract
The interface dermatitides encompass a vast array of cutaneous entities which, at times, may present with particular clinical variants with adnexal predilection. Similarly, hair follicle and eccrine gland involvement of some of these entities has been observed on histopathology. This review aims to describe the various adnexotropic presentations of the interface dermatitides. Recognizing that the adnexa can be a frequent site of involvement of these conditions may aid dermatopathologists in making the correct diagnosis and avoid misinterpreting adnexotropism for other conditions such as the great imitator, mycosis fungoides.
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8
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Wells A, Desai A, Rudnick EW, Motaparthi K. Erythema ab igne with features resembling keratosis lichenoides chronica. J Cutan Pathol 2020; 48:151-153. [PMID: 32990396 DOI: 10.1111/cup.13885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/30/2020] [Accepted: 09/20/2020] [Indexed: 12/18/2022]
Abstract
Erythema ab igne (EAI) is an asymptomatic dermatosis that develops in response to chronic exposure to low-grade heat. Characteristic findings on histopathology include epidermal atrophy, dermal elastosis, atypical histiocytes, and melanin and hemosiderin deposition. Reactive endothelial changes and prominent vascular proliferation are variable. Keratosis lichenoides chronica (KLC) is a rare lichenoid hyperkeratotic dermatosis. Acanthosis with parakeratosis and a lichenoid interface dermatitis with lymphocytes, histiocytes, and plasma cells are characteristic findings of KLC. Although its etiology remains unclear, KLC has been reported to occur in response to heat. Herein, we report a case of EAI with features resembling KLC.
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Affiliation(s)
- Amy Wells
- University of Florida College of Medicine, Gainesville, Florida, USA
| | - Anand Desai
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Eric W Rudnick
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
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9
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Cheraghlou S, Levy LL. Fixed drug eruptions, bullous drug eruptions, and lichenoid drug eruptions. Clin Dermatol 2020; 38:679-692. [PMID: 33341201 DOI: 10.1016/j.clindermatol.2020.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Drug reactions are among the most common reasons for inpatient dermatology consultation. These reactions are important to identify because discontinuation of the offending agent may lead to disease remission. With the rising use of immunomodulatory and targeted therapeutics in cancer care and the increased incidence in associated reactions to these drugs, the need for accurate identification and treatment of such eruptions has led to the development of the "oncodermatology" subspecialty of dermatology. Immunobullous drug reactions are a dermatologic urgency, with patients often losing a significant proportion of their epithelial barrier; early diagnosis is critical in these cases to prevent complications and worsening disease. Lichenoid drug reactions have myriad causes and can take several months to occur, often leading to difficulties identifying the offending drug. Fixed drug eruptions can often mimic other systemic eruptions, such as immunobullous disease and Stevens-Johnson syndrome, and must be differentiated from them for effective therapy to be initiated. We review the clinical features, pathogenesis, and treatment of immunobullous, fixed, and lichenoid drug reactions with attention to key clinical features and differential diagnosis.
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Affiliation(s)
| | - Lauren L Levy
- Private Practice, New York, New York, USA; Private Practice, Westport, Connecticut, USA.
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10
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Akiyama M, Takeichi T, McGrath JA, Sugiura K. Autoinflammatory keratinization diseases: An emerging concept encompassing various inflammatory keratinization disorders of the skin. J Dermatol Sci 2018; 90:105-111. [DOI: 10.1016/j.jdermsci.2018.01.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/20/2018] [Accepted: 01/23/2018] [Indexed: 12/15/2022]
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11
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Nasimi M, Azizpour A, Lajevardi V, Nikoo A, Etesami I. A case of pediatric keratosis lichenoides chronica with unusual presentation of severe oral erosions. JAAD Case Rep 2018; 4:267-269. [PMID: 29687068 PMCID: PMC5909479 DOI: 10.1016/j.jdcr.2017.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Maryam Nasimi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arghavan Azizpour
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahideh Lajevardi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Azita Nikoo
- Department of Pathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ifa Etesami
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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12
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Li AW, Damsky W, King BA. Keratosis lichenoides chronica successfully treated with isotretinoin and methotrexate. JAAD Case Rep 2017; 3:205-207. [PMID: 28443310 PMCID: PMC5394184 DOI: 10.1016/j.jdcr.2017.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Alvin W Li
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - William Damsky
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Brett A King
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
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13
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Cardoso JC, Veraitch O, Gianotti R, Ferrara G, Tomasini CF, Singh M, Zalaudek I, Stefanato CM. 'Hints' in the horn: diagnostic clues in the stratum corneum. J Cutan Pathol 2017; 44:256-278. [PMID: 27717008 DOI: 10.1111/cup.12839] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 10/03/2016] [Accepted: 10/03/2016] [Indexed: 02/06/2023]
Abstract
The stratum corneum or horny layer is the uppermost layer of the epidermis, and is mainly responsible for the skin's barrier function. In spite of its complexity at the ultrastructural and molecular level, the features accessible to visualization on conventional histology are relatively limited. Nevertheless, knowledge of subtle clues that one may observe in the stratum corneum can prove useful in a wide range of situations in dermatopathology. We herein review a selection of common and rare entities in which the horny layer may reveal significantly important hints for the diagnosis. These clues include parakeratosis and its different patterns (focal, confluent, alternating, associated with spongiosis, epidermal hyperplasia or lichenoid changes), subcorneal acantholysis, infectious organisms in the stratum corneum (including fungal, bacterial and parasitic), thickening or thinning of the stratum corneum and the presence of different kinds of pigment. Even when normal, the horny layer may prove to be useful when seen in association with severe epidermal damage, a combination of features testifying to the acute nature of the underlying pathological process.
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Affiliation(s)
- José Carlos Cardoso
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - Ophelia Veraitch
- St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - Raffaele Gianotti
- Dermatopathology Laboratory, Department of Dermatology, Universita' degli Studi di Milano, Milano, Italy
| | - Gerardo Ferrara
- Oncology Department, Anatomic Pathology Unit, Gaetano Rummo General Hospital, Benevento, Italy
| | - Carlo F Tomasini
- Dermatopathology, University Hospital Città della Salute e della Scienza, Turin, Italy
| | - Manuraj Singh
- Manuraj Singh, Department of Dermatology, St George's University Hospital, London, UK
| | - Iris Zalaudek
- Iris Zalaudek, Division of Dermatology, Non-Melanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria
| | - Catherine M Stefanato
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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14
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Abstract
Keratosis lichenoides chronica also known as Nekam's disease is a rare mucocutaneous disorder, characterized clinically by asymptomatic violaceous keratotic papules arranged in linear, reticular, or plaque form usually on the trunk and extremities and histologically by interface dermatitis. The disease is considered rare with only 128 cases being reported in the literature till date and very few from India. We report a case of a 40-year-old man who presented with constellation of features of lichen planus, seborrheic dermatitis, and apthous ulcers, which upon workup was found to be Nekam's disease.
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Affiliation(s)
| | | | - T. Neelima
- Department of Pathology, Katuri Medical College, Guntur, Andhra Pradesh, India
| | - Haritha Bandaru
- Department of DVL, Katuri Medical College, Guntur, Andhra Pradesh, India
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15
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Payette MJ, Weston G, Humphrey S, Yu J, Holland KE. Lichen planus and other lichenoid dermatoses: Kids are not just little people. Clin Dermatol 2015; 33:631-43. [PMID: 26686015 DOI: 10.1016/j.clindermatol.2015.09.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Lichenoid dermatoses, a group of inflammatory skin conditions with characteristic clinical and histopathologic findings, range from common to rare. Classic lichen planus typically presents as pruritic, polygonal, violaceous flat-topped papules and plaques; many variants in morphology and location also exist. Other lichenoid dermatoses share similar clinical presentations and histopathologic findings. These include lichenoid drug eruption, lichen planus-like keratosis, lichen striatus, lichen nitidus, and keratosis lichenoides chronica. Epidemiologic characteristics vary among each lichenoid disorder. While classic lichen planus is considered a disease of adults, other lichenoid dermatoses may be more common in younger populations. The literature contains an array of reports on the variations in presentation and successful management of lichen planus and lichenoid dermatoses among diverse populations. Familiarity with the characteristics of each lichenoid dermatosis, rare or common within each patient population, is key to accomplishing timely recognition and effective management.
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Affiliation(s)
- Michael J Payette
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Second Floor, Farmington, CT 06032.
| | - Gillian Weston
- University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030
| | - Stephen Humphrey
- Department of Dermatology, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Wauwatosa, WI 53226
| | - JiaDe Yu
- Department of Dermatology, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Wauwatosa, WI 53226
| | - Kristen E Holland
- Department of Dermatology, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Wauwatosa, WI 53226
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16
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Wee JS, Viros A, Ffolkes L, Misch K, Natkunarajah J. Keratosis lichenoides chronica masquerading as discoid lupus erythematosus. Clin Exp Dermatol 2013; 38:327-9. [PMID: 23517367 DOI: 10.1111/j.1365-2230.2012.04477.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J S Wee
- Department of Dermatology, Kingston Hospital, Kingston upon Thames, Surrey, UK.
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17
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Nomura T, Toichi E, Miyachi Y, Kabashima K. A Mild Case of Adult-Onset Keratosis Lichenoides Chronica Successfully Treated with Narrow-Band UVB Monotherapy. Case Rep Dermatol 2012. [PMID: 23185159 PMCID: PMC3506084 DOI: 10.1159/000345277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Keratosis lichenoides chronica (KLC) is a rare keratotic disorder of unknown origin. Effective treatment has not been established yet. Here, we present adult-onset KLC, which was treated by narrow-band ultraviolet B (NB-UVB) monotherapy. Although NB-UVB was reported to be effective for pediatric-onset KLC, it has not been clear if this regimen is also useful for adult-onset type because pediatric-onset KLC is suggested to be different in nature. We assume that KLC is treatable by NB-UVB regardless of the age of the patient.
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Affiliation(s)
- Takashi Nomura
- Department of Dermatology, Kyoto University, Kyoto, Japan
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18
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Abstract
Keratosis lichenoides chronica (KLC) is an acquired keratinization disorder that is rare in childhood. We report a case of sporadic pediatric-onset KLC with seborrheic dermatitis-like lesions on the forehead, papules in a retiform pattern in the axillae and mons pubis, and eye and oral mucosal involvement,with additional features of premature canities and a transient photosensitive eruption.
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19
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20
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Zinelabidine K, Meziane M, Mernissi FZ. [Chronic familial lichenoid keratosis]. Ann Dermatol Venereol 2011; 138:715-7. [PMID: 21978515 DOI: 10.1016/j.annder.2011.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 03/18/2011] [Accepted: 05/10/2011] [Indexed: 10/18/2022]
Affiliation(s)
- K Zinelabidine
- Service dermatologie, centre hospilato-universitaire Hassan II, Fès, Maroc.
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21
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Martins LCG, Horne M, Moreira Júnior DN, Follador I, Almeida VRPD. Queratose liquenoide crônica: relato de caso. An Bras Dermatol 2011; 86:S148-51. [DOI: 10.1590/s0365-05962011000700039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Accepted: 12/27/2010] [Indexed: 11/22/2022] Open
Abstract
A queratose liquenoide crônica ou doença de Nekam é uma dermatose mucocutânea rara da queratinização, com curso crônico e progressivo, que acomete geralmente indivíduos entre 20 e 40 anos. Existem, aproximadamente, 70 casos descritos na literatura. Devido à raridade desta dermatose e à ausência de tratamento efetivo, é uma doença de difícil manejo. No caso em questão, apresentamos um paciente de 42 anos com pápulas violáceas, hiperqueratósicas, algumas confluentes, com aspecto linear, rendilhado e em placas, localizadas no tronco e membros há cinco anos. Lesões aftoides na cavidade oral e úlceras rasas na genitália também faziam parte do quadro. O anatomopatológico foi bastante sugestivo de queratose liquenoide crônica. Introduziu-se tratamento com acitretina e dapsona, havendo melhora parcial do quadro
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AdiÅen E, Erdem O, Celepçi S, Gürer MA. Easy to diagnose, difficult to treat: keratosis lichenoides chronica. Clin Exp Dermatol 2010; 35:47-50. [DOI: 10.1111/j.1365-2230.2008.03069.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Regula CG, Morrell DS, Groben PA, Burkhart CN. Keratotic papular eruption in a teenager. Pediatr Dermatol 2009; 26:615-6. [PMID: 19840323 DOI: 10.1111/j.1525-1470.2009.00996.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Christie G Regula
- Penn State Milton S. Hershey Medical School, Hershey, Pennsylvania, USA.
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24
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[Keratosis lichenoides chronica in two siblings with marked response to UVB phototherapy]. Ann Dermatol Venereol 2008; 135:835-8. [PMID: 19084693 DOI: 10.1016/j.annder.2008.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Accepted: 04/25/2008] [Indexed: 11/22/2022]
Abstract
BACKGROUND Keratosis lichenoides chronica (KLC) is a rare chronic keratinisation disorder. Out of almost 60 published cases of KLC, only two report its occurrence in siblings. We report a new case in which a brother and sister present KLC that improved markedly with UVB phototherapy. PATIENTS AND METHODS A 10-year-old girl presented with hyperkeratotic papules symmetrically arranged in a reticular pattern on the face and the extremities. Onset occurred at the age of six months. For a number of years, minimum sunlight was allowed owing to a diagnosis of lupus. However, KLC was our first diagnostic assumption, confirmed by an elbow lesion biopsy sample. The patient's brother, one and a half years old, had been presenting similar lesions since the age of two months. Sibship was demonstrated by DNA analysis using short tandem repeat markers. No consanguinity was found. After one month of narrow-band UVB phototherapy, most of the papules had flattened. DISCUSSION KLC is uncommon in childhood and familial occurrence is very rare. Clinically, thick keratotic papules arranged in parallel lines or small networks cover the dorsal aspects of the limbs symmetrically. The face may be affected by a seborrhoea-like dermatitis. Histology typically shows alternating acanthosis and atrophy, with focal parakeratosis. An extensive lichenoid lymphohistiocytic and plasmocytic infiltrate is demonstrated in the dermis. The course is chronic. Spontaneous resolution may occur. Sunlight has been shown to be effective in the few paediatric cases reported. Narrow-band UVB phototherapy appears to be an effective therapeutic option.
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