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Orloff J, Patel DD, Powers CM, Piontkowski AJ, Phelps RG, Richter J, Gulati N. Pityriasis lichenoides et varioliformis acuta in a patient treated with cevostamab. JAAD Case Rep 2024; 47:23-25. [PMID: 38576898 PMCID: PMC10993135 DOI: 10.1016/j.jdcr.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Affiliation(s)
- Jeremy Orloff
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dev D. Patel
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Camille M. Powers
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Austin J. Piontkowski
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert G. Phelps
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joshua Richter
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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Rai E, Kamzan A, Boozalis E, Hogeling M, Fong K. A case of febrile ulceronecrotic Mucha-Habermann disease responsive to systemic corticosteroids. Pediatr Dermatol 2022; 40:573-575. [PMID: 36573550 DOI: 10.1111/pde.15234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/12/2022] [Indexed: 12/28/2022]
Abstract
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare, potentially fatal subtype of pityriasis lichenoides et varioliformis acuta (PLEVA). Herein, we present a rare case of a 14-year-old male without significant past medical history who was diagnosed with FUMHD without a clear inciting factor. He was effectively treated with systemic corticosteroids with complete resolution of symptoms.
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Affiliation(s)
- Ekra Rai
- Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, UCLA, Los Angeles, California, USA
| | - Audrey Kamzan
- Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, UCLA, Los Angeles, California, USA
| | - Emily Boozalis
- Division of Dermatology, David Geffen School of Medicine at University of California Los Angeles, UCLA, Los Angeles, California, USA
| | - Marcia Hogeling
- Division of Dermatology, David Geffen School of Medicine at University of California Los Angeles, UCLA, Los Angeles, California, USA
| | - Kelly Fong
- Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, UCLA, Los Angeles, California, USA
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Calcaterra V, Cavalli R, Croci GA, Fiori L, Fabiano A, Lunardon L, Avanzini MA, Berti E, Zuccotti G. Type D lymphomatoid papulosis with pityriasis lichenoides et varioliformis acuta-like features in a child with parvovirus infection: a controversial diagnosis in the spectrum of lymphoid proliferations: case report and literature review. Ital J Pediatr 2022; 48:183. [PMID: 36307824 PMCID: PMC9616621 DOI: 10.1186/s13052-022-01371-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background Lymphomatoid papulosis (LyP) is a rare condition in pediatrics; LyP histological type D has been reported in only 7 children. The differential diagnosis of LyP in the spectrum of lymphoid proliferation remains controversial. Case presentation A 6-year-old boy presented to Emergency Department with a 3-week history of an erythematous papulo-vesicular itchy eruption over the submandibular regions, trunk and extremities. History, symptoms and laboratory tests were unremarkable. SARS-CoV-2 antigen was negative. The clinical suspicion of pityriasis lichenoides et varioliformis acuta (PLEVA) was posed, and topical steroids were introduced. One week after, he returned with an extensive painful scaly papulo-erythematous rash, with some ulcerated and necrotic lesions, and fever; therefore the child was hospitalized. Biochemical results were within reference limits, except for high level of C-reactive protein, aspartate aminotransferase, alanine transaminase and bilirubin. Due to a persistently high fever, systemic corticosteroid treatment was administered, with a good clinical response and an improvement of the skin lesions. Anti-PVB-19 Immunoglobulin M was detected. Elevated levels of IL-6, IL-10 and IFN-γ were also recorded. Five days post-admission, most of the lesions had cleared, and the child was discharged. Methotrexate was started, with a positive response. At skin biopsy a “PLEVA-like” pattern was apparent, with a dense, wedge shaped lymphoid infiltrate featuring epidermotropism and morphologically comprising pleomorphic and blastic cells. The pattern of infiltration was highlighted by immunohistochemical stains, which prove the process to feature a CD8+/CD30 + phenotype, the latter being intense on larger cells, with antigenic loss. Polymerase chain reaction for T-cell receptor gamma (TCRG) chain clonality assessment documented a monoclonal peak. A diagnosis of LyP type D was favored. Conclusion The reported case encompasses most of the critical features of two separated entities—PLEVA and LyP—thus providing further support to the concept of them representing declinations within a sole spectrum of disease. Studying the role of infectious agents as trigger potential in lymphoproliferative cutaneous disorders and detecting novel markers of disease, such as cytokines, could have a crucial impact on pathogenic disease mechanisms and perspective therapies.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine, University of Pavia, 27100, Pavia, Italy.,Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Riccardo Cavalli
- Pediatric Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Giorgio A Croci
- Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Laura Fiori
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Antonella Fabiano
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Luisa Lunardon
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Maria Antonietta Avanzini
- Cell Factory, Pediatric Hematology Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Emilio Berti
- Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy. .,Department of Biomedical and Clinical Science, University of Milan, 20157, Milan, Italy.
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Al Muqrin AM, Alruwaili ZMN. Pityriasis lichenoides chronica induced by COVID-19 messenger RNA vaccination. JAAD Case Rep 2022; 27:52-4. [PMID: 35875513 DOI: 10.1016/j.jdcr.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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De La Garza H, Saliba E, Rosales Santillan M, Brem C, Vashi NA. Pityriasis Lichenoides et Varioliformis Acuta as a Complication of COVID-19 Infection. Dermatopathology (Basel) 2022; 9:244-250. [PMID: 35892481 PMCID: PMC9326675 DOI: 10.3390/dermatopathology9030028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Pityriasis lichenoides is an acute and/or chronic skin disease associated with recurrent erythematous papules that self-resolve. While its etiology is unknown, preceding viral infection may play a role. We present an atypical case of a 40-year-old woman with pityriasis lichenoides et varioliformis acuta as a complication of a COVID-19 infection.
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Affiliation(s)
- Henriette De La Garza
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA; (H.D.L.G.); (E.S.); (M.R.S.); (C.B.)
| | - Elie Saliba
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA; (H.D.L.G.); (E.S.); (M.R.S.); (C.B.)
- Department of Dermatology, Brown University, Providence, RI 02903, USA
| | - Monica Rosales Santillan
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA; (H.D.L.G.); (E.S.); (M.R.S.); (C.B.)
| | - Candice Brem
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA; (H.D.L.G.); (E.S.); (M.R.S.); (C.B.)
| | - Neelam A. Vashi
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA; (H.D.L.G.); (E.S.); (M.R.S.); (C.B.)
- Boston Health Care System, U.S. Department of Veterans Affairs, Boston, MA 02130, USA
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Jastrząb BA, Stefaniak AA, Hryncewicz-Gwóźdź A, Nockowski P, Szepietowski JC. Pityriasis Lichenoides et Varioliformis Acuta Triggered by Human Papillomavirus Vaccine: A Case Report and Literature Review. Acta Derm Venereol 2021; 101:adv00552. [PMID: 34515802 PMCID: PMC9425601 DOI: 10.2340/00015555-3921] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Beata A Jastrząb
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, PL-50-368 Wroclaw, Poland
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Zhang M, Yu J, Huang H, Zhou C, Zhai Z, You Y, Song Z. Secondary Syphilis in a 12-Year-Old Girl Misdiagnosed as Pityriasis lichenoides et varioliformis acuta: A Case Report. Clin Cosmet Investig Dermatol 2021; 14:815-820. [PMID: 34262318 PMCID: PMC8275113 DOI: 10.2147/ccid.s315235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/11/2021] [Indexed: 12/03/2022]
Abstract
Syphilis is a complex, systemic infectious disease caused by Treponema pallidum subspecies pallidum. Herein, we report a rare case of secondary syphilis with probable neurosyphilis that was misdiagnosed as pityriasis lichenoides et varioliformis acuta (PLEVA) in a 12-year-old human immunodeficiency virus (HIV) negative patient. A female patient presented to our hospital with a four-month history of relapsed systemic rash, accompanied by hair loss, arthralgia and fatigue. Based on physical examination and skin biopsy, she was initially diagnosed as PLEVA and treated both locally and systemically but failed to present a dermatologic improvement. The diagnosis of secondary syphilis with probable neurosyphilis was made based on serologic and cerebrospinal fluid tests. After neurosyphilis therapy, the clinical manifestations of the patient were significantly improved. Physicians should be alert for the possibility of syphilis when encountering cases with unusual clinical manifestations.
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Affiliation(s)
- Min Zhang
- Department of Dermatology and Venereology, The First Affiliated Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Jia Yu
- Department of Dermatology, Distinct HealthCare, Chongqing, People's Republic of China
| | - Hui Huang
- Department of Dermatology and Venereology, The First Affiliated Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Cunjian Zhou
- Department of Dermatology and Venereology, The First Affiliated Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Zhifang Zhai
- Department of Dermatology and Venereology, The First Affiliated Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Yi You
- Department of Dermatology and Venereology, The First Affiliated Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Zhiqiang Song
- Department of Dermatology and Venereology, The First Affiliated Hospital, Army Medical University, Chongqing, People's Republic of China
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Abstract
BACKGROUND/OBJECTIVES Pityriasis lichenoides is an uncommon papulosquamous disorder of unknown etiology. The objective of this study was to review the clinical features and treatment responses of individuals with pityriasis lichenoides seen at a tertiary referral center. METHODS Seventy-five patients diagnosed with pityriasis lichenoides between 1997 and 2013 were reviewed, and 46 had long-term follow-up via telephone interviews. RESULTS Fifty (67%) patients were diagnosed with pityriasis lichenoides chronica, 22 (29%) with pityriasis lichenoides et varioliformis acuta, and 3 (4%) with mixed pityriasis lichenoides chronica and pityriasis lichenoides et varioliformis acuta features. Mean ± standard deviation age at onset was 12 ± 13 years (median 8 years). Disease duration was significantly shorter for patients with pityriasis lichenoides et varioliformis acuta (35 ± 35 months) than for those with pityriasis lichenoides chronica (at least 78 ± 48 months). At long-term follow-up, 23 of 28 (82%) patients with pityriasis lichenoides chronica and 3 of 16 (19%) with pityriasis lichenoides et varioliformis acuta had active disease. None progressed to lymphomatoid papulosis or cutaneous T-cell lymphoma. Ten of 23 active pityriasis lichenoides chronica cases had residual pigmentary change independent of race and lasted at least 35 ± 20 months. The most effective treatments were phototherapy (47% response rate), heliotherapy (33%), topical corticosteroids (27%), and antibiotics (25%). CONCLUSION Pityriasis lichenoides is a predominantly pediatric disorder. The time course of pityriasis lichenoides chronica is significantly longer than that of pityriasis lichenoides et varioliformis acuta. Pityriasis lichenoides chronica may persist with pigmentary alterations in the absence of other signs of active inflammation. Treatment response is often limited, particularly for patients with pityriasis lichenoides chronica.
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Affiliation(s)
- Julie B Zang
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Sarah J Coates
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Jing Huang
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Eric C Vonderheid
- Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Bernard A Cohen
- Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Ankad BS, Beergouder SL. Pityriasis lichenoides et varioliformis acuta in skin of color: new observations by dermoscopy. Dermatol Pract Concept 2017; 7:27-34. [PMID: 28243491 PMCID: PMC5315037 DOI: 10.5826/dpc.0701a05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 10/28/2016] [Indexed: 11/16/2022] Open
Abstract
Background Pityriasis lichenoides is an uncommon skin disease that presents in three different forms: pityriasis lichenoides et varioliformis acuta (PLEVA), pityriasis lichenoides chronica (PLC) and febrile ulceronecrotic-Mucha-Habermann disease. These represent a spectrum of a disease. PLEVA presents as skin eruption of multiple, small, red papules that develop into polymorphic lesions with periods of varying remissions, as well as possible sequels of hyper/hypopigmentation and varicella-like scars. Diagnosis of this condition is mainly clinical, and sometimes clinical differentiation from other conditions may be a difficult task that often requires histological analysis. In this study, PLEVA lesions were examined by dermoscopy, and the significance of specific dermoscopic findings was investigated in order to facilitate their differentiation from other inflammatory conditions. Objectives To evaluate dermoscopic patterns in PLEVA and to correlate these patterns with histopathology. Materials and methods The study was conducted at S. Nijalingappa Medical College, Bagalkot. It was an observational case series study and patients were selected randomly. Ethical clearance and informed consent were obtained. PLEVA lesions in early and late phases were evaluated. A manual DermLite 3 (3Gen, San Juan Capistrano, CA) dermoscope attached to a Sony (Cyber Shot DSC-W800, Sony Electronics Inc., San Diego, California, USA, digital, 14 mega pixels) camera was employed. Histopathology was done to confirm the diagnosis. Data was collected and analyzed. Results were statistically described in terms of frequencies and types of dermoscopic patterns. Results There was a total of 14 patients; 8 males and 6 females. Mean age of patients was 19 years. Mean duration of disease was 7 months. Dermoscopy in early-phase lesions revealed amorphous brownish areas around the hair follicles, dotted vessels, and scaling. Dermoscopy in late-phase lesions showed whitish-structureless areas and central white crust within whitish-structureless rim with scale, focal bluish-grayish areas or centrifugal strands irregularly distributed along the periphery and yellow structures. Red dots and hemorrhage were seen at the center and glomerular vessels at the periphery. Conclusion PLEVA demonstrates specific dermoscopic patterns that correlate well with histologic changes. New dermoscopic findings are described. Thus, dermoscopy is a good diagnostic tool in the clinical diagnosis of PLEVA.
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Affiliation(s)
- Balachandra S Ankad
- Department of Dermatology, S. Nijalingappa Medical College, Bagalkot, Karnataka, India
| | - Savitha L Beergouder
- Department of Dermatology, S. Nijalingappa Medical College, Bagalkot, Karnataka, India
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Zheng Y, Jia J, Tian Q, Dong X, Wang X, Ying Z, Xiao S, Li W. Lymphomatoid papulosis misdiagnosed as pityriasis lichenoides et varioliformis acuta: Two case reports and a literature review. Exp Ther Med 2014; 8:1927-1933. [PMID: 25371758 PMCID: PMC4217770 DOI: 10.3892/etm.2014.2006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 09/11/2014] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to improve the level of diagnosis and differential diagnosis of lymphomatoid papulosis (LyP). Two cases of type B LyP were identified and the literature was reviewed to summarize the clinical outcomes and pathology of LyP and its treatment. The two patients exhibited symptoms with papulonodular lesions, the centers of which gradually underwent ulceration and necrosis. CD30, a helper T-cell marker specifically expressed in tumor cells was analyzed by immunohistochemical staining and the result showed that CD30-negative or only scattered CD30-positive cells were present. Therefore, a diagnosis of type B LyP was made. A fairly good curative effect was achieved following treatment with retinoic acid, glucocorticoids and immunomodulatory drugs. LyP is a type of low-level malignant lymphoma and is easily misdiagnosed as pityriasis lichenoides et varioliformis acuta and other diseases. In order to avoid under diagnosis and misdiagnosis, doctors should evaluate suspected patients by histopathological and immunohistochemical examination.
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Affiliation(s)
- Yan Zheng
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Jinjing Jia
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Qiong Tian
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Xinyu Dong
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Xin Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Zhaoxia Ying
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Shengxiang Xiao
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Wensheng Li
- Department of Pathology, The Third Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710068, P.R. China
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Markus JR, Carvalho VO, Lima MN, Abagge KT, Nascimento A, Werner B. The relevance of recognizing clinical and morphologic features of pityriasis lichenoides: clinicopathological study of 29 cases. Dermatol Pract Concept 2013; 3:7-10. [PMID: 24282656 PMCID: PMC3839824 DOI: 10.5826/dpc.0304a02] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 07/09/2013] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Pityriasis lichenoides (PL) is a lymphoproliferative disease of unknown origin; its diagnosis is based on clinical characteristics and confirmed by histology. OBJECTIVES To describe clinical and histological features of PL in 29 pediatric patients. MATERIALS AND METHODS Retrospective descriptive study of children (patients less than 15 years old) diagnosed with PL between 1986 and 2010 at a Reference Service in Pediatric Dermatology from South Brazil. RESULTS Twenty-nine PL cases were found by chart review in 24 years. Mean age of diagnosis was 8 years (22 to 178 months) and a mean time of diagnosis was 13.8 months (1 to 120 months). Twenty cases (69%) were male. Seasonal correlation was found with colder months in 62% of cases (p<0.01). Clinical diagnosis was pityriasis lichenoides chronica (PLC) in 25 cases, and pityriasis lichenoides et varioliformis acuta (PLEVA) in four. Itching was the main reported symptom occurring in 13 (45%). Fourteen cases had been histologically evaluated. In six, microscopic findings were consistent with PLC, in four consistent with PLEVA, and four biopsies exhibited mixed characteristics of both forms. Concordance between clinical and histological diagnosis was seen in most cases. CONCLUSION PL occurs in children and young adults, more commonly in males, and during cold months. PLC was the more frequent clinicohistologic form, and necrotic lesions characterized PLEVA. Associating clinical and histological findings is important for differentiating between PLC and PLEVA diagnosis.
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