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lichenoid infiltrate

Monday 13 June 2011

lichenoid inflammation; interface inflammation : lichenoid pattern

Etiology

- dermatomyositis
- erythema multiforme
- fixed drug reaction
- graft versus host disease
- lichen nitidus
- lichen planus
- lichen sclerosus et atrophicus
- lichen striatus
- pityriasis lichenoides chronica
- pityriasis lichenoides et varioliformis acuta
- poikiloderma atrophicans vasculare
- skin graft rejection
- subacute cutaneous lupus erythematosus

Examples

- cutaneous syphilis / secondary syphilis : psoriasiform pattern + lichenoid infiltrate with histiocytes great clue. Plasma cells ++

- lichen striatus (lichenoid inflammation and perieccrine inflammation ) quite old lesion

Diagnosis of lichenoid infiltration

- eosinophils ?

  • lichenoid drug reaction

- sawttooth pattern

  • LP

- follicle involvment and bone marrow transplantation

  • GVHD

- sun damage / atrophy RR

- S+D / superficial+deep

  • hypertrophic lupus

Diagnosis of interface inflammatory infiltration

- no S+D / no superficial+deep

- S+D / superficial+deep

  • plasmocytes, thin RR : syphilis
  • papillary edema : light
  • lichen striatus
  • mucin, follicular pluging, BM increase, IF+ : SLE / DM
    • epidermal atrophy : DM
    • no epidermal atrophy : SLE

Ref: @loyoladermpath

Digital cases

- UI:902 - Lichen planus
- UI:881 - Lichen sclerosis et atrophicus

See also

- lesional patterns

  • cutaneous lesional patterns

- dermal infiltrates - dermal infiltration