A Case of Palmar Lichen Nitidus Presenting as a Clinical Feature of Pompholyx

Lichen nitidus (LN) is an uncommon chronic eruption of an unknown cause, and it is characterized by tiny, discrete, flesh-colored papules. The sites of predilection are the genitalia, trunk and extremities. Unilateral palmar involvement with pruritus is infrequent. We report here on a case of LN confined to the right palm, and the patient presented with multiple, pruritic, erythematous to flesh-colored, tiny papules and vesicles that mimicked pompholyx. The histopathological examination of a skin biopsy specimen showed the typical findings of LN.     

A Case of Generalized Lichen Nitidus with Koebner's Phenomenon

A 12-year-old boy was seen in our department with a three year history of eruptions on his back consisting of normal colored or slightly reddish, pinhead-sized papules, which had gradually spread to his trunk within the previous year. Four days before the first visit, May 13, 1992, the eruption involved his entire extremities. On the back side of his lumbar region, Koebner's phenomenon was observed. He had received several medications for more than two years to treat this eruption in several hospitals, but none were effective. He was in good general health. Mantoux reaction was negative two months after BCG injection. Histopathologic features of the papules included focal epidermal hyperplasia and elongation of the rete ridges in a narrow area and a well demarcated dense lymphohistiocytic infiltrate on the papillar layer. Biscoclaurine alkaloids (20 mg/day) and Jumi-haidoku-to (TJ-6; 7.5 g/day) were administered to the patient after the biopsy. No topical ointments were applied. Two weeks after of these treatments, he reported moderate pruritus on the back. The eruption diminished rapidly within 2 weeks after the therapy began. Almost all the eruptions were cured within one year. Mantoux reaction developed 8 times 8 mm erythema two and half months after the treatment began, and it was significantly positive (23 times 30 mm) 6 months later.     

Childhood Lichen Planus Pemphigoides: A Case Report and Review of the Literature

Abstract:  Lichen planus pemphigoides is a rare autoimmune blistering disease that is characterized by evolution of vesico-bullous skin lesions in patients with active lichen planus. We describe a case of lichen planus pemphigoides in a 6-year-old boy and review the clinical and immunopathologic features of all reported cases of pediatric lichen planus pemphigoides. The mean age at onset of childhood lichen planus pemphigoides is 12 years with a male to female ratio of 3:1 and a mean lag-time between lichen planus and the development of lichen planus pemphigoides of 7.9 weeks. Vesiculo-bullous lesions were found on the extremities in all patients and there was palmoplantar involvement in about half of the cases. Direct and indirect immunofluorescence features were similar to those reported in adults. One patient had Western immunoblot data revealing antigens of 180, 230, and 200 kDa. Immunoelectron microscopy in two cases showed localization of immune deposition different from that in bullous pemphigoid. We found that topical corticosteroids or oral dapsone caused resolution of lichen planus pemphigoides without known relapse of blistering in four cases, suggesting that it might be possible to reserve oral corticosteroids as a second line of therapy in children with lichen planus pemphigoides.     

Marjolin's Ulcer Presenting with In-Transit Metastases: A Case Report and Literature Review

Marjolin''s ulcer is an aggressive cutaneous malignancy common in previously traumatized or chronically inflamed skin. It has high regional metastasis and fatality rates. Our patient presented with subcutaneous nodules and ulcerations on the right limb. He had a history of osteomyelitis of the fifth toe. Histopathological examination of the nodule and ulceration demonstrated squamous cell carcinoma. The nodules and ulcerations were in-transit metastases of Marjolin''s ulcer. Here, we present a case of squamous cell carcinoma arising at a site of a chronic osteomyelitis with resultant in-transit metastases.     

Lichen Planus Limited to the Nails in Childhood: Case Report and Literature Review

Abstract: Although nail abnormalities have been reported to occur in 1% to 10% of patients with lichen planus, in children with lichen planus they are rarely mentioned in the literature. An 11-year-old boy had a two-month history of naii dystrophy affecting all the fingernails and the great toenaiis. The naii plates showed longitudinal ridging and thinning as well as onycholysis and distal splitting. There were no cutaneous or mucous membrane abnormalities. A nail biopsy specimen showed hyperkeratosis, hypergranulosis, and acanthosis in the ventral portion of the proximal nail fold and in the nail matrix. A bandlike lymphocytic infiltrate was present in the superficial dermis, and the basal iayer showed vacuolar alterations. A diagnosis of iichen planus was made. Treatment was intramuscular triamcinolone 20 mg once a month for six months. Since 1969 only 13 proved pediatric cases of lichen planus limited to the nails have been reported, including two children with 20-nall dystrophy and four with idiopathic atrophy of the nails.     

Lichen Nitidus with Involvement of the Palms

A 14‐year‐old girl presented with hyperkeratotic, pitted, skin‐colored papules on a slightly erythematous surface on her palms and erythematous and squamous papules around her ankles. She was clinically and histopathologically diagnosed with lichen nitidus, which is observed rarely on the palms.     

Vulvar Melanoma Associated with Lichen Sclerosus in a Child: Case Report and Literature Review

The authors describe the sixth pediatric case to date of primary vulvar melanoma associated with lichen sclerosus and propose a practical management for such a rare cancer.     

Treatment of Generalized Lichen Nitidus with PUVA

Generalized lichen nitidus refractory to topical and systemic corticosteroids completely responded to PUVA. The similarity of lichen nitidus to lichen planus and the presumed lymphocytotoxic effect of PUVA were the bases for our use of oral photochemotherapy.     

Henoch-Schonlein Purpura Presenting as Hemorrhagic Vesicles and Bullae: Case Report and Literature Review

Abstract: Henoch-Schonlein purpura is a syndrome characterized by nonthrombocytopenic purpura accompanied by arthralgia, gastrointestinal symptoms, or renal involvement. We report a 5.5-year-old boy with high fever and hemorrhagic vesicles and bullae varying in size from 2 to 50 mm in diameter, on both pinnas, the hard palate, gums, dorsa of the hands, buttocks, and both legs, and review the pertinent literature.     

Extragenital Bullous Lichen Sclerosus in a Pediatric Patient: A Case Report and Literature Review

A 14‐year‐old girl presented with a 1‐year history of a pruritic, bullous lesion on her posterior neck. A biopsy revealed bullous lichen sclerosus. Although unusual, this bullous variant of lichen sclerosus is well recognized in the adult literature, but extragenital bullous and hemorrhagic lesions are rare in children. A review of this case and the literature describes the clinical features, pathophysiology, and treatment options for this extragenital bullous variant in an effort to raise awareness of this rare clinical presentation.     

Subacute Cutaneous Lupus Erythematosus Presenting in Childhood: A Case Report and Review of the Literature

A 2‐year‐old African American, Hispanic boy presented with well‐defined, violaceous, annular dermal plaques without scale over the upper extremities, face, lower extremities, and buttocks. The clinical presentation and laboratory studies were consistent with a diagnosis of subacute cutaneous lupus erythematous (SCLE). SCLE presenting in childhood is exceedingly rare, with only eight cases previously reported. It is important to clinically differentiate SCLE from other eruptions more common to children, such as atopic dermatitis, urticarial drug eruptions, and psoriasis vulgaris, because progression to systemic lupus erythematous (SLE) may occur. SLE needs to be closely followed. We present the first case (to our knowledge) of SCLE in a child of African American or Hispanic descent and provide a table of other documented pediatric presentations of SCLE for comparison.     

Mucoceles of the Oral Cavity in Neonates and Infants—Report of a Case and Literature Review

Oral mucoceles are common lesions that normally appear in the second decade of life. They are uncommon in neonates and infants. We present a case of a mucocele in a 10‐month‐old infant and review the literature regarding the epidemiology and treatment in this age group.     

Congenital Smooth Muscle Hamartoma Presenting as a Linear Atrophic Plaque: Case Report and Review of the Literature

Abstract: Congenital smooth muscle hamartoma usually manifests as a well-circumscribed, hyperpigmented plaque, frequently hypertrichotic, on the trunk or extremities. We report such a lesion in a 7-month-old girl that presented as a linear, mottled, purplish red plaque appearing In areas to be atrophic, involving her right buttock, posterior thigh and leg, and fifth toe. Although the clinical appearance suggested linear morphea, a biopsy specimen had numerous haphazardly oriented bundles of smooth muscle in the reticular dermis. Masson trichrome staining, smooth muscle specific actin, and electron microscopic studies confirmed the smooth muscle nature of the cells. A diagnosis of smooth muscle hamartoma was made. To our knowledge, this linear clinical presentation has not been described previously.     

Three Cases of Lichen Nitidus Associated with Various Cutaneous Diseases

Lichen nitidus (LN) is an uncommon, usually asymptomatic cutaneous eruption characterized by the presence of multiple, small, flesh-colored papules. The epidemiologic and pathophysiologic characteristics of LN have not yet been defined. Furthermore, LN has rarely been described in association with other cutaneous diseases. We herein report 3 cases of LN associated with various cutaneous diseases, including lichen striatus, oral lichen planus, and psoriasis vulgaris.     

Generalized Lichen Nitidus in a boy with Niemann-Pick disease type B

Generalized lichen nitidus is an uncommon chronic inflammatory dermatosis with very characteristic histological findings. Its pathogenesis is still unclear; very rarely it has been associated with genetic disorders. Herein we report the case of a 12-year-old boy with Niemann-Pick disease who developed generalized lichen nitidus.     

臂桡侧瘙痒症1例及文献复习

目的报道1例臂桡侧瘙痒症,并回顾文献,学习该病的临床特征、影像学变化及治疗,以提高临床医生对该病的认识。方法分析1例臂桡侧瘙痒症患者的临床表现、影像学检查及治疗预后,并复习近年国内外相关文献。结果老年男性患者,近1年无明显诱因出现双侧前臂瘙痒,夜间较重,不能忍受。皮肤科情况:双前臂外侧散在暗红色粟粒大小坚实丘疹,大片褐色色素沉着。患者既往颈椎病多年,颈椎X光片示颈椎退变,C5-C6椎间隙狭窄。颈部核磁共振成像(MRI)示C3-C7多节段椎间盘突出,椎管狭窄,以C5-C6为著。诊断:臂桡侧瘙痒症。治疗:0.1%他克莫司软膏(商品名:普特彼软膏)2次/d外用。2周后瘙痒明显减轻,1个月后皮疹消失,无瘙痒感,停药,3个月随访暂无复发。结论臂桡侧瘙痒症发病可能与颈椎退变相关,治疗可选择外用他克莫司软膏。     

V型20甲扁平苔藓1例

报道V型20甲扁平苔藓1例.患者女,16岁,20甲破坏、萎缩脱落伴瘙痒9年.组织病理示:角化过度,颗粒层呈楔形增厚,棘层不规则增厚,基底细胞液化变性,真皮上部淋巴细胞带状浸润.