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Lichen sclerosus (LS) is an uncommon, chronic, inflammatory mucocutaneous disorder found predominantly in females with unknown etiology. It presents as a white sclerotic plaque commonly located on the anogenital area. Extragenital LS is less prevalent, and LS affecting the oral mucosa is extremely rare, with only 39 biopsy-confirmed cases reported in the literature. Due to its several mimicking conditions, histological examination is usually required for a definitive diagnosis, particularly in patients with oral LS. Current evidence-based treatment recommendations for oral LS are unavailable; however, most cases tend to improve after treatment with topical or intralesional corticosteroids. We report a case of a 58-year-old female referred from the otolaryngology department for evaluating an asymptomatic whitish sclerotic plaque on the lower lip mucosa that had existed for 1 year. Following a punch biopsy, the patient was diagnosed with LS of labial mucosa. The condition improved after 2 months of treatment with topical and intralesional corticosteroids. The present case report raises awareness in recognizing oral LS and contributes to knowledge of this rare disorder.

There are dermatoses that arise within healed zosteriform sites, such as granulomas annulare, acneiform eruptions, psoriasis, lichen planus, and giant cell lichenoid dermatitis \"GCLD.\" Nonetheless, graft-versus-host disease should be considered and ruled out, especially in patients post-bone marrow transplant. Herein, we report a case of GCLD manifesting within healed zosteriform sites.

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Abstract- A syndrome of uveitis, associated with depigmentation and erosion of areas of skin and mucous membrane on the head and, in one dog, on the scrotum, was observed by the authors in two male Siberian Huskies. These clinical signs are similar to the Vogt-Koyanagi-Harada syndrome in man. Histological examination of the affected skin revealed a lichenoid dermatitis of the upper dermis. Intensive topical therapy with mydriatic and cycloplegic drugs and corticosteroids coupled with systemic prednisolone and azathioprine were used to control the disease. Both subjects were monitored for 10 months and retained useful vision. The skin and oral lesions resolved. Résumé- Un syndrome d\'uvéite idiopathique, non traumatique, associée à une dépigmentation et une érosion de zones cutanée et muqueuse sur la tête et, chez un chien, sur le scrotum, a été observé par les auteurs sur deux mâles Siberian Huskies. Ces signes cliniques évoquent le syndrome de Vogt-Koyanagi-Harada de l\'homme. Un examen histologique de la peau atteinte a montré l\'existence d\'une dermatite lichénoide du derme superficiel. Un traitement topique intensif par des médicaments mydriatiques et cyclopégiques, ausociéà l\'administration systémique de prednisolone et d\'azathioprine a été utilisé pour controler la maladie. Les 2 sujets ont été observés pendant 10 mois et ont retrouvé une vision utile. Les lésions cutanées et orales ont guéri. Zusammenfassung- Bei zwei Husky-Rüden wurden von dem Autoren ein Krankheitssyndrom aus idiopathischer, nicht-traumatisch bedingter Uveitis, Depigmentierung einzelner Haut- und Schleimhautbezirke am Kopf und-bei einem Hund-am Skrotum festgestellt. Diese Symptome ähneln dem Vogt-Koyanagi-Harada-Syndrom beim Menschen. Bei der histologischen Untersuchung von Biopsien der erkrankten Hautbezirke wurde eine lichénoide Dermatitis der oberen Dermisschichten diagnostiziert. Durch eine intensive örtliche Behandlung mit Mydriatica, Cycloplegica und Corticosteroiden in Kombination mit systemischer Prednisolon- und Azathioptringabe konnte die Erkrankung unter Kontrolle gehalten werden. Beide Patienten wurden 10 Monate überwacht und sahen zufriedenstellend aus. Die Veränderungen an Haut und Mundhöhle bildeten sich zurück. Resumen  Los autores describen un síndrome de uveitis no traúmatica idiopática asociada a una despigmentación y erosión de áreas de la piel y de las membranas cutáneas de la cabeza, en un perro y del escroto en otro perro. Ambos animales pertenecían a la raza Siberian Husky. Estos signos clínicos se asemejan en los descritos en la síndrome de Vogt-Koyanagi-Harada de las personas. El examen histológico mostró la presencia de un infiltrado inflamatorio liquenoide en la dermis superficial. Para el tratamiento a la enfermedad se aplicaron corticosteroides y fármacos midriáticos y ciclopéjicos de forma tópica y prednisona de forma sistémica. Ambos animales fueron controlados durante diez meses y mantuvieron la visión. Las lesiones orales y cutáneas se resolvieron por completo.

Pembrolizumab is an immune checkpoint inhibitor approved for use in many cancer types such as non-small cell lung cancer (NSCLC), metastatic melanoma, head and neck cancers, hepatocellular carcinoma, and renal cell carcinoma. There are many reported cases of patients on immunotherapy who have discontinued treatment due to the development of immune-related adverse effects (irAE). Recognition of the histopathologic patterns of dermatologic toxicities due to immunotherapy will become increasingly important for ensuring appropriate management and optimal patient care. Here, we present a case of a 72-year-old man with metastatic carcinoma of unknown primary origin treated with pembrolizumab who developed an immune-related cutaneous adverse event (ircAE) in the form of lichenoid dermatitis.

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.

Antineoplastic agents that use the immune system have revolutionized cancer treatment. Specifically, implementation of immune checkpoint inhibitors, monoclonal antibodies that block cytotoxic T-lymphocyte-associated antigen-4, programmed cell death protein 1, or programmed cell death ligand 1 show improved and sustained responses in patients with cancer. However, these agents are associated with a plethora of adverse events, many manifesting in the skin. As the clinical application of cancer immunotherapies expands, understanding the clinical and histopathologic features of associated cutaneous toxicities becomes increasingly important to dermatologists, oncologists, and pathologists to ensure timely diagnosis and appropriate care. This review discusses cutaneous reactions to immune checkpoint inhibitors, focusing on histopathologic features.

Infliximab is a tumor necrosis factor-alpha inhibitor used to treat a range of inflammatory diseases. Most reports of cutaneous eruptions from tumor necrosis factor-alpha inhibitors have described the paradoxical development of psoriasis or psoriasiform drug reaction. In our report, we present a 31-year-old female with inflammatory bowel disease who developed an unusual lichenoid drug reaction to infliximab involving the hair follicles, resulting in progressive global alopecia. Clinical features and histopathological findings were consistent with drug-induced lichen planopilaris with eosinophils and lichenoid dermatitis.

BACKGROUND: Lichenoid granulomatous dermatitis (LGD) is an uncommon reaction pattern for which clinical correlates can be difficult to establish. LGD combines vacuolar degeneration with variable types of granulomas.
OBJECTIVE: To determine clinical correlates of LGD.
METHODS: The laboratory information systems at the University of Florida, the Medical College of Wisconsin, and Inform Diagnostics Research Institute were queried to identify 56 cases of LGD. Cases were reviewed for information regarding eosinophils, plasma cells, deep perivascular infiltrates, granuloma subtype, parakeratosis, epidermal atrophy, psoriasiform epidermal changes, pseudoepitheliomatous hyperplasia, periadnexal inflammation, vasculitis, and red blood cell extravasation.
RESULTS: The most common clinical correlates were drug eruption (39.3%, n = 22) and lichenoid keratosis (19.6%, n = 11). Tattoo reaction, postherpetic dermatitis, and scabies or postscabietic dermatitis each accounted for 7.1% (n = 4) of cases. Pigmented purpuric dermatosis and lichen striatus each accounted for 5.4% (n = 3) of cases. Dermal eosinophils (P = .005) and psoriasiform epidermal changes (P = .055) were associated with drug hypersensitivity. Perineural (P = .049) and perifollicular (P = .003) inflammation were associated with tattoo reaction and postherpetic dermatitis. Red blood cell extravasation was helpful in cases of pigmented purpuric dermatosis (P = .049).
CONCLUSIONS: This study is limited by its retrospective nature and statistical power.
CONCLUSIONS: Dermal eosinophilia, psoriasiform epidermal changes, periadnexal inflammation, and red blood cell extravasation might aid in the clinical diagnosis of patients with LGD.