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This is the first case of chronic lichenoid keratosis described in this country. The clinical picture and histologic findings suggest that this dermatosis be regarded as an atypical variety of lichen ruber planus.
Histologically, multiple wart-like papules or hyperkeratotic plaques on the ear pinnae from 4 dogs were characterized as idiopathic benign lichenoid keratosis. Common histologic features included a discrete lesion of irregular and papillated epidermal hyperplasia with a moderate diffuse lichenoid interface inflammatory infiltrate consisting of lymphocytes and plasma cells. There was also focal hydropic degeneration of the epidermal basal cell layer, pigmentary incontinence, and mixed orthokeratotic and parakeratotic hyperkeratosis. In all 4 dogs, the pinnal lesions were unilateral and asymptomatic. Complete surgical excision was curative.
A male patient of 28 years, with typical clinical features and histopathological changes of keratosis lichenoides (CLK) chronica is described. CLK has some histological features similar to lichen planus, but there are also histological and clinical differences.
Regarding systemic (SLE) and chronic discoid lupus erythematosus (CDLE), the diagnostic value of the lupus band test ist generally accepted. In the literature, however, there are but few obligatory criteria concerning the definition of a positive lupus band. In order to illustrate the influence of sunlight on the evolution of junctional deposits of immunoglobulins, we examplarily studied actinic keratosis (AK) as a chronic light-dependent dermatosis. The junctional deposits in AK were qualitatively and quantitatively compared with the lupus band typical for CDLE. In CDLE we mostly found more distinct band-like junctional deposits of immunoglobulins and complements. Light-dependent, non-specific junctional patterns of immunofluorescence similar to LE, therefore, require clear morphological criteria of immunohistology.
We report on a case of keratosis lichenoides chronica. In our opinion, this very rare disease is an entity which might be classified as a primary inflammatory dermatosis.
Treatment with oral etretinate is reported in a case of arsenical keratosis with Bowen's disease. Good (80%) clearance in keratoses was obtained, which is maintained after 15 months' follow up.
Seborrheic keratosis (Leser-Trélat sign) and extensive florid papillomatosis of the skin and the mucous membranes of the nose, mouth, throat, and external genitalia were associated with adenocarcinoma of the breast in a 61-year-old woman.
Keratosis lichenoides chronica may be seen clinically and histologically as a variant of lichen planus. One in three patients have nail involvement with changes that may superficially resemble psoriasis, but pitting and pustulosis do not occur. Hyperkeratotic hypertrophy of the periungual tissues is a distinctive feature. Psoralens and UV-A therapy as well as etretinate have improved some cases.
We present two cases of keratosis lichenoides striata. Both patients have the typical features of the disease: linear verrucous formations on the limbs, and a seborrheic--like dermatitis. The oral mucosa was involved, showing erythematous patches and papules. A treatment by etretinate did not bring a significant improvement.
Case report of a patient with keratosis lichenoides chronica and good response to a combined therapy with retinoids and photochemotherapy.
We report on a 31-year-old man with keratosis punctata (punctate hyperkeratosis) of the palmar creases. We examined a lesion ultrastructurally and were unable with routine electron microscopic techniques to note any significant abnormalities.
A very uncommon ocular and mucocutaneous syndrome is reported. Cutaneous manifestations include keratotic plugs occasionally disposed into verrucous plaques (in mountainous chain), lichenoid lesions on face, neck and hand's back, and nail's involvement. Histologically three types of lesions are observed: marked hyperkeratosis, lichenoid aspect, and follicular pustulosis. Mucous membranes alterations, present for almost as long as 20 years, include stomatitis, chronic balanitis with ulcerative and keratotic lesions leading to synechiae; ocular abnormalities has had a follow up into lesions similar to those of cicatricial pemphigoid; direct immunofluorescence study in the vicinity of a buccal erosion showed a complement deposit on basement membrane; immunofluorescence studies on involved and uninvolved skin, and indirect immunofluorescence were negative. Several diagnosis were considered, in first place an atypical Reiter's syndrome. A part the possibility of a new entity, the most attractive hypothesis is this of a keratosis lichenoides chronica with severe mucous cicatrical lesions. A large number of treatment had been inefficacious but a clear improvement of keratotic lesions was noted with oral retinoid therapy.
Seborrheic keratoses are benign lesions and, generally, are easily diagnosed based on clinical criteria. However, several types of benign as well as malignant lesions have been found associated with seborrheic keratoses, thus confusing the clinical picture. Presented is the first reported case of trichilemmomas occurring within seborrheic keratosis and masquerading as melanoma with regression. Biopsy of unusual seborrheic keratoses is recommended.
BACKGROUND: Various types of hyperkeratotic lesions can be observed in patients with psoriasis treated with PUVA. Clinically it can be difficult to classify them and to differentiate benign from malignant hyperkeratotic lesions. Recently, we introduced the term PUVA keratosis, which we regard as a distinct entity. OBJECTIVE: The purpose of the study was to describe in more detail the clinical and histopathologic features of PUVA keratoses and to investigate a possible relation with nonmelanoma skin cancer. METHODS: A group of 13 psoriasis patients with PUVA keratoses was studied and compared with 247 psoriasis patients without these keratoses, who had also received long-term therapy with PUVA. RESULTS: The presence of PUVA keratoses was associated with an increased risk of nonmelanoma skin cancer. The estimated relative risk for skin cancer in patients with PUVA keratoses, adjusted for age, sex, and UVA dose, as compared with psoriasis patients without these keratoses, who had also received long-term PUVA treatment, was 6.5 (95% confidence interval, 1.3 to 32.1). Squamous cell carcinomas contributed the most to this increased risk. CONCLUSION: PUVA keratoses are associated with an increased risk of nonmelanoma skin cancer. Therefore careful clinical follow-up of psoriasis patients with PUVA keratoses is necessary, and cessation of PUVA treatment should be considered.
Keratosis diffusa fetalis is a rare autosomic recessive disorder, in which infants are covered with large parchment-like scales, split by deep fissures. Most affected infants die a few weeks after birth because of infections and respiratory problems. The authors present the clinical, histological and ultrastructural aspects of two cases of Ichthyosis congenita fetalis observed in negro-African newborns.
A 70-year-old man had a rapid growth of a pigmented eyelid lesion, previously stationary for at least 50 years. Because of the suspicion of malignant melanoma, the lesion which resembled a cutaneous horn was excised. Histologic examination demonstrated a benign epithelial tumor, inverted follicular keratosis.
This is a case report of malignant melanoma presenting with both clinical and histopathologic features of a seborrheic keratosis. Not a rare phenomenon, this report emphasizes the importance of biopsy to evaluate apparent seborrheic keratoses. We believe that this phenomenon is best considered a presentation of melanoma. Diminished routine histopathologic evaluation of apparent seborrheic keratoses may well increase the number of mistaken diagnoses in such cases.
The incidence of nonmelanoma skin cancer, including both squamous cell carcinoma and basal cell carcinoma, is a significant health problem in the United States. Actinic keratosis (AK), the precursor of cutaneous squamous cell carcinoma, is a major risk factor for nonmelanoma skin cancer. In addition, AKs are tissue targets for the identification of biomarkers for use in chemopreventive studies. The biomarker addressed in this study is epidermal cell proliferation, as quantitated by proliferating cell nuclear antigen (PCNA). Shave biopsies were obtained from AKs, tissue immediately adjacent to AKs, normal-appearing, upper-medial arm skin, and non-sun-exposed skin from 19 subjects. When any degree of PCNA staining was considered positive (semiquantitative 1-4 scale), there was a significant difference and a progressively increasing mean PCNA labeling index (LI) in the total epidermis (basal and suprabasal layers), beginning with non-sun-exposed buttock skin, with the lowest LI (2.5 + or - 1.6%), followed by upper-medial arm skin (12.3 + or - 7.4%; P = 0.0015), skin adjacent to AKs (19.2 + or - 12.2%; P = 0.0218), and finally, AKs with the highest LI (34.6 + or - 20.1%; P = 0.0017). This same pattern was observed when the epidermis was separated into basal and suprabasal layers, with the exception of a nonsignificant result for upper-medial arm skin compared with adjacent skin in the basal layer (P = 0.3981). PCNA LIs were also analyzed separately by staining intensity (i.e., scores of 1-4). The PCNA LI in skin with varying degrees of sun damage and/or histological atypia is a candidate surrogate end point biomarker for skin cancer chemoprevention studies.