A patient presenting with febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta pleva requires an entirely different approach than a patient presenting with pityriasis lichenoides chronica plc. Department of dermatology, faculty of medicine, king saud university, riyadh, saudi arabia. There are intense acute inflammatory symptoms, and old and new eruptions are present. The mild chronic form, pityriasis lichenoides chronica plc, is characterised by the gradual development of symptomless, small, scaling papules that. Nov 30, 2016 pityriasis lichenoides et varioliformis acuta pleva this subtype of pityriasis lichenoides presents acutely with numerous red papulovesicles that are itchy and sometimes painful. Pityriasis lichenoides et varioliformis acuta may change to plc after an acute phase. Presents with redbrown papules with waferlike scale. This is a 3year retrospective and prospective, descriptive study of all patients clinically diagnosed as pityriasis lichenoides and confirmed by histopathology. Guttate pityriasis lichenoides chronica is an uncommon presentation of this tcellmediated disease. Plc demonstrates more subtle histology whereas, at the other end of the.
Its chronic longerlasting form is known as pityriasis lichenoides chronica plc. It is considered in a spectrum with pityriasis lichenoides et varioloformis acuta and rarely mycosis fungoides and cd30 lymphomas. Histopathologic diagnosis of pityriasis lichenoides et. Pityriasis lichenoides chronica, he 20x 5236 pityriasis lichenoides chronica, he 10x 1590 pityriasis lichenoides chronica, he 40x 1591 another case. Dec 04, 2018 the rash varies from being chronic and mild to being acute and having severe eruptions. A 19yearold woman presented with a fiveyear history of guttate macules and yellow to skincolored papules with collarette of fine scale on the trunk and the upper and lower extremities. There is a predilection for males, though both males and females are affected. Superficial lymphocytic infiltrate, slight exocytosis, sometimes slight spongiosis, parakeratosis, slight vacuolar degeneration of the basal layer. A manual dermlite 3 3gen, san juan capistrano, ca dermoscope. Fully developed lesions exhibit parakeratosis with neutrophils, hypogranulosis, psoriasiform. Pityriasis lichenoides is an idiopathic disorder that can be viewed as a clinical and histopathologic spectrum with the clinical disorders pityriasis lichenoides et varioliformis acuta pleva, mucha habermann disease at one end, and, more commonly, pityriasis lichenoides chronica. Possibility for pityriasis lichenoides chronica, parapsoriasis small plaque form or lichen planus was considered. Pityriasis lichenoides et varioliformis acuta wikipedia.
Pdf pityriasis lichenoides pathophysiology, classification, and. This form is also known as pityriasis lichenoides et varioliformis acuta pleva chronic pityriasis lichenoides. Pityriasis lichenoides pl is a skin condition characterized by small, raised pink spots that tend to come together in groups. Jan 09, 2017 pityriasis lichenoides pl is a skin condition characterized by small, raised pink spots that tend to come together in groups. Pityriasis lichenoides et varioliformis acuta pleva and pityriasis lichenoides chronica plc are related benign disorders without recognized association with cutaneous tcell lymphoma ctcl. Pityriasis lichenoides chronica pathology outlines. This pdf is available for free download from a site hosted.
Stratum corneum findings as clues to histological diagnosis of. Pdf differentiation of pityriasis lichenoides chronica. A clinical and histolopathological study of pityriasis lichenoides. Pityriasis lichenoides chronica typically does not ulcerate or scar. Mycosis fungoides mf is the most common form of cutaneous t cell lymphoma ctcl with many clinical variants including papular and pityriasis lichenoides chronica plclike variants. Overlaps with pityriasis lichenoides et varioliformis acuta. The rash varies from being chronic and mild to being acute and having severe eruptions. Several variants exist including pityriasis lichenoides et varioliformis acuta pleva, pityriasis lichenoides chronica plc, and febrile ulceronecrotic muchahabermann disease. Pityriasis lichenoides hub information and resources for. Pityriasis lichenoides is a papulosquamous disorder of unknown etiology with remissions and exacerbations. Pityriasis lichenoides is an uncommon, acquired, idiopathic, selflimiting skin disease that poses a challenge to patients and clinicians to diagnose and treat.
The aim of the study is to describe cases of a unique pleva variant. The histologic diagnosis of pleva was clinically substantiated in 16 of these 42 cases. Pityriasis lichenoides is a rare skin disorder of unknown cause. The term pityriasis lichenoides means that the rash is scaly pityriasis and that it was once thought to look like a lichen a type of plant that lives on rocks because it is made up of small bumpy areas.
Pityriasis lichenoides chronica hiv dermatitis syphilis mycosis fungoides. Pityriasis lichenoides chronica responds to minocycline in three patients. Pityriasis lichenoides chronica pityriasis lichenoides chronica is an uncommon skin disorder that presents with recurrent approach to the patient with an intertriginous skin disorder stain demonstrating grampositive filaments and rods confirms the diagnosis pityriasis rosea occasionally, pityriasis rosea can present as well. Pityriasis lichenoides chronica histopathology diagnose blut. We report the cases of two children with documented pleva evolving into. Pityriasis lichenoides symptoms, diagnosis and treatment. Pityriasis lichenoides is an idiopathic disorder that can be viewed as a clinical and histopathologic spectrum with the clinical disorders pityriasis lichenoides et varioliformis acuta pleva, mucha habermann disease at one end, and, more commonly, pityriasis lichenoides chronica plc at the other. Home skin nontumor pityriasis lichenoides et varioliformis acuta. Pityriasis lichenoides chronica genetic and rare diseases. Overlaps with pityriasis lichenoides chronica sudden onset of crops of small, ulcerated papules on trunk. This form is also referred to as pityriasis lichenoides chronica plc. Dermatopathology reference describes pityriasis lichenoides chronica histopathology including histologic features and provides links to additional medical references.
Jul 10, 2016 pityriasis lichenoides chronica plc tends to present as a more mild, less symptomatic rash smaller papules, little to no itching that continues for a longer period of time, from months to years. Pityriasis lichenoides chronica plc is considered as mild and or plc were enrolled into the study. Pityriasis lichenoides and cutaneous t cell lymphoma. Pityriasis lichenoides chronica plc is a benign, acquired, idiopathic dermatosis characterized by recurrent crops of scaling papules, which may resolve spontaneously over weeks to months or follow a more indolent course. The disease is more common in males and usually occurs in young adulthood, although it has been seen in every age group. The disease is more common in males and usually occurs in young adulthood, although it has been seen in every age group and every race.
This condition is not commonly observed in infants or during old age. It is the more severe version of pityriasis lichenoides chronica. Pityriasis lichenoides is a term used to refer to a group of rare acquired inflammatory skin disorders that includes pityriasis lichenoides chronica plc, pityriasis lichenoides et varioliformis acuta pleva, and the febrile ulceronecrotic muchahabermann disease fumhd variant of pleva. Pityriasis lichenoides chronica, he 20x 5235 pityriasis lichenoides chronica, he 20x 1592. Jun 05, 2018 laboratory workup largely is a function of the acuity of the disease. Pityriasis lichenoides chronica is an uncommon, idiopathic, acquired dermatosis, characterized by evolving groups of erythematous, scaly papules that may persist for months. Pityriasis lichenoides chronica plc and pityriasis lichenoides et varioliformis acuta pleva, but. Pityriasis lichenoides designates a group of rare cutaneous disorders ranging from acute ulceronecrotic lesions called pityriasis lichenoides et varioliformis acuta pleva. Pityriasis lichenoides chronica in a 14yearold boy.
A clinical and histopathological study of pityriasis. Although other forms of the disease occur at younger ages, some individuals start having long term symptoms at thirty years of age. Skin nontumor lichenoid and interface reaction patterns pityriasis lichenoides et varioliformis acuta. Pityriasis lichenoides et varioliformis acuta in skin of color. Pityriasis lichenoides is an uncommon rash of unknown cause. The mild and chronic type is termed as plc or pityriasis lichenoides chronica and it is characterized by slowly developing scaling papules, which are small in size, without other symptoms. Lichen planus lp is a chronic inflammatory and immune mediated disease that affects the skin, nails, hair, and mucous membranes. Jul 31, 20 dermatopathology reference describes pityriasis lichenoides chronica histopathology including histologic features and provides links to additional medical references. Pathology of pityriasis lichenoides top 10 facts dr. Histopathologic diagnosis of pityriasis lichenoides et varioliformis acuta and its clinical correlation. It can range from a relatively mild chronic form to a more severe acute eruption. Pityriasis lichenoides et varioliformis acuta pleva is commonly thought of as a disease of young adults, yet we identified five cases, involving patients who were 3, 5, 6, 8, and 11 years of age, among 000 consecutive specimens submitted to a general dermatopathology laboratory during a 15week period.
Pityriasis lichenoides is an uncommon, acquired, idiopathic skin condition. Pityriasis lichenoides chronica plc, which is a benign eruption with lymphocytic infiltrates of the skin, presents as a persistent, erythematous, papular eruption with scale. Pleva and plc are not distinct diseases but are different manifestations of the same process. The exact nature of these lesions is not fully understood. The lesions have ulcerated, necrotic or haemorrhagic features and in the early stages can resemble chickenpox. David weedon ao md frcpa fcaphon, in weedons skin pathology third edition. Pathology outlines pityriasis lichenoides chronica. Pityriasis lichenoides chronica histopathology diagnose. It also exhibits slight parakeratotic scale and minimal keratocytic necrosis and spongiosis in the epidermis. It is a challenging disorder to diagnose, categorise, and treat due to its varied presentation and uncertain course. Pityriasis lichenoides et varioliformis acuta pleva medind. Pityriasis lichenoides chronica is a rare skin condition that causes small raised papules to develop on various areas of the skin. Perelman department of dermatology, new york university abstract.
Clinical and histologic features of pityriasis lichenoides et. Pityriasis lichenoides is usually a selflimited process that evolves after several weeks to months. Differentiation and clonality of lesional lymphocytes in. Pityriasis lichenoides chronica plc is a rare, chronic cutaneous disorder most commonly seen in children and young adults with a slight male predominance. This form is usually found in children and is more severe. During psoralen and ultraviolet a puva treatment of mf, plclike papular lesions were observed to appear. It is characterized by polygonal, flattopped, violaceous papules and plaques with overlying, reticulated, fine white scale wickhams striae, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. Pityriasis lichenoides is a rare cutaneous disorder of unknown etiology.
Histopathology of skin showed irregular acanthosis, interface dermatitis. Pityriasis lichenoides is an erythematous, papulosquamous, tcellmediated dermatosis. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Pityriasis lichenoides chronica plc is a skin disease that causes the development of small, scaling, raised spots on the skin. Pityriasis lichenoides et varioliformis acuta pleva is a disease of the immune system. Thus, cases clinically diagnosed as pityriasis lichenoides et varioliformis acuta plevapityriasis lichenoides chronica plc but not having basal cell vacuolization. Pityriasis lichenoides and its subtypes sciencedirect. Clinical differentiation between pityriasis lichenoides chronica plc and guttate psoriasis gp may sometimes be a difficult task, which often requires histological analysis to reach a definitive diagnosis.
Histopathology helps greatly in the diagnosis of this condition. Pityriasis lichenoides pictures, causes, symptoms, treatment. Pityriasis lichenoides is an uncommon skin disease that presents in three. The cause of pityriasis lichenoides is not known, but the symptoms that occur. We studied clinical and histopathological features of pityriasis lichenoides in our patients. Puvainduced pityriasis lichenoides chronicalike papular. Some seasonal variation, worsening in winter and some improvement in sunlight. Pityriasis lichenoides chronica responds to minocycline in.
The mild chronic form, pityriasis lichenoides chronica plc, is characterised by the gradual development of symptomless, small, scaling papules that spontaneously flatten and regress over weeks. Aug 21, 20 pityriasis lichenoides and cutaneous t cell lymphoma. Pityriasis lichenoides primary care dermatology society uk. Plc is the relatively mild form of the disease pityriasis lichenoides. The exact cause of this disorder is not clearly understood, although there are a number of theories surrounding the origin of this rash. Apr 28, 2018 pityriasis lichenoides chronica plc is a skin disease that causes the development of small, scaling, raised spots on the skin. Pityriasis lichenoides chronica, he 60x 10278 pityriasis lichenoides chronica, he 60x 10279. Pityriasis lichenoides is divided into two main forms, pityriasis lichenoides chronica plc and pityriasis lichenoides et varioliformis acuta pleva, but intermediate forms or patients with both forms are often seen. Age and sex distribution pityriasis lichenoides chronica affects a wide age group, but is more common in adolescents, teenagers, and young adults. At the completion of this learning activity, participants should be familiar with the clinical manifestations, histopathological findings, proposed mechanisms for pathogenesis, methods of treatment, and potential outcomes of pityriasis lichenoides and its subtypes. The disease is characterized by rashes and small lesions on the skin.
Overlaps with pityriasis lichenoides et varioliformis acuta shows predeliction for males in late childhood and early adulthood involve the arms, legs, trunk and buttocks. Pityriasis lichenoides an overview sciencedirect topics. Pityriasis lichenoides encompasses a spectrum of clinical presentations ranging from acute papular lesions that rapidly evolve into pseudovesicles and central necrosis pityriasis lichenoides et varioliformis acuta or pleva to small, scaling, benignappearing papules pityriasis lichenoides chronica or plc. Aug 23, 20 pityriasis rosea pityriasis lichenoides by ajai sasi malabar medical college slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. An update on the diagnosis and management of the most common benign and malignant cutaneous lymphoproliferative diseases in children.
Pityriasis lichenoides british association of dermatologists. Plc is the most common form and presents with small redbrown papules with an adherent micalike scale. A person with plc tends to have multiple episodes of papules on the skin lasting for months or a few years, meaning the disease is chronic. Introduction pityriasis lichenoides pl is an uncommon selflimited dermatosis which occurs at any age, particularly in children and young adults1,2,3. Pityriasis lichenoides represents a group of uncommon skin disorders that tend to affect children and young adults, and are divided into two main conditions. What is pityriasis lichenoides pityriasis lichenoides is an uncommon rash of unknown cause. Pityriasis lichenoides chronica presenting with bilateral. Pityriasis lichenoides is the name given to an uncommon rash of unknown cause. Jun 05, 2018 pityriasis lichenoides encompasses a spectrum of clinical presentations ranging from acute papular lesions that rapidly evolve into pseudovesicles and central necrosis pityriasis lichenoides et varioliformis acuta or pleva to small, scaling, benignappearing papules pityriasis lichenoides chronica or plc.
Dec 22, 2018 who gets pityriasis lichenoides chronica. If you continue browsing the site, you agree to the use of cookies on this website. Differentiation of pityriasis lichenoides chronica from. A clinical and histopathological study of pityriasis lichenoides. Differentiation of pityriasis lichenoides chronica from guttate psoriasis by dermoscopy. If you would like a highquality copy or to use the image for commercial purposes, contact the owner. Pityriasis lichenoides chronica jeffrey s henning do dermatology online journal 10 3.
Pityriasis lichenoides pl, an uncommon dermatitis, previously included in the parapsoriasis group, may appear in two clinical forms. A skin biopsy was taken, and histological examination revealed evidence for pityriasis lichenoides chronica. Pityriasis lichenoides et varioliformis acuta photo of the pityriasis lichenoides et varioliformis acuta or mucha habermanns disease, showing the right leg specialty. Pityriasis lichenoides encompasses a spectrum of clinical presentations ranging from acute papular lesions that rapidly evolve into pseudovesicles and central necrosis pityriasis lichenoides et varioliformis acuta or pleva to small, scaling, benignappearing papules p. The more acute sudden onset form is known as pityriasis lichenoides et varioliformis acuta pleva, also known as muchahabermann disease. You may share the image if you comply with our image licence. Pityriasis lichenoides manifests as diffuse polymorphic, papulosquamous dermatitis that varies in severity, temporal onset and development, and prognosis. Due to the suspicion for drug induced pityriasis, acetylsalicylic acid. Pityriasis lichenoides is a rare skin disorder that is limited to the skin.