Lichen simplex chronicus: Difference between revisions
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Lichen_simplex_chronicus_-_low_mag.jpg | |||
| Width = | |||
| Caption = Lichen simplex chronicus. [[H&E stain]]. | |||
| Micro = irregular psoriasiform change (acanthosis), hyperkeratosis, parakeratosis, +/-spongiosis | |||
| Subtypes = | |||
| LMDDx = [[prurigo nodularis]], oral lichen simplex chronicus | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[skin]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = scratching, irritation | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
}} | |||
'''Lichen simplex chronicus''', abbreviated '''LSC''', a relatively common diagnosis in [[dermatopathology]]. | |||
It is also known as ''squamous cell hyperplasia''.<ref name=Ref_PBoD1011>{{Ref PBoD8|1011}}</ref> | |||
In the [[oral pathology|oral]] cavity, it may go by the name ''benign alveolar ridge keratosis''.<ref name=pmid18158926>{{Cite journal | last1 = Natarajan | first1 = E. | last2 = Woo | first2 = SB. | title = Benign alveolar ridge keratosis (oral lichen simplex chronicus): A distinct clinicopathologic entity. | journal = J Am Acad Dermatol | volume = 58 | issue = 1 | pages = 151-7 | month = Jan | year = 2008 | doi = 10.1016/j.jaad.2007.07.011 | PMID = 18158926 }}</ref> | |||
==General== | |||
*May be considered a variant of ''spongiotic dermatitis''.<ref name=Ref_DCHH296>{{Ref DCHH|296}}</ref>; more specifically, some think it is an ''atopic dermatitis'' (which fits in the large ''[[spongiotic dermatitis]]'' category).<ref name=Ref_Derm26>{{Ref Derm|26}}</ref> | |||
*It is lumped with the [[psoriasiform dermatitides]]. | |||
Etiology:<ref>URL: [http://emedicine.medscape.com/article/1123423-overview http://emedicine.medscape.com/article/1123423-overview]. Accessed on: 20 August 2010.</ref> | |||
*Pruritus (itchness) -> mechanical trauma -> lichenification (thickened/leathery<ref>URL: [http://www.medterms.com/script/main/art.asp?articlekey=10131 http://www.medterms.com/script/main/art.asp?articlekey=10131]. Accessed on: 20 August 2010.</ref>. | |||
==Microscopic== | |||
Features:<ref name=Ref_PBoD1065-6>{{Ref PBoD|1065-6}}</ref> | |||
*Acanthosis (epithelial thickening) - irregular. | |||
*Hyperkeratosis. | |||
Other features:<ref>URL: [http://emedicine.medscape.com/article/1123423-diagnosis http://emedicine.medscape.com/article/1123423-diagnosis]. Accessed on: 20 August 2010.</ref> | |||
*[[Spongiosis]] (epidermal intercellular edema -- cells appear to have a clear halo around 'em). | |||
*[[Parakeratosis]] = retention of nuclei in the stratum corneum. | |||
DDx: | |||
*[[Prurigo nodularis]] - focal process (nodule or papule). | |||
*Benign alveolar ridge keratosis ([[AKA]] oral lichen simplex chronicus<ref name=pmid18158926>{{Cite journal | last1 = Natarajan | first1 = E. | last2 = Woo | first2 = SB. | title = Benign alveolar ridge keratosis (oral lichen simplex chronicus): A distinct clinicopathologic entity. | journal = J Am Acad Dermatol | volume = 58 | issue = 1 | pages = 151-7 | month = Jan | year = 2008 | doi = 10.1016/j.jaad.2007.07.011 | PMID = 18158926 }}</ref>) - see [[oral pathology]]. | |||
===Images=== | |||
<gallery> | |||
Image:Lichen simplex chronicus - very low mag.jpg | LSC - very low mag. (WC) | |||
Image:Lichen simplex chronicus - low mag.jpg | LSC - low mag. (WC) | |||
Image:Lichen simplex chronicus - intermed mag.jpg | LSC - intermed. mag. (WC) | |||
Image:Lichen simplex chronicus - very high mag.jpg | LSC - very high mag. (WC) | |||
</gallery> | |||
==Sign out== | |||
<pre> | |||
SKIN, PUNCH BIOPSY: | |||
- LICHEN SIMPLEX CHRONICUS. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Oral=== | |||
<pre> | |||
RETROMOLAR PAD, RIGHT, PUNCH BIOPSY: | |||
- ORAL LICHEN SIMPLEX CHRONICUS. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
<pre> | |||
ALVEOLAR RIDGE, RIGHT INFERIOR, BIOPSY: | |||
- ORAL MUCOSA WITH SQUAMOUS CELL HYPERPLASIA. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Micro=== | |||
The sections show a squamous mucosa with irregular psoriasiform change, parakeratosis, and focal hypergranulosis. There is no inflammation at the interface. Epidermal intercellular bridges are easily seen. There is no significant nuclear atypia. Mitoses are not evident. | |||
==See also== | |||
*[[Non-malignant skin disease]]. | |||
*[[Dermatopathology]]. | |||
*[[Inflammatory skin disease]]. | |||
*[[Erythroplakia]]. | |||
*[[Leukoplakia]]. | |||
*[[Eczematous dermatitis]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Dermatopathology]] | |||