Difference between revisions of "Lichen simplex chronicus"

Lichen simplex chronicus
	Diagnosis in short
	; Lichen simplex chronicus. H&E stain.
LM	irregular psoriasiform change (acanthosis), hyperkeratosis, parakeratosis, +/-spongiosis
LM DDx	prurigo nodularis, oral lichen simplex chronicus
Site	skin
Clinical history	scratching, irritation
Prevalence	common
Prognosis	benign

Latest revision as of 21:17, 9 December 2013

Lichen simplex chronicus, abbreviated LSC, a relatively common diagnosis in dermatopathology.

It is also known as squamous cell hyperplasia.^[1]

In the oral cavity, it may go by the name benign alveolar ridge keratosis.^[2]

General

May be considered a variant of spongiotic dermatitis.^[3]; more specifically, some think it is an atopic dermatitis (which fits in the large spongiotic dermatitis category).^[4]
It is lumped with the psoriasiform dermatitides.

Etiology:^[5]

Pruritus (itchness) -> mechanical trauma -> lichenification (thickened/leathery^[6].

Microscopic

Features:^[7]

Acanthosis (epithelial thickening) - irregular.
Hyperkeratosis.

Other features:^[8]

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^[2]) - see oral pathology.

Images

LSC - very low mag. (WC)
LSC - low mag. (WC)
LSC - intermed. mag. (WC)
LSC - very high mag. (WC)

Sign out

SKIN, PUNCH BIOPSY:
- LICHEN SIMPLEX CHRONICUS.
- NEGATIVE FOR MALIGNANCY.

Oral

RETROMOLAR PAD, RIGHT, PUNCH BIOPSY:
- ORAL LICHEN SIMPLEX CHRONICUS.
- NEGATIVE FOR MALIGNANCY.

ALVEOLAR RIDGE, RIGHT INFERIOR, BIOPSY:
- ORAL MUCOSA WITH SQUAMOUS CELL HYPERPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

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.

References

↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1011. ISBN 978-1416031215.
↑ ^2.0 ^2.1 Natarajan, E.; Woo, SB. (Jan 2008). "Benign alveolar ridge keratosis (oral lichen simplex chronicus): A distinct clinicopathologic entity.". J Am Acad Dermatol 58 (1): 151-7. doi:10.1016/j.jaad.2007.07.011. PMID 18158926.
↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 296. ISBN 978-0470519035.
↑ Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 26. ISBN 978-0443066542.
↑ URL: http://emedicine.medscape.com/article/1123423-overview. Accessed on: 20 August 2010.
↑ URL: http://www.medterms.com/script/main/art.asp?articlekey=10131. Accessed on: 20 August 2010.
↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1065-6. ISBN 0-7216-0187-1.
↑ URL: http://emedicine.medscape.com/article/1123423-diagnosis. Accessed on: 20 August 2010.

[Ref_PBoD1011-1] Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1011. ISBN 978-1416031215.

[pmid18158926-2] 2.0 ^2.1 Natarajan, E.; Woo, SB. (Jan 2008). "Benign alveolar ridge keratosis (oral lichen simplex chronicus): A distinct clinicopathologic entity.". J Am Acad Dermatol 58 (1): 151-7. doi:10.1016/j.jaad.2007.07.011. PMID 18158926.

[Ref_DCHH296-3] Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 296. ISBN 978-0470519035.

[Ref_Derm26-4] Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 26. ISBN 978-0443066542.

[5] URL: http://emedicine.medscape.com/article/1123423-overview. Accessed on: 20 August 2010.

[6] URL: http://www.medterms.com/script/main/art.asp?articlekey=10131. Accessed on: 20 August 2010.

[Ref_PBoD1065-6-7] Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1065-6. ISBN 0-7216-0187-1.

[8] URL: http://emedicine.medscape.com/article/1123423-diagnosis. Accessed on: 20 August 2010.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

@@ Line 1: / Line 1: @@
-#redirect [[Non-malignant_skin_disease#Squamous_cell_hyperplasia]]
+{{ 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:Dermatopathology]]

Difference between revisions of "Lichen simplex chronicus"

Latest revision as of 21:17, 9 December 2013

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