Lichen simplex chronicus is a skin disease that mostly affects female patients,
with a peak incidence between ages 35 and 50 years. On the scalp, it appears as
a single or multiple oval lesions, showing scaling and hair shaft loss or
breakage. An important dermoscopic feature of the disease are the "broom
fibers." Histopathology reveals the "hamburger" and the "gear wheel" signs. The
aim of this report is to demonstrate a case of lichen simplex chronicus on the
scalp with typical and exuberant clinical, dermoscopic, and histopathological
findings.
Granuloma annulare is a benign cutaneous inflammatory disease, whose lesions have
spontaneous improvement in two years in 50% of cases, but there is recurrence in
40% of patients. Treatment may be topical, intralesional or systemic. The use of
phototherapy with narrowband UVB is highlighted, whose mechanism of action in
this disease is still unclear, probably related to the inhibition of T
lymphocytes. Herein, a case of a disseminated granuloma annulare of difficult
therapeutic management is described. It was treated with narrowband UVB
phototherapy twice a week for six months, with good clinical improvement, being
a good low-risk therapeutic option and that, in this case, provided quick and
satisfactory response.
Lupus tumidus is considered a rare subtype of chronic cutaneous lupus
erythematosus, characterized by erythema and bright urticarial
erythematous-violaceous lesions that leave no scars after regression.
Histopathology reveals perivascular and periannexal lymphohistiocytic
infiltrates in the papillary and reticular dermis and interstitial mucin
deposition. Treatment is based on photoprotection, topical corticosteroids and
antimalarials. We report two cases of lupus tumidus, which deserve attention for
their low frequency in the literature, in addition to their relevance as a
differential diagnosis among dermatologic disorders.
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