Gorlin syndrome or basal cell nevus syndrome (BCNS) is a rare autosomal dominant disorder. The condition appears to have complete penetrance and variable expressivity, which makes clinilcal presentation among families variable. All known BCNS carry mutations in PATCHED gene. A 65 years old male patient presented with complaints of characteristic skin lesions on his face, back, palms since early adulthood. The lesions were pigmented nodules with characteristic border. The histopathology showed characteristic features suggestive of Basal Cell Carcinoma (BCC). This case was atypical due to appearance of lesions quite later in life.
BACKGROUNDAcne vulgaris is a chronic inflammatory disease of the pilosebaceous unit characterised by comedones, papules, pustules, nodules and cysts, which may later on develop into scarring. This disease occurs worldwide and usually starts in adolescence and resolves in the mid 20s. Initially, isotretinoin was used only for severe grades of acne, but in recent years, this drug has been increasingly prescribed in moderate cases of acne unresponsive to the conventional treatment. Isotretinoin is the most dependable acne treatment and maybe justified in moderate grades of acne where scarring is imminent or acne associated with psychological diseases. Though the recommended dose produces good results, it causes many side effects, cheilitis being most common. To overcome these side effects, lower doses of isotretinoin are being tried in various clinical trials.
Lichen planus follicularis tumidus (LPFT) is an extremely rare variant of lichen planus characterized by white to yellow milia-like cysts and comedones on a violaceous to hyperpigmented plaque most commonly involving retroauricular area. Clinically, it resembles milia
en plaque
. It is usually asymptomatic, more common in middle-aged females. Histopathologically, it has features of lichen planopilaris along with follicular cysts in dermis surrounded by lichenoid infiltrate. We are reporting a case of LPFT in a 62-year-old male patient involving bilateral retroauricular areas due to the rarity of this condition.
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