A Rare Form of Lichenoid Tissue Reaction: Lichenoid Granulomatous Dermatitis

Abstract

Interface dermatitis is characterized by inflammatory infiltration dermoepidermal junction and defined as lichenoid tissue reaction. This histopathological appearance and pathophysiological process are mainly observed in lichen planus, lichenoid drug reaction, lichenoid autoimmune connective tissue disease, lichenoid purpura and lichenoid granulomatosis dermatitis. In this case, we report a 51-yearold female patient, diagnosed with lichenoid granulomatous dermatitis concurrence with myasthenia gravis and thymoma.

Lichenoid granulomatous dermatitis: A case with dramatic desquamation and multiple potential causes

“…There has been a wide range of reported clinical morphologies of LGD including violaceous macules and papules, erythematous papules and plaques with or without scale, unilateral or dermatomal papules, annular plaques with central atrophy, and miliary-like lesions with lichenoid papules appearing to be the most common clinical presentation of LGD in the literature. 3 A review of the literature revealed no reported cases of LGD presenting with a generalized purpuric, exfoliative eruption as seen in this case.…”

“…The causes of LGD are diverse and include a range of inflammatory, autoimmune, and infectious conditions, as well as several known triggering medications. [1][2][3][4][5][6][7][8][9][10][11] Notably, our patient has multiple comorbidities and a complex medical history, including diseases which have been implicated with LGD, such as hepatobiliary disease, endocrinopathy, rheumatoid arthritis, and infection. Our patient initially presented with bilateral, nonspecific areas of ground-glass opacities on chest CT, which raised EGPA and sarcoidosis as potential causes of the cutaneous eruption.…”

“… 1 LGD represents an uncommonly encountered mixed-pattern dermatitis with histopathologic features of band-like lymphocytic inflammation of the dermal-epidermal junction, with or without lichen planus-like changes, and granulomatous inflammation involving the dermis. 1 – 4 Notwithstanding these mixed histologic findings, LGD is a distinct histologic entity microscopically. However, the same cannot be said about the clinical morphology of LGD, which presents with a wide range of primary lesions including erythematous-violaceous macules-plaques with varying amount of scale.…”

“…However, the same cannot be said about the clinical morphology of LGD, which presents with a wide range of primary lesions including erythematous-violaceous macules-plaques with varying amount of scale. 3 LGD also has diverse clinical associations including but not limited to drug eruption, infectious processes, endocrinopathies, cutaneous T-cell lymphoma (CTCL), hepatobiliary disorders, and rheumatoid arthritis. [1][2][3][4][5] We present a challenging clinicopathologic case of LGD in a 58-year-old woman with a purpuric, exfoliative rash and a substantially complex medical history with multiple potential causes.…”

Assessment of cases of lichenoid granulomatous stomatitis in respect to demographics, histological features, and subcategories in known population

“…It is considered to be multifactorial disease. It affects skin, mucous membrane, nails and hairs [3]. Clinically it appears grayish white radiating striations seen in buccal mucosa bilaterally.…”