An unusual case of idiopathic localized giant cell lichenoid dermatitis

Giant cell lichenoid stomatitis - An oral medicine case book

“…9 Cordoba et al described a patient with acute lymphoblastic leukaemia who developed GCLD limited to the site of scar formation following herpes zoster resolution. 10 In both case reports, authors suggested that a hypersensitivity reaction could have played a role in triggering the condition, supporting the view of Gonzalez et al 7,[9][10] In summary, the current case showed histological features of a mixed lichenoid inflammatory infiltrate with multinucleated giant cells, in the absence of infective aetiological agents and without evidence of granulomatous inflammation, and is therefore best termed giant cell lichenoid stomatitis. It is proposed that this entity should be considered analogous to a rare dermatological condition, giant cell lichenoid dermatitis, which shows similar histological features.…”

“…Drug intake as an aetiological agent was supported by the fact that there was clinical improvement following discontinuation of the chronic medications the patient was taking. [6][7] In this original case report, the authors postulated that the cause of the giant cells might be related to an impaired immune system due to longstanding SLE and low-dose corticosteroid administration.…”

“…Both GCLD and sarcoidosis of the skin show similar clinical and histological features. 7 Although cutaneous lesions are rare in sarcoidosis, they generally present with purple to brown papules and plaques, however, cases presenting with a pruritic scaly rash have also been described. 8 Histologically, sarcoidosis of the skin is characterised by so-called naked granulomas containing multiple multinucleated giant cells in a lichenoid pattern at the dermo-epidermal junction.…”

“…These features show some degree of overlap with GCLD, however GCLD lacks the characteristic granulomatous inflammatory component. 7 The importance of considering sarcoidosis as a possible diagnosis for GCLD lies in its association with systemic disease. The authors concluded by emphasising the importance of a clinical work-up to exclude sarcoidosis in all patients with clinical and histological features of GCLD.…”

Granulomatous Dermatitis and Others

“…Giant cell lichenoid dermatitis is a rare lichenoid reaction that can be either idiopathic or as a hypersensitivity reaction to medication. There have been only few case reports regarding this entity involving the skin [137,138]. Pruritic, erythematous, and violaceous macules, papules, plaques, and nodules are typically seen on the trunk and extremities.…”