“…1 It most commonly affects middle-aged women, 1,2 although it has been described in both sexes and in various age groups. 3 The retroauricular areas are often involved (as noted in our patient), but it has also been reported on the cheeks, neck, chin, ears, scalp, temple and lumbosacral area. 1,[3][4][5] It typically presents as itchy, reddishbrown/violaceous plaques, with associated cysts, milia and comedonal openings.…”
Section: Discussionsupporting
confidence: 72%
“…LPFT is a rare subtype of lichen planus (LP), first described in 1977 with < 20 reported cases . It most commonly affects middle‐aged women, although it has been described in both sexes and in various age groups . The retroauricular areas are often involved (as noted in our patient), but it has also been reported on the cheeks, neck, chin, ears, scalp, temple and lumbosacral area .…”
Section: Discussionmentioning
confidence: 49%
“…There is no clear consensus on how to treat LPFT. Multiple approaches have been described in individual cases, including topical and systemic corticosteroids, systemic retinoids, ciclosporin and surgical removal, with relapse at the site of surgery noted in some cases . Our patient had successful resolution of the initial lesion following surgical excision, but has had further lesions develop at different sites, which have remained untreated at her request, and she remains under follow‐up.…”
Section: Discussionmentioning
confidence: 82%
“…Trichoadenoma is a rare, usually solitary, follicular neoplasm characterized by numerous follicular/infundibular cysts, but again lacking inflammation. Given the density of the lymphocytic infiltrate, folliculotropic mycosis fungoides was also considered in this case; however, there was minimal folliculotropism of lymphocytes and no overt cytological atypia . Follicular mucinosis was excluded by the lack of mucin within follicular epithelium …”
A 55-year-old woman presented in 2016 with a slowly enlarging solitary itchy plaque on her left occipital hairline. It had become mildly tender and thickened over a 9-month period. The patient was otherwise well, and used only occasional salbutamol inhalers for asthma. Physical examination revealed an erythematous plaque 30 mm in size, within which were comedonal openings and small cysts, from which could be expressed a mucoid discharge (Fig. 1a). The lesion was initially biopsied, then subsequently excised due to diagnostic uncertainty, and healed well.The patient remained under annual dermatology follow-up with no new lesions until 3 years later in 2019, when she developed similar itchy lesions affecting her left temple and left postauricular areas (Fig. 1b-d). In the intervening time, the patient had been successfully treated for endometrial cancer with hysterectomy, with no other changes to her health. Further skin biopsies were taken from the lesions. The patient was subsequently diagnosed with polymyalgia rheumatica, for which a reducing dose of prednisolone was started. She had also noticed a new similar erythematous patch on her right forehead.
“…1 It most commonly affects middle-aged women, 1,2 although it has been described in both sexes and in various age groups. 3 The retroauricular areas are often involved (as noted in our patient), but it has also been reported on the cheeks, neck, chin, ears, scalp, temple and lumbosacral area. 1,[3][4][5] It typically presents as itchy, reddishbrown/violaceous plaques, with associated cysts, milia and comedonal openings.…”
Section: Discussionsupporting
confidence: 72%
“…LPFT is a rare subtype of lichen planus (LP), first described in 1977 with < 20 reported cases . It most commonly affects middle‐aged women, although it has been described in both sexes and in various age groups . The retroauricular areas are often involved (as noted in our patient), but it has also been reported on the cheeks, neck, chin, ears, scalp, temple and lumbosacral area .…”
Section: Discussionmentioning
confidence: 49%
“…There is no clear consensus on how to treat LPFT. Multiple approaches have been described in individual cases, including topical and systemic corticosteroids, systemic retinoids, ciclosporin and surgical removal, with relapse at the site of surgery noted in some cases . Our patient had successful resolution of the initial lesion following surgical excision, but has had further lesions develop at different sites, which have remained untreated at her request, and she remains under follow‐up.…”
Section: Discussionmentioning
confidence: 82%
“…Trichoadenoma is a rare, usually solitary, follicular neoplasm characterized by numerous follicular/infundibular cysts, but again lacking inflammation. Given the density of the lymphocytic infiltrate, folliculotropic mycosis fungoides was also considered in this case; however, there was minimal folliculotropism of lymphocytes and no overt cytological atypia . Follicular mucinosis was excluded by the lack of mucin within follicular epithelium …”
A 55-year-old woman presented in 2016 with a slowly enlarging solitary itchy plaque on her left occipital hairline. It had become mildly tender and thickened over a 9-month period. The patient was otherwise well, and used only occasional salbutamol inhalers for asthma. Physical examination revealed an erythematous plaque 30 mm in size, within which were comedonal openings and small cysts, from which could be expressed a mucoid discharge (Fig. 1a). The lesion was initially biopsied, then subsequently excised due to diagnostic uncertainty, and healed well.The patient remained under annual dermatology follow-up with no new lesions until 3 years later in 2019, when she developed similar itchy lesions affecting her left temple and left postauricular areas (Fig. 1b-d). In the intervening time, the patient had been successfully treated for endometrial cancer with hysterectomy, with no other changes to her health. Further skin biopsies were taken from the lesions. The patient was subsequently diagnosed with polymyalgia rheumatica, for which a reducing dose of prednisolone was started. She had also noticed a new similar erythematous patch on her right forehead.
“…LPFT has been reported in association with diseases, such as hepatitis B, hepatitis C,[ 1 ] and autoimmune thyroiditis. [ 5 ] It may be associated with other forms of lichen planus as well. [ 6 ] In our case, no such association was noticed.…”
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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