Dermoscopy of lichen planus‐like keratosis: a model of inflammatory regression

Abstract

Our results show a large correlation among clinical, histologic and dermoscopic aspects of LPLK may be interpreted as a spectrum of cutaneous lesions going into inflammatory regression, showing different clinical and dermoscopic patterns according to the involuting stage. The early type of LPLK (FE) shows a localized granular pattern where regression is at the very early stage. The classic dermoscopic features of regressing lesion for LPLK (pigmented granular pattern) apply to the most frequent encountered pigmented atrophic flat type or classic pigmented type, where sometimes regression is advanced or almost complete and no clear diagnosis of a previous benign/malignant - epithelial or melanocytic lesion can often be given. Regressive dermoscopic features must be evaluated in the context of global and clinical pattern of the lesion. Nonetheless dermoscopy can close correlate with clinical incipient or complete regression and must prompt the need for eventual prophylactic surgical removal.

Studying Regression of Seborrheic Keratosis in Lichenoid Keratosis with Sequential Dermoscopy Imaging

“…Tumoral regression may be mediated by different mechanisms, where the immune response, apoptosis, anti-angiogenesis and genomic instability may play a role [12]. Cytotoxic T cells may be the final common denominator of regression in LK, keratoacanthoma and halo nevus [12,19]. However, contrary to halo nevus, cytotoxic T cells only play a marginal role in LK and additional and more complex mechanisms are also involved [19].…”

“…The histopathological correlation of these findings is the presence of pigmentary incontinence and melanophages in the papillary dermis [8,9,10]. Occasionally clumps of dark brown to black pigment, grayish globules, grayish short lines and vascular structures may also be present in some LK [8,9,10,12]. In the localized granular pattern, one can discern the dermoscopic features of solar lentigo or seborrheic keratosis and a localized area of grayish-brown coarse granularity.…”

“…Regression is a phenomenon present in a variety of cutaneous lesions (keratoacanthoma, halo nevus, LK, etc). Tumoral regression may be mediated by different mechanisms, where the immune response, apoptosis, anti-angiogenesis and genomic instability may play a role [12]. Cytotoxic T cells may be the final common denominator of regression in LK, keratoacanthoma and halo nevus [12,19].…”

Atypical Pseudonetworks in Pigmented Facial Macules: A Report of Two Cases

“…We supposed that other dermoscopic clues for BCC might be helpful in ruling out melanoma in such case. In addition, several lesions such as LichenplanusLike Keratosis (LPLK: a kind of irritated seborrheic keratosis) and Pigmented Actinic Keratosis (PAK), can mimic facial LM/LMM [6][7][8]. However, the common LM/LMM findings of asymmetrical follicular openings and a hyperpigmented rim of follicular openings are very rarely reported in LPLK and PAK [9].…”

Broadband Light Treatment for Multiple Benign Lichenoid Keratoses of Flat Erythematous Type

“…1 Clinically, BLK lesions are categorized into flat erythematous, flat pigmented, and plaque-like types. 6 Treatment modalities for BLK include excisional biopsy, curettage and electrodessication, cryotherapy, and ablative laser treatments using 2,940-nm erbium (Er):yttriumaluminum-garnet (YAG) or 10,600-nm carbon dioxide (CO2) lasers. Deciding on a particular treatment can be determined according to the clinical types and locations of target lesions and histopathological features thereof.…”