1998
DOI: 10.1111/j.1440-0960.1998.tb01242.x
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Hypertrophic lichen planus mimicking squamous cell carcinoma

Abstract: A 74-year-old woman presented with a 3 month history of an itchy rash on the dorsal forearms and left anterior shin. Physical exam revealed violaceous scaly papules and plaques along the dorsal forearms, as well as a hyperpigmented verrucous plaque with nodules along the left anterior shin (figure 1). Initial biopsy of the left anterior shin revealed well-differentiated squamous cell carcinoma (SCC, figure 2); however, due to a clinical appearance consistent with hypertrophic lichen planus (LP), three more bio… Show more

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Cited by 26 publications
(17 citation statements)
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References 10 publications
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“…This case underscores the importance of recognizing HLP as a mimicker of SCC to avoid unnecessary interventions and ensure timely initiation of appropriate treatment. At least 4 patients with HLP mistaken as SCC have been reported in the literature, highlighting the challenge of identifying the correct diagnosis 2, 3…”
Section: Discussionmentioning
confidence: 99%
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“…This case underscores the importance of recognizing HLP as a mimicker of SCC to avoid unnecessary interventions and ensure timely initiation of appropriate treatment. At least 4 patients with HLP mistaken as SCC have been reported in the literature, highlighting the challenge of identifying the correct diagnosis 2, 3…”
Section: Discussionmentioning
confidence: 99%
“…Typical features of LP, including hypergranulosis and basal cell vacuolar degeneration, may not be present 2 . Like other chronic inflammatory conditions associated with rubbing and irritation, HLP may be associated with features of pseudoepitheliomatous hyperplasia (PEH), which can be difficult to distinguish from SCC 2, 6. PEH is characterized by hyperplasia of the epidermis and adnexal epithelium, gross irregular acanthosis, and horn cyst formation 2, 3, 6.…”
Section: Discussionmentioning
confidence: 99%
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“…However, histologic clues that point to PEH include a lichenoid infiltrate at the tips of the rete ridges along with dyskeratosis, pigment incontinence, lack of cytologic atypia, and proliferation from follicular infundibula 4,5 . Furthermore, clinical clues such as response to steroids and multiplicity and acuity of lesions may be more useful than histopathology to indicate PEH rather than SCC 1,3,4 .…”
Section: Discussionmentioning
confidence: 99%
“…Similarly, multiple studies have commented on the difficulty of differentiating SCC from PEH arising from hypertrophic LP histologically, and a multitude of prior cases have been reported in which the preliminary diagnosis of SCC was reversed to hypertrophic LP following supportive clinical evidence 1,3 . In the majority of these cases the lesions showed significant improvement with near-resolution by 6 months following treatment with topical steroids 1 .…”
Section: Figuresmentioning
confidence: 99%