Lichen myxedematosus in a patient with hepatocellular carcinoma

Py, Lo; Ty, Tzung

doi:10.1046/j.1365-2133.2000.03684.x

Cited by 13 publications

(6 citation statements)

References 7 publications

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“…An unusual histopathological finding that may include, in addition to the constant histopathological features, an interstitial granulomatous pattern mimicking granuloma annulare has been recently described . On the other hand, features such as monoclonal gammopathy, thyroid disorder, HIV and HCV infections, peripheral eosinophilia, thymic carcinoma, and hepatocellular carcinoma are associated findings reported in some cases and to which any new emerging finding can be added. Being variable, we believe that none of these associated features, including monoclonal gammopathy and thyroid disorder, should be considered either as inclusive or exclusive criteria for the diagnosis and classification of LM and its subtypes.…”

Section: Diagnostic Criteria and Classificationmentioning

confidence: 97%

Lichen myxedematosus: diagnostic criteria, classification, and severity grading

Nofal

Amer²,

Alakad

et al. 2016

Int J Dermatology

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We propose two sets of diagnostic criteria to define the disease more precisely and to avoid confusion associated with the other classification. The first set comprises constant clinical and histopathological features that are always present in every case, and the second set includes associated features that were variably reported in some patients. LM is then subclassified according to the presence or absence of systemic manifestations into a systemic severe form (scleromyxedema) and a non-disabling, pure cutaneous form.

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Section: Diagnostic Criteria and Classificationmentioning

confidence: 97%

Lichen myxedematosus: diagnostic criteria, classification, and severity grading

Nofal

Amer²,

Alakad

et al. 2016

Int J Dermatology

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“…Banno et al 4 . and Lo and Tzung 5 and have noted what appears to be a form of atypical LM in patients with hepatitis C. Rongioletti and Rebora 6 have also identified what appears to be an atypical LM in a patient with chronic active hepatitis C. Interestingly, when this patient underwent interferon α‐2a treatment, the skin lesions increased in number and spread rapidly, then stabilized when interferon treatment was stopped. They hypothesized that the patient's worsened disease was due to an effect of interferon on basic fibroblast growth factor (bFGF), which resulted in increased fibroblast proliferation and increased fibroblast mucin production.…”

Section: Discussionmentioning

confidence: 86%

Scleromyxedema‐like fibromucinosis in a patient undergoing hemodialysis

McNeill

Barr

2002

Int J Dermatology

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Fifteen hemodialysis patients were recently reported with a new scleromyxedema‐like fibrosing disorder thought to be associated with renal dialysis. A case of this new clinicopathological entity is described as well as a limited review of the literature relevant to this disease. The patient was a 31‐year‐old Hispanic female with firm cutaneous plaques with brawny hyperpigmentation on the thighs and arms, which started 1 month after starting hemodialysis therapy for end‐stage renal disease. There was no monoclonal gammopathy or evidence of systemic mucin deposition or other organ system disease. Histopathologically, the skin biopsy samples show haphazardly arranged dermal fibroblasts with associated collagen and small collections of interfibrillar mucin. The skin biopsy was interpreted as scleromyxedema‐like fibromucinosis. This represents an additional case of this new renal dialysis‐associated disorder. The disease may also occur in nondialysis patients, including those with liver disease.

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“…Cases of lichen myxoedematosus associated with liver disorders have also been documented. Two patients had chronic active hepatitis, one had hepatocellular carcinoma, and all were HCV‐related 8–10 . No case of lichen myxoedematosus associated with primary biliary cirrhosis has ever been described and our patient was anti‐HCV‐negative.…”

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confidence: 73%

Multiple cutaneous myxoid cysts with transepidermal elimination

Bessis

Rebora

Rongioletti

2008

British Journal of Dermatology

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including the absence of severe oral lesions and lichenoid eruptions without acantholysis reflect that our case was predominantly mediated by cellular autoimmunity rather than humoral immunity.The most striking and unusual clinical feature of our case was that there was no mucosal involvement. The underlying cause of the absence of mucosal involvement in our patient remains unknown. Amagai et al. 9 reported that almost all patients with PNP have circulating anti-Dsg3 autoantibodies and demonstrated that anti-Dsg autoantibodies were involved in the pathogenesis of blister formation. If this postulation is correct, we can suspect that the absence of detectable anti-Dsg3 autoantibodies in our patient may be responsible for the absence of both mucosal and cutaneous acantholytic lesions.However, the pathomechanism of oral lesions in PNP is still unclear and may be more complex than in classic pemphigus vulgaris, because PNP produces autoantibodies against multiple antigens, including plakin family proteins as well as Dsgs. Several cases of PNP without anti-Dsg autoantibodies have been reported; 10 however, the patients still had oral and cutaneous acantholytic lesions. Thus, the absence of anti-Dsg3 autoantibodies in itself is insufficient to explain the absence of mucosal involvement in our patient. Moreover, cell-mediated immune responses like lichen planus and EM also cause cytotoxicity to mucosal epithelia.This case is a further example showing diversity of clinical manifestations of PNP. Further studies are necessary to elucidate the underlying pathomechanism causing clinical diversity of PNP.

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Lichen myxedematosus in a patient with hepatocellular carcinoma

Cited by 13 publications

References 7 publications

Lichen myxedematosus: diagnostic criteria, classification, and severity grading

Lichen myxedematosus: diagnostic criteria, classification, and severity grading

Scleromyxedema‐like fibromucinosis in a patient undergoing hemodialysis

Multiple cutaneous myxoid cysts with transepidermal elimination

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