Lichenoid Tissue Reaction/Interface Dermatitis: Clinical and Histological Perspectives

Abstract

A number of uncommon, clinically diverse and poorly understood inflammatory skin diseases are linked by the presence of a set of histopathological elements that have traditionally been referred to as the "lichenoid tissue reaction/interface dermatitis" (LTR/IFD). The prototypic skin disease in this category is lichen planus. However, the LTR/IFD can also be seen in skin disorders associated with systemic illnesses (lupus erythematosus, dermatomyositis), and the skin changes of potentially fatal disorders such as graft-versus-host disease, Stevens-Johnson syndrome, and toxic epidermal necrolysis. It has been traditionally felt that cytotoxic T-lymphocytes represent the final effector cell type for the epidermal basal cell layer injury pattern that is common to LTR/IFD disorders. Recent work has suggested that a number of different LTR/IFD skin disorders share a common inflammatory signaling pathway involving the actions of plasmacytoid dendritic cell-derived IFN-alpha. This signaling pathway appears to amplify cytotoxic T cell injury to the epidermal basal cell compartment. This review will summarize the work implicating this pathway as well as the other cellular and molecular mechanisms that are thought to be responsible for the prototypic LTR/IFD disorder, lichen planus. It is hoped that a better understanding of the immunological commonalities shared by various LTR/IFD disorders will lead to more effective safer treatment options for these illnesses.

Lichen Planus in Association with Adult-onset Still’s Disease Successfully Treated with Mycophenolate Mofetil

“…The latter can also be seen in skin disorders associated with systemic illnesses (e.g., SLE, dermatomyositis) 12 , and this may also explain the myositic element observed in our case.…”

Clinicopathological Study of Lichenoid Reactions: A Retrospective Analysis

“…14 The damage and disorganisation of the cells in epidermal basal layer is the characteristic epidermal change in the LTR. 5 The basal layer degeneration is described as hydropic/ liquefactive/ vacuolar degeneration. 5 Two types of cells are seen in the dermal layer in the lesions of lichen planus, attributed to the basal cell injury, that are melanophages and colloid bodies.…”

“…5 The basal layer degeneration is described as hydropic/ liquefactive/ vacuolar degeneration. 5 Two types of cells are seen in the dermal layer in the lesions of lichen planus, attributed to the basal cell injury, that are melanophages and colloid bodies. Majority of inflammatory infiltrate cells in LTR are T lymphocytes, macrophages, dendritic cells.…”

“…Cell rich LTRs include lichen plaus with its variants and cell poor LTRs include conditions like autoimmune connective tissue disorders and erythema multiforme. 5 This study focuses on the clinical and histopathological spectrum of various LTR as prompt diagnosis of these lesions can greatly influence the morbidity associated with the disease. Page 5552…”

PUVA phototherapy-induced secondary amyloidosis in patients with mycosis fungoides: a rare adverse effect of phototherapy

“…Melanophages are dermal phagocytic cells of macrophage lineage that are able to engulf large amounts of melanin pigment released from epidermal basal layer keratinocytes and melanocytes that have been damaged by the interface change. Colloid bodies are thought to represent injured basal layer keratinocytes that have undergone amyloid degeneration (23,24).…”