Lichenoid tissue reaction/interface dermatitis: Recognition, classification, etiology, and clinicopathological overtones

Abstract

Lichenoid tissue reaction or interface dermatitis embrace several clinical conditions, the prototype of which is lichen planus and its variants, drug induced lichenoid dermatitis, special forms of lichenoid dermatitis, lichenoid dermatitis in lupus erythematosus, and miscellaneous disorders showing lichenoid dermatitis, the salient clinical and histological features of which are described to facilitate their diagnosis. Background of lichenoid reaction pattern has been briefly outlined to enlighten those interested in this entity.

Lichen planus and lichenoid reactions as a systemic disease

“…LDR are inflammatory lesions with varied etiologies including immune-mediated disorders, reactions to systemic medications and to dental materials (20). The term "lichenoid" refers to papular lesions of skin diseases of which LP is the prototype (21). There are no standardized criteria for the diagnosis of lichenoid reactions.…”

“…There are no standardized criteria for the diagnosis of lichenoid reactions. The condition mimics LP but may have some eczematous elements (21).…”

Spectrum of Interface dermatitis : An Observational study'

“…Skin lesions of dermatomyositis manifest an atrophying cell-poor lym-phocytic interface dermatitis accompanied by dermal mucinosis and vascular alterations that vary according to the age of the lesion biopsied and the presence or absence of myopathy: in patients with myopathic dermatomyositis, a characteristic injury pattern comprising a variably cell-poor, often thrombogenic lymphocytic vasculopathy mainly affecting the dermal papillae capillaries is seen . [1,3] In our study we had 02 cases of dermatomyositis with 100% clinical concordance.…”

“…This has changed the negative feelings of clinical dermatologists regarding the utility of biopsy in diagnosis of inflammatory conditions . [3] Lichen Planus is the prototype of the term "Lichenoid'which refers to papular lesion of certain skin disorders. [4] .…”

A Rare Form of Lichenoid Tissue Reaction: Lichenoid Granulomatous Dermatitis

“…It may be accompanied by degenerative epithelial changes in the form of vasculopathy, dyskeratosis, and colloid body formation. Histiocytic infiltration can be seen as one of five patterns: 1) superficially disposed, loose small histiocytic aggregates amidst a band-like lymphocytic infiltrate; 2) small epithelioid granulomata within and subjacent to the areas of band-like lymphocytic infiltration; 3) an interstitial array between collagen fibers reminiscent of interstitial granuloma annulare (GA); 4) scattered singly disposed Langhans and/or foreign body type giant cells; and 5) granulomatous vasculitis [1][2][3][4]. Histopathologic features in our case were consisted with second type of histiocytic infiltration.…”