Unusual variant of lupus erythematosus or lichen planus. Clinical, histopathologic, and immunofluorescent studies

Abstract

Eleven patients with a skin disorder in which clinical, histopathologic, and immunofluorescent findings showed overlap features of both lupus erythematosus (LE) and lichen planus (LP) were observed for several years. Clinical lesions were extremely long-term and consisted primarily of livid red to violaceous atrophic patches and plaques, most common on acral aspects of the extremities. Nails were also commonly involved, often showing anonychia. Histologic changes combined cell-rich and cell-poor lichenoid patterns in the papillary dermis, suggesting both LP and LE. The major immunofluorescent finding in all patients was the presence of ovoid bodies at the dermal-epidermal (D-E) junction and in the upper dermis. Most patients showed both a linear arrangement and a clustering pattern of these bodies. Four patients also had coexistant but poorly developed linear deposits of immunoglobulins and complement at the D-E junction.

Update on primary cicatricial alopecias

“…An overlap syndrome with heterogeneous features of LP and lupus erythematosus on clinical, histologic, and immunopathologic analysis has been described, [164][165][166][167][168][169][170] with a report of associated cicatricial alopecia. 164 It is unclear whether this is an autonomous disorder, a form of DLE with LP-like features, or a sign of coexisting LP and lupus erythematosus.…”

“…164 It is unclear whether this is an autonomous disorder, a form of DLE with LP-like features, or a sign of coexisting LP and lupus erythematosus. [166][167][168][169] Acral involvement with verrucous or annular livid red-violet plaques is typical and often affects the palmoplantar surfaces. 168,169 The cicatricial alopecia is a poorly characterized feature 164,167-169 that appeared as erythematous patches succeeded by follicular plugging in one report.…”

“…[166][167][168][169] Acral involvement with verrucous or annular livid red-violet plaques is typical and often affects the palmoplantar surfaces. 168,169 The cicatricial alopecia is a poorly characterized feature 164,167-169 that appeared as erythematous patches succeeded by follicular plugging in one report. 164 Awareness of the existence of this condition is important for management and prognostic purposes, since conversion to SLE has been reported and may not be evident for years.…”

Control of Widespread Hypertrophic Lupus Erythematosus with T-Cell-Directed Biologic Efalizumab

“…The closest differential diagnoses are spinocellular carcinoma and verrucous lichen planus. Both diagnoses can be concomitant with HLE [7,10,11], and spinocellular carcinoma in particular has been described to develop within verrucous HLE plaques after sun exposure. In addition, keratoacanthoma, hypertrophic actinic keratosis, nodular prurigo and psoriasis vulgaris must be ruled out [6,8].…”

Appearance of Lupus erythematosus in a Patient with Lichen planus Treated by Isoniazide

“…However, only few cases have been published in the past in which final differentiation between both diseases could not be made. These cases were described by some as an unusual variant of lupus erythematosus or lichen planus [Copeman et al, 1970;Romero et al, 1977] and by others as mixed lichen planus lupus erythematosus disease [Piamphongsant et al, 1978].…”