| The Pityriasis
Lichenoides I./ La Pitiriasis Liquenoide I. DATA-MEDICOS
DERMAGIC/EXPRESS 2-(85)
11 Diciembre 1.999 11 December 1.999
~ La pitiriasis Liquenoide ~
~ The Pityriasis Lichenoides ~
EDITORIAL ESPANOL
=================
Hola Amigos, DERMAGIC de nuevo en la red. Hace una semana se comento en la lista
DERMLIST Brazil el tema de la PITIRIASIS LIQUENOIDE, el Dr. George Leal me
pidio que hiciera una revision del tema, y alli va. Hay 2 variantes: La PITIRIASIS
LIQUENOIDE ET VARIOLIFORME AGUDA (MUCHA HABERMANN) Y
LA PITIRIASIS LIQUENOIDE CRONICA. Si examinan bien las referencias
Bibliograficas notaran que AMBAS pueden estar asociada a malignidad o ser el
comienzo de la misma. De dificil tratamiento y curso imprevisto, un sindrome
paraneoplasico ???, una manifestacion cutanea de una futura malignidad ??? alli les dejo
estas 41 referencias.
Saludos a todos,,,
Dr. Jose Lapenta R.
EDITORIAL ENGLISH
=================
Hello Friends, DERMAGIC again in the net. Tha past week in the list DERMLIST
(Brazil) its speak the topic of the PITYRIASIS LICHENOIDES, the Dr. George Leal
request me a revision of the topic, and there it goes. There are 2 variants of the disease:
The PITYRIASIS LICHENOIDES ET VARIOLIFORMIS ACUTA (MUCHA
OF HABERMANN) AND THE PITYRIASIS LICHENOIDES CHRONICA. If
you examine the Bibliographical references well you will noticed that BOTH can be
associated to malignancy or being the beginning of the same one. Of difficult treatment
and accidental course, A paraneoplastic syndrome ???, a cutaneous manifestation of a
future malignancy??? there I leave you these 41 references.
Greetings to all,
Dr. Jose Lapenta R.,,,
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REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES
==================================================================
1.) Atypical manifestations of pityriasis lichenoides chronica: development into
paraneoplasia and non-Hodgkin lymphomas of the skin.
2.) Comparative clinicopathological study on pityriasis lichenoides
chronica and small plaque parapsoriasis.
3.) The transformation of pityriasis lichenoides chronica into parakeratosis variegata in an
11-year-old girl.
4.)Immunopathologic studies in pityriasis lichenoides.
5.)Psoralens and ultraviolet A therapy of pityriasis lichenoides.
6.) Phototherapy of pityriasis lichenoides.
7.) Long-term follow-up of photochemotherapy in pityriasis lichenoides.
8.) [Ulcers of the tongue, pityriasis lichenoides and primary parvovirus B19 infection]
9.) The relation between toxoplasmosis and pityriasis lichenoides chronica.
10.) Pityriasis lichenoides in children: clinicopathologic review of 22 patients.
11.) Pityriasis lichenoides in children: a long-term follow-up of eighty-nine cases.
12.) Pityriasis lichenoides in children: therapeutic response to erythromycin.
13.) [Pityriasis lichenoides in a sibling pair]
14.) Cutaneous T-cell lymphoma (parapsoriasis en plaque). An association with pityriasis
lichenoides et varioliformis acuta in young children.
15.) Pityriasis lichenoides et varioliformis acuta in HIV-1+ patients: a marker of early
stage disease. The Military Medical Consortium for the Advancement of Retroviral
Research (MMCARR).
16.) [Lichenoid pityriasis. Clinical study of 13 cases].
17.) Immunopathology of pityriasis lichenoides acuta.
18.) Pityriasis lichenoides et varioliformis acuta in pregnancy: a case report.
19.) Mucha-Habermann disease and its febrile ulceronecrotic variant.
Author
20.) Febrile ulceronecrotic Mucha-Habermann disease: a case report and review of the
literature.
21.) Febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta.
22.) Mucha-Habermann disease-like eruptions due to Tegafur.
23.) [Parakertosis variegata after pityriasis lichenoides et varioliformis acuta].
24.) Methotrexate treatment of pityriasis lichenoides and lymphomatoid papulosis.
25.) Pityriasis lichenoides and lymphomatoid papulosis.
26.) Clinical and histologic differentiation between lymphomatoid papulosis and pityriasis
lichenoides.
27.) Lymphomatoid papulosis/pityriasis lichenoides in two children.
28.) Immunohistology of pityriasis lichenoides et varioliformis acuta and
pityriasis lichenoides chronica. Evidence for their interrelationship with
lymphomatoid papulosis.
29.) Lymphomatoid papulosis: clinicopathological comparative study with
pityriasis lichenoides et varioliformis acuta.
30.) Examination of cutaneous T-cell lymphoma for human herpesviruses by
using the polymerase chain reaction
31.) Molecular diagnosis of lymphocytic infiltrates of the skin.
32.) Gene rearrangements and T-cell lymphomas.
33.)Lymphomatoid papulosis associated with pityriasis lichenoides et
varioliformis acuta with transition in a large-cell anaplastic cutaneous
Ki-1 lymphoma. Treatment with alpha-interferon
34.) Pityriasis lichenoides chronica with acral distribution mimicking
palmoplantar syphilid.
35.) Pityriasis lichenoides and acquired toxoplasmosis.
36.) Paraneoplastic pityriasis lichenoides chronica.
37.) Cutaneous T-cell lymphoma presenting with 'segmental pityriasis lichenoides
chronica'.
38.) Successful long-term use of cyclosporin A in HIV-induced pityriasis
lichenoides chronica [letter]
39.) Pityriasis lichenoides chronica resolving after tonsillectomy.
40.) Segmental pityriasis lichenoides chronica.
41.) Pityriasis lichenoides et varioliformis acuta and group-A beta
hemolytic streptococcal infection.
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1.) Atypical manifestations of pityriasis lichenoides chronica: development
into paraneoplasia and non-Hodgkin lymphomas of the skin.
============================================================
AU: Panizzon-RG; Speich-R; Dazzi-H
AD: Department of Dermatology, University Hospital Zurich, Switzerland.
SO: Dermatology. 184(1):65-9 1992
PY: 1992
PT: JOURNAL-ARTICLE
AB-A: Three patients with atypical courses and manifestations of pityriasis
lichenoides chronica (PLC) are presented. The first patient is a
21-year-old white woman who showed a good response of her PLC lesions as
well as her reactive oligoarthritis to repeated PUVA treatments combined
with oral prednisone during 1 year. The effect of the treatment then
decreased. The patient developed a low-grade malignant lymphoma of the
lung. When the lymphoma of the lung improved after chemotherapy, the PLC
eruptions improved, too. The second patient is a 41-year-old man, whose
Hodgkin's disease stage IVa was successfully treated by chemotherapy and
radiotherapy in 1984. In 1987 he showed PLC lesions which responded well to
PUVA therapy, later also in combination with etretinate. Until 1988
repeated skin biopsies revealed a non-specific eczematous pattern. In 1989
the recalcitrant PLC eruptions finally revealed a pleomorphic non-Hodgkin
lymphoma of the skin with medium-sized cells. The third patient had a PLC
for about 9 years when Hodgkin's disease stage Ia was diagnosed. At the
beginning the skin biopsy showed an eczematous pattern, but 2 years later,
in 1990, skin infiltrations of a large-cell, anaplastic non-Hodgkin
lymphoma were seen. These cases show that PLC in rare cases may either
represent a paraneoplastic skin disease or may itself develop into
cutaneous lymphomas. (Abstract from CANCERLIT)
============================================================
2.) Comparative clinicopathological study on pityriasis lichenoides
chronica and small plaque parapsoriasis.
============================================================
SO - Am J Dermatopathol 1988 Jun;10(3):189-96
AU - Benmaman O; Sanchez JL
PT - JOURNAL ARTICLE
AB - The term parapsoriasis refers to a group of chronic asymptomatic
scaly dermatoses of unknown etiology about which there is still controversy
over the nosology and nomenclature of the different conditions that
comprise the group, particularly pityriasis lichenoides chronica (PLC) and
small plaque parapsoriasis (SPP). In an attempt to establish the
distinctive clinicopathologic features of these two dermatosis, we
prospectively studied 44 patients who presented with the typical clinical
and histologic picture of either of these two diseases. SPP was clinically
characterized by scaly oval plaques on the trunk and proximal aspect of
extremities. Spongiosis was the salient histopathologic feature, with
absence of fibrosis or melanophages. PLC presented with a scaly papular
eruption over the trunk and extremities and histologically was
characterized by an interface dermatitis. We conclude that sufficient
clinical and histologic features differentiate these two entities and we
propose that the term parapsoriasis be used only to designate SPP and large
plaque parapsoriasis.
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3.) The transformation of pityriasis lichenoides chronica into parakeratosis variegata in an
11-year-old girl.
============================================================
Author
Niemczyk UM; Zollner TM; Wolter M; Staib G; Kaufmann R
Address
Department of Dermatology, University of Frankfurt Medical School, Germany.
Source
Br J Dermatol, 137(6):983-7 1997 Dec
Abstract
Parakeratosis variegata is a rare disorder with unknown aetiology. In a few
cases it arises from benign skin diseases such as pityriasis lichenoides et
varioliformis acuta (Mucha Habermann disease) or pityriasis lichenoides
chronica. However, transformation into malignant diseases such as cutaneous
T-cell lymphoma has been observed. We report an 11-year-old girl with a
10-year history of pityriasis lichenoides chronica now presenting with
parakeratosis variegata. Analysis of skin infiltrating T cells showed
clonally rearranged T-cell receptor gamma chains occurring with a frequency
of more than 2%. This finding is compatible with the clinical observation
of parakeratosis variegata transforming into a malignant T-cell disorder.
We therefore suggest that patients suffering from parakeratosis variegata
and other diseases such as pityriasis lichenoides et varioliformis acuta or
pityriasis lichenoides chronica should be continuously monitored.
============================================================
4.)Immunopathologic studies in pityriasis lichenoides.
============================================================
SO - Arch Dermatol Res 1988;280 Suppl:S61-5
AU - Giannetti A; Girolomoni G; Pincelli C; Benassi L
PT - JOURNAL ARTICLE
AB - Skin biopsy specimens from five patients with pityriasis lichenoides
et varioliformis acuta and from six patients with pityriasis lichenoides
chronica were studied by direct immunofluorescence and by an
immunoperoxidase technique using a panel of monoclonal antibodies. The
dermal inflammatory infiltrate was composed of T cells, macrophages, and a
small proportion of CD1a+ cells, mostly perivascular. CD8+ cells
(cytotoxic/suppressor phenotype) predominated in the epidermis according to
the degree of epidermal necroses, whereas CD4+ cells (helper/inducer
phenotype) were superior in number among dermal T cells. A few B cells and
Leu7+ cells were detected in only a small proportion of lesions. The
results obtained confirm that the two conditions are variants of a single
disease process and suggest that cell-mediated immune mechanisms may be
important in the pathogenesis of the epidermal and vascular damage.
Endothelial cells (HLA-DR+ and HLA-DQ+) and CD1a+ cells (epidermal and
possibly dermal) could be primarily involved, acting as antigen-presenting
cells.
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5.)Psoralens and ultraviolet A therapy of pityriasis lichenoides.
============================================================
SO - J Am Acad Dermatol 1984 Jan;10(1):59-64
AU - Powell FC; Muller SA
PT - JOURNAL ARTICLE
AB - Three patients with long-standing pityriasis lichenoides, which was
resistant to other forms of therapy, were successfully treated with PUVA
(psoralens and ultraviolet light of wavelength A). One patient had complete
clearing of all lesions, and the other two had marked improvement. PUVA is
being used to treat increasing numbers of patients with pityriasis
lichenoides, and the results have been very good.
============================================================
6.) Phototherapy of pityriasis lichenoides.
============================================================
Arch Dermatol 1983 May;119(5):378-80
LeVine MJ
Eleven patients with chronic pityriasis lichenoides chronica were treated
with topically applied bland emollient cream and minimally erthemogenic
doses of UV radiation from fluorescent sunlamps. The conditions of all
patients cleared completely in an average of 29 treatments, requiring an
average UV dose of 388 millijoules/sq cm at clearance. Phototherapy
provides a convenient effective outpatient therapy for pityriasis
lichenoides chronica.
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7.) Long-term follow-up of photochemotherapy in pityriasis lichenoides.
============================================================
Acta Derm Venereol 1982;62(5):442-4
Boelen RE, Faber WR, Lambers JC, Cormane RH
Five patients with a histopathologically confirmed diagnosis of pityriasis
lichenoides were treated with PUVA or irradiated with a light source
emitting UVB and UVA, without prior intake of psoralens. All patients
showed a good response to treatment. Long-term follow up showed that
patients remained free of lesions during a period of 20 to 36 months; 3
patients had a recurrence of the disease, though less extensive than
before, after 25, 23, and 23 months, respectively.
============================================================
8.) [Ulcers of the tongue, pityriasis lichenoides and primary parvovirus B19 infection]
============================================================
Author
Labarthe MP; Salomon D; Saurat JH
Address
Service de Dermatologie, H^opital Cantonal Universitaire de Gen`eve, Suisse.
Source
Ann Dermatol Venereol, 123(11):735-8 1996
Abstract
INTRODUCTION: We report a case of parapsoriasis en gouttes (or pityriasis
lichenoides) which presents two peculiarities. First, the patient had
lingual ulcerations and second, the eruption appeared during a
seroconversion for Parvovirus B19. OBSERVATION: A 25 old woman presented a
first episode of characteristic parapsoriasis en gouttes associated with
purpuric palmoplantar lesions and lingual ulcerations, reaching deep
muscular in histology. DISCUSSION: This observation of parapsoriasis en
gouttes, peculiar because of lingual ulcerations, is mostly interesting
because of its association with a primo-infection to Parvovirus B19. The
receptor of the virus is localised on endothelial cells and that could
explain purpuric lesions and ulcerations observed.
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9.) The relation between toxoplasmosis and pityriasis lichenoides chronica.
============================================================
Author
Nassef NE; Hammam MA
Address
Department of Parasitology, Faculty of Medicine, Menoufia University, Egypt.
Source
J Egypt Soc Parasitol, 27(1):93-9 1997 Apr
Abstract
Pityriasis lichenoides chronica (PLC) is a rare skin disease of uncertain
aetiology. Many infectious agents have been incriminated as the cause of
the disease. One of these agents is toxoplasmosis. The aim of this work was
to find out if there is a relationship between toxoplasmosis and PLC.
Twenty two patients (17 males and 5 females) diagnosed clinically and
histopathologically as PLC were chosen for this study. Also twenty
apparently healthy individuals free from skin lesions were included as a
control group. Patients and controls were examined clinically for signs of
toxoplasmosis and submitted for indirect haemagglutination (IHA) and
indirect immunofluorescent antibody (IFA) tests in our Parasitology
laboratory for serodiagnosis of toxoplasmosis. Toxoplasmosis was diagnosed
in 8 (36.36%) and 3 (15%) in PLC patients and controls respectively by both
tests. Using pyrimethamine and trisulfapyrimidine in treating PLC patients,
showed subsidence of skin lesions in five patients with toxoplasmosis
within two months from the beginning of therapy. The remaining patients
showed no response to treatment. On conclusion, toxoplasmosis appears to
play a role in the aetiology of PLC and serological tests for diagnosing
toxoplasmosis should be performed in all PLC patients.
============================================================
10.) Pityriasis lichenoides in children: clinicopathologic review of 22 patients.
============================================================
Author
RomanŽi J; Puig L; FernŽandez-Figueras MT; de Moragas JM
Address
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona,
Spain.
Source
Pediatr Dermatol, 15(1):1-6 1998 Jan-Feb
Abstract
Pityriasis lichenoides (PL) is a cutaneous disease of unknown origin, with
an autoinvolutive course, that can occur in pediatric patients.
Traditionally, acute and chronic variants have been described, but other
special forms of presentation have been reported. We reviewed the clinical
records and histopathologic specimens of all pediatric patients diagnosed
with PL in our hospital from 1980 to 1995 to assess the clinicopathologic
features of this disorder in our environment. Twenty-two of the 118 cases
reviewed were pediatric patients less than 15 years old (12 males and 10
females, 18.6% of all patients). Their ages ranged from 3 to 15 years, with
a mean of 9.3 years. Most of the patients (72%) had the chronic variant of
the disease, while the remainder had an acute course. One patient suffered
from acute ulceronecrotic PL. Systemic treatments prescribed were
erythromycin in eight patients, PUVA in five patients, and methotrexate in
one patient. Three patients had a prolonged course with more than two
episodes. Acute and chronic PL are polar extremes, but individual cases
cannot be classified only on the basis of histopathologic data, since
coexistence of lesions in different stages of evolution can lead to
sampling bias. Acute ulceronecrotic forms and the presence of a variable
degree of cellular atypia in the infiltrate are liable to cause
differential diagnostic problems with lymphomatoid papulosis (LP), which
cannot be completely resolved on the basis of T-cell receptor clonal
rearrangement detection.
============================================================
11.) Pityriasis lichenoides in children: a long-term follow-up of eighty-nine cases.
============================================================
J Am Acad Dermatol 1990 Sep;23(3 Pt 1):473-8
Gelmetti C, Rigoni C, Alessi E, Ermacora E, Berti E, Caputo R
Department of Dermatology and Pediatric Dermatology I, University of Milan,
Italy.
Pityriasis lichenoides is usually classified into an acute and a chronic
form. From a review of 89 cases of the disease seen since 1974 it seems
that a more realistic classification into three main groups, according to
the distribution of pityriasis lichenoides lesions, could be made, namely,
a diffuse, a central, and a peripheral form, each characterized by a
different clinical course. Conversely, no correlations were detected in our
series between the severity of skin lesions and their distribution or the
overall course of the disease. None of our cases suggests the possible
evolution of pityriasis lichenoides into lymphomatoid papulosis. Although
no infectious causative agent has been identified, a viral origin seems
likely in some cases. Most patients responded favorably to UVB irradiation.
Our conclusions are (1) that pityriasis lichenoides is probably a clinical
disorder with a diverse etiology and (2) that its classification by
distribution seems more useful than its subdivision into an acute and a
chronic form.
============================================================
12.) Pityriasis lichenoides in children: therapeutic response to erythromycin.
============================================================
J Am Acad Dermatol 1986 Jul;15(1):66-70
Truhan AP, Hebert AA, Esterly NB
Fifteen of twenty-two children with pityriasis lichenoides were treated
with oral erythromycin. Eleven (73%) had a remission, usually within 2
months. Two others showed partial improvement, and two were unimproved.
Seven of the children who experienced a remission were off erythromycin and
free of lesions after 2 to 5 months of therapy. A trial of erythromycin as
described herein should be considered in children with pityriasis
lichenoides before other, possibly more toxic, measures are instituted.
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13.) [Pityriasis lichenoides in a sibling pair]
============================================================
ARTICLE SOURCE: Hautarzt (Germany, West), Nov 1981, 32(11) p592-4
AUTHOR(S): Deuchert C
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: Two brothers are reported, who had pityriasis lichenoides within
an interval of eighteen months. The hitherto unknown etiology of this
dermatosis is discussed.
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14.) Cutaneous T-cell lymphoma (parapsoriasis en plaque). An association with pityriasis
lichenoides et varioliformis acuta in young children.
============================================================
Authors
Fortson JS. Schroeter AL. Esterly NB.
Institution
Department of Dermatology, Wright State University School of Medicine,
Dayton, Ohio 45401-0927.
Source
Archives of Dermatology. 126(11):1449-53, 1990 November.
Abstract
Pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis
lichenoides chronica (PLC) are related benign disorders without recognized
association with cutaneous T-cell lymphoma (CTCL). We report the cases of
two children with documented PLEVA evolving into CTCL over several years.
One child had the clinical lesions of PLC but the dermatopathologic
findings of PLEVA at age 2 years. At age 12 years, he had skin changes of
poikiloderma atrophicans vasculare and dermatopathologic findings
consistent with parapsoriasis en plaque. The second child presented at age
7 years with scaling dermatitis and dermatopathologic findings of PLEVA. At
age 12 years, the histologic diagnosis was parapsoriasis. Monoclonal
antibody studies performed on biopsy specimens from both patients revealed
70% to 100% cells staining with CD5, 80% to 90% staining with CD4, 30% to
50% staining with CD8, and an increase in CD1-staining cells in the
papillary dermis, indicating a predominantly helper T-cell infiltrate. We
believe that PLC and PLEVA may be part of the spectrum of CTCL.
Furthermore, CTCL may be more common in young children than once thought.
============================================================
15.) Pityriasis lichenoides et varioliformis acuta in HIV-1+ patients: a marker of early
stage disease. The Military Medical Consortium for the Advancement
of Retroviral Research (MMCARR).
============================================================
Author
Smith KJ; Nelson A; Skelton H; Yeager J; Wagner KF
Address
Medical Research Institute of Chemical Defense, Aberdeen, Maryland, USA.
Source
Int J Dermatol, 36(2):104-9 1997 Feb
Abstract
BACKGROUND: The high incidence of cutaneous disease in HIV-1+ patients may
be a marker of the chronic state of immune activation. In addition,
specific cutaneous diseases may be related to the pattern and degree of
immune dysregulation present in the patients at the time of the eruption.
We have observed that HIV-1+ patients with pityriasis lichenoides et
varioliformis acuta (PLEVA) were in the early to midstage of HIV-1 disease.
MATERIALS AND METHODS: To determine if there was a correlation between the
phenotype of the lymphoid infiltrate and surface markers of the epidermis
and the known changes in early or late-stage HIV-1 disease, we studied five
HIV-1+ patients with PLEVA. Cutaneous biopsy specimens were obtained and
immunohistochemical stains were used to determine the expression of ELAM-1,
ICAM-1, and HLA-DR and the phenotype of the lymphoid infiltrate. RESULTS:
The HIV-1+ patients showed increased expression of HLA-DR on keratinocytes
as well as on the mononuclear and dendritic cell populations in the
epidermis and dermis. The majority of T cells were activated CD8+ cells.
CONCLUSIONS: Immunophenotyping of the inflammatory infiltrate in these
patients is consistent with a pattern of immune dysregulation seen only in
earlier stages of HIV-1 disease. Thus, PLEVA may be useful as a marker of
early to midstages of HIV-1 disease.
============================================================
16.) [Lichenoid pityriasis. Clinical study of 13 cases].
============================================================
Med Cutan Ibero Lat Am 1977;5(3):189-96
[Article in Spanish]
Bravo Piris J
13 patients with Pityriasis Lichenoides are studied clinical and
histologically, showing a clinical polymorphism of the lesions, mainly in
the papulous, vesiculous, and necrotic ones. The data about age, sex,
evolution and response to the treatment in the present study are similar to
those found by other authors. Constantly, we found, a variable degree of
vasculitis. In almost all the cases there was a damage of the epithelium
--exoserosis and exocytosis--, as well as presence in some cases, of red
cells extravasated within the epidermis. In upper dermis we found in all
biopsies, divers degrees of perivascular cell infiltration mainly composed
of lymphocytes and histiocytes with predominance of the last ones, in five
cases. In the majority of our cases, there was a strong relationship
between the clinical and the histological aspects, but in some cases, mild
lesions showed an acute microscopical picture. We are of the opinion that
Pityriasis Lichenoides must be considered as a different entity from
Parapsoriasis. In addition, we think that PL, is a clinical picture that
manifests itself as a chronic or an acute form, and both types can be seen
in the disease evolution. Finally, we could not find an evident influence
and a positive response to the treatment in our patients with the classical
therapeutics.
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17.) Immunopathology of pityriasis lichenoides acuta.
============================================================
ARTICLE SOURCE: J Am Acad Dermatol (United States), May 1984, 10(5 Pt 1)
p783-95
AUTHOR(S): Muhlbauer JE; Bhan AK; Harrist TJ; Moscicki RA; Rand R;
Caughman W; Loss B; Mihm MC Jr
PUBLICATION TYPE: JOURNAL ARTICLE
ABSTRACT: Eleven biopsy specimens (five papules and six dusky or crusted
lesions) from four patients with pityriasis lichenoides et varioliformis
acuta ( PLEVA ) were studied by direct immunofluorescence and
immunoperoxidase technics. Slight vascular deposits of IgM and C3 were
present in most lesions. Slight perivascular deposits of fibrin were
observed in early lesions; more extensive perivascular and interstitial
deposits of fibrin were detected in advanced lesions. Most of the
infiltrating cells were T lymphocytes; cells with cytotoxic/suppressor
phenotype (T8-positive) were generally more numerous than cells with
helper/inducer phenotype (Leu-3a-positive, T4-positive). A marked increase
in epidermal T8-positive cells over epidermal Leu-3a/T4-positive cells was
found in late lesions. Moreover, a reduction of the ratio of circulating
T4-positive to T8-positive cells was observed in most cases. The number of
epidermal T6-positive (Langerhans/indeterminate) cells was decreased in the
lower as compared with the upper stratum spinosum. About 5% of perivascular
infiltrating cells were T6-positive. These results suggest that
cell-mediated immune mechanisms are probably important in the pathogenesis
of PLEVA
============================================================
18.) Pityriasis lichenoides et varioliformis acuta in pregnancy: a case report.
============================================================
Author
Fukada Y; Okuda Y; Yasumizu T; Hoshi K
Address
Department of Obstetrics and Gynecology, Yamanashi Medical University, Japan.
Source
J Obstet Gynaecol Res, 24(5):363-6 1998 Oct
Abstract
If pityriasis lichenoides et varioliformis acuta (PLAVA) exists in the
vagina or cervical os of the uterus, it may cause premature labor and
premature rupture of the membranes.
============================================================
19.) Mucha-Habermann disease and its febrile ulceronecrotic variant.
Author
============================================================
Tsuji T; Kasamatsu M; Yokota M; Morita A; Schwartz RA
Address
Department of Dermatology, Nagoya City University Medical School, Nagoya,
Japan.
Source
Cutis, 58(2):123-31 1996 Aug
Abstract
In 1916 Mucha and in 1925 Habermann reported an acute form of pityriasis
lichenoides characterized by the abrupt onset of papulovesicular eruptions
and gave the name, pityriasis lichenoides et varioliformis acuta (PLEVA) or
Mucha-Habermann disease (MH). In 1966, Degos reported a rare febrile
ulceronecrotic variant of MH. MH occurs mainly in young adults, while
febrile ulceronecrotic Mucha-Habermann's disease (FUMHD) occurs more
frequently in children. The etiology of MH remains obscure, but it may be
the result of a hypersensitivity reaction to an infectious agent. Although
clinical and histologic features of the disease in children are similar to
those of adults, more diseases need to be differentiated in pediatric
patients. In addition, a number of effective therapeutic options in adults
with MH are unsuitable for use in pediatric patients, to whom beginning
with oral antibiotics, usually erythromycin, is recommended. A summary of
previously reported fifteen cases with FUMHD, including our case, is listed.
============================================================
20.) Febrile ulceronecrotic Mucha-Habermann disease: a case report and review of the
literature.
============================================================
Author
SuŽarez J; LŽopez B; Villalba R; Perera A
Address
Section of Dermatology, Hospital La Candelaria, Santa Cruz de Tenerife,
Spain.
Source
Dermatology, 192(3):277-9 1996
Abstract
A 32-year-old male with febrile ulceronecrotic Mucha-Habermann disease
(FUMHD) responsive to methotrexate is reported. This is a severe variant of
pityriasis lichenoides et varioliformis acuta characterized by the acute
onset of a widespread ulceronecrotic cutaneous eruption together with high
fever and systemic involvement. To our knowledge, only 13 patients with
FUMHD have been reported to date.
============================================================
21.) Febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta.
============================================================
Dermatology 1994;189 Suppl 2:50-3
De Cuyper C, Hindryckx P, Deroo N
Algemeen Ziekenhuis Sint-Jan, Ruddershove, Brugge, Belgium.
An unusually severe form of pityriasis lichenoides et varioliformis acuta
(PLEVA) with a fatal outcome in an 82-year-old woman is reported. After a
period of a mild eruption, extensive polymorphous, papular and
ulcerohemorrhagic skin lesions developed, associated with intermittent high
temperature and constitutional symptoms. Skin biopsies showed the typical
histopathological changes of PLEVA. Early recognition of this severe
variant of PLEVA is important, since the fulminating course can lead to
death.
============================================================
22.) Mucha-Habermann disease-like eruptions due to Tegafur.
============================================================
Author
Kawamura K; Tsuji T; Kuwabara Y
Address
Department of Dermatology, Nagoya City University Medical School, Japan.
Source
J Dermatol, 26(3):164-7 1999 Mar
Abstract
The first case of Mucha-Habermann disease-like drug eruptions due to
Tegafur is reported. A 59-year-old man noticed various skin lesions after
he had taken 300 mg of Tegafur daily for about 200 days. The patient had
papulonecrotic eruptions on his trunk and extremities. The histology from a
papular lesion revealed epidermal necrosis surrounded by spongiosis,
perivascular inflammatory infiltrations composed of lymphocytes and
erythrocytes, and endothelial swelling. The etiology of Mucha-Habermann
disease is not known, but an immune mechanism may be supported by our case.
============================================================
23.) [Parakertosis variegata after pityriasis lichenoides et varioliformis acuta].
============================================================
Hautarzt 1995 Jul;46(7):498-501
Kiene P, Folster-Holst R, Mielke V
Universitats-Hautklinik, Kiel.
We report on a 34-year-old male patient who developed generalized
parakeratosis variegata lesions 4 years after suffering from pityriasis
lichenoides et varioliformis acuta. For further investigation of a possible
interrelationship between these two diseases of the parapsoriasis group and
their relationship to the T-cell type of cutaneous non-Hodgkin-lymphoma,
histological, immunohistological and molecular-biological techniques were
applied. We were able to demonstrate typical morphological features common
to both diseases, and a polyclonal T-cell infiltrate in both. It is
concluded that pityriasis lichenoides et varioliformis acuta and
parakeratosis variegata are separate entities without monoclonal
rearrangement or signs of malignancy.
============================================================
24.) Methotrexate treatment of pityriasis lichenoides and lymphomatoid papulosis.
============================================================
Cutis 1979 May;23(5):634-6
Lynch PJ, Saied NK
Pityriasis lichenoides is a notoriously difficult disease to treat. Three
patients with this condition and a fourth with lymphomatoid papulosis have
been successfully treated with doses of methotrexate once a week. Toxicity
noted during the treatment periods has been minimal.
============================================================
25.) Pityriasis lichenoides and lymphomatoid papulosis.
============================================================
Semin Dermatol 1992 Mar;11(1):73-9
Rogers M
Department of Dermatology, Children's Hospital, Camperdown, Australia.
The clinical features, histopathology, immunopathology, and management of
pityriasis lichenoides and lymphomatoid papulosis are discussed, with
particular emphasis on the pediatric aspects of these conditions. The
difficulties in logically separating pityriasis lichenoides into an acute
(pityriasis lichenoides et varioliformis acuta) and a chronic (pityriasis
lichenoides chronical) form are addressed. The development of
lymphoreticular malignancy in patients with lymphomatoid papulosis has been
well documented, but pityriasis lichenoides has characteristically been
regarded as a benign condition. However, recent reports of the development
of large plaque parapsoriasis in patients with pityriasis lichenoides have
led to a reconsideration. Some of these patients were in the pediatric age
group. Although there are significant clinical, histopathological, and
immunopathological differences between pityriasis lichenoides and
lymphomatoid papulosis, the demonstration of similar clonal T cell receptor
gene rearrangements and the confirmation of the potentially premalignant
nature of both suggests that there may indeed be an interrelationship
between these two controversial entities. Close follow-up of patients with
both of these conditions is recommended, with observation being
discontinued only when the patient has been free of lesions for several
years.
============================================================
26.) Clinical and histologic differentiation between lymphomatoid papulosis and pityriasis
lichenoides.
============================================================
J Am Acad Dermatol 1985 Sep;13(3):418-28
Willemze R, Scheffer E
The relationship between lymphomatoid papulosis and pityriasis lichenoides
is a matter of considerable debate. Differentiation between these two
conditions is, however, important because patients with lymphomatoid
papulosis, unlike those with pityriasis lichenoides, may develop systemic
lymphoma and thus require long-term follow-up. In our study the clinical
and histologic features of eighty-two patients with pityriasis lichenoides
and twenty-six patients with lymphomatoid papulosis were reviewed and
compared. Clinical and histologic differences were recognized, not only
allowing differentiation between the two conditions, but also suggesting
that they are pathogenetically distinct diseases. Finally, evidence is
presented to suggest that the different views on the relationship between
these diseases mainly result from differences in patient selection.
============================================================
27.) Lymphomatoid papulosis/pityriasis lichenoides in two children.
============================================================
Pediatr Dermatol 1987 Nov;4(3):238-41
Ashworth J, Paterson WD, MacKie RM
Department of Dermatology, University of Glasgow, United Kingdom.
Two children developed lymphomatoid papulosis/pityriasis lichenoides at
ages 3 and 6 years. Follow-up continued for 13 years in the former patient
and for 6 years in the latter. Both children now have continuing low-grade
disease activity requiring in the one case topical corticosteroid therapy
and in the other low-dose systemic steroid therapy. These children are
reported to emphasize to pediatricians, pediatric pathologists, and
hematologists that pseudolymphomatous conditions can exist in young
children and do not require potent cytotoxic therapy. In both of our
patients, the initial diagnosis was thought to be an aggressive lymphoma.
============================================================
28.) Immunohistology of pityriasis lichenoides et varioliformis acuta and
pityriasis lichenoides chronica. Evidence for their interrelationship with
lymphomatoid papulosis.
============================================================
J Am Acad Dermatol 1987 Mar;16(3 Pt 1):559-70
Wood GS, Strickler JG, Abel EA, Deneau DG, Warnke RA
Pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides
chronica are idiopathic, papular eruptions that exhibit certain
clinicopathologic similarities to each other and to lymphomatoid papulosis.
In order to determine if these disorders are also similar immunologically,
we studied the immunopathology of five biopsy specimens from three cases of
pityriasis lichenoides et varioliformis acuta and three biopsy specimens
from three cases of pityriasis lichenoides chronica. We then compared them
to our prior immunohistologic study of nine cases of lymphomatoid
papulosis. Pityriasis lichenoides et varioliformis acuta and pityriasis
lichenoides chronica both exhibited a dermal and epidermal infiltrate of
CD4+ and CD8+ T cells expressing activation antigens. These were admixed
with numerous macrophages. The lesional epidermis was diffusely human
lymphocyte antigen (HLA)-DR+ and contained decreased CD1+ dendritic cells.
Endothelial cells were also HLA-DR+. Cells bearing the phenotypes of B
cells, follicular dendritic cells, or natural killer/killer cells were
essentially absent. Except for the lack of large atypical cells, the
results resembled those described previously for lymphomatoid papulosis.
These findings indicate that pityriasis lichenoides chronica, pityriasis
lichenoides et varioliformis acuta, and lymphomatoid papulosis share
several immunohistologic features. Together with certain clinicopathologic
similarities, they are consistent with the hypothesis that these three
disorders are interrelated.
============================================================
29.) Lymphomatoid papulosis: clinicopathological comparative study with
pityriasis lichenoides et varioliformis acuta.
============================================================
J Dermatol 1991 Oct;18(10):580-5
Erpaiboon P, Mihara I, Niimura M
Department of Dermatology, Jikei University School of Medicine, Tokyo, Japan.
We have compared the clinical and histopathological features of 6 patients
with lymphomatoid papulosis (LP) and 14 patients with pityriasis
lichenoides et varioliformis acuta (PLEVA). There were some differences
between the clinical features in the two diseases, including the size and
appearance of skin lesions and the duration of the course of disease. Ki-1
Ag positive, large, atypical, lymphoid cells were always seen in
lymphomatoid papulosis; none of lymphoid cells of pityriasis lichenoides et
varioliformis acuta demonstrated this antigen. We conclude that
lymphomatoid papulosis and PLEVA, although sharing some common features,
should be considered to be different clinical and immunopathological
entities.
============================================================
30.) Examination of cutaneous T-cell lymphoma for human herpesviruses by
using the polymerase chain reaction
============================================================
AU: Brice-SL; Jester-JD; Friednash-M; Golitz-LE; Leahy-MA; Stockert-SS;
Weston-WL
AD: B-153, Department of Dermatology, University of Colorado, Health
Sciences Center, 4200 East 9th Avenue, Denver, CO 80262, United States
SO: J-Cutan-Pathol. 20(4):304-7 1993
CP: Denmark
PT: JOURNAL-ARTICLE
AB-A: The etiology of cutaneous T-cell lymphoma remains unknown, although
an association with viral infection, in particular certain retroviruses and
human herpesviruses, has been suggested. The purpose of this study was to
examine skin biopsies of cutaneous T-cell lymphoma for the presence of
Epstein-Barr virus, herpes simplex virus type 1 and type 2, and human
herpesvirus-6 by using the polymerase chain reaction. Lesional skin
biopsies from 30 patients with cutaneous T-cell lymphoma were studied.
Control specimens included biopsies from 9 patients with lymphomatoid
papulosis and 10 patients with pityriasis lichenoides et varioliformis
acuta. DNA extracted from each specimen, as well as from a known positive
control for each virus, was examined by using the polymerase chain reaction
with viral-specific primers. Each DNA specimen was also amplified with
control primers for human beta globin. The specificity of the amplified
products was confirmed by Southern analysis. Neither Epstein-Barr virus nor
herpes simplex virus was detected in any of the patient specimens examined.
Human herpesvirus-6 was detected in one specimen of cutaneous T-cell
lymphoma and one specimen of lymphomatoid papulosis. These results do not
support a role for any of these herpesviruses in the pathogenesis of
cutaneous T-cell lymphoma. (Abstract from CANCERLIT AND EMBASE)
============================================================
31.) Molecular diagnosis of lymphocytic infiltrates of the skin.
============================================================
Authors
Weinberg JM. Rook AH. Lessin SR.
Institution
Department of Dermatology, University of Pennsylvania, Philadelphia.
Source
Archives of Dermatology. 129(11):1491-500, 1993 November.
Abstract
BACKGROUND: Advances in our understanding of the molecular genetics of
lymphocyte antigen receptors (B-cell immunoglobulin and T-cell antigen
receptor), have led to the application of molecular biologic techniques to
molecularly characterize lymphocytic infiltrates of the skin. Molecular
diagnosis refers to the application of these techniques as a diagnostic aid
in the clinicopathologic evaluation of cutaneous lymphocytic infiltrates.
OBSERVATION: Molecular studies have clinical application in the
determination of lineage and detection of retroviruses in cutaneous
lymphoid neoplasms, distinguishing between lymphoproliferative and reactive
infiltrates, and staging and monitoring response to therapy in cutaneous
T-cell lymphoma. Southern blot analysis of immunoglobulin and T-cell
antigen receptor gene rearrangements may fail to aid the clinician in
establishing a diagnosis of a cutaneous malignancy due to the limits of
detection sensitivity in minimally infiltrated lesions (eg, parapsoriasis
and patch-stage mycosis fungoides) or the still uncertain prognostic
significance of clonality in benign cutaneous diseases (eg, follicular
mucinosis, pityriasis lichenoides et varioliformis acuta, lymphomatoid
papulosis, and cutaneous lymphoid hyperplasia). CONCLUSIONS: Molecular
studies have enormous research value, providing new means to explore the
pathogenesis and clonal evolution of lymphoproliferative skin diseases.
Presently, however, they have limited applications as an independent
diagnostic tool. As our understanding of the clinical and biologic
significance of the molecular detection of clonal lymphocyte populations in
the skin expands and as the application of polymerase chain reaction
amplification provides us with greater detection sensitivity and
specificity, the clinical utility of molecular diagnosis of lymphocytic
infiltrates of the skin will be enhanced.
============================================================
32.) Gene rearrangements and T-cell lymphomas.
============================================================
Authors
Terhune MH. Cooper KD.
Institution
Department of Dermatology, University of Michigan School of Medicine, Ann
Arbor.
Source
Archives of Dermatology. 129(11):1484-90, 1993 November.
Abstract
BACKGROUND: Cutaneous T-cell lymphomas comprise a broad spectrum of
neoplasia ranging from indolent to highly aggressive types. To determine
subset lineage and malignant vs benign nature, morphologic analysis,
immunophenotyping, and flow cytometry have been used. However, given the
shortcomings of these methods, molecular genetic techniques, which take
particular advantage of the clonal nature of malignancy, are now being
applied to better characterize and diagnose these lymphomas. RESULTS: Each
antigen-specific T cell and its clonal progeny has a unique rearrangement
of its T-cell receptor gene such that it can recognize very specific
antigenic epitopes. By visualizing these particular T-cell receptor gene
rearrangements, Southern hybridization techniques and polymerase chain
reaction amplification can detect clonal populations of T cells in the
skin, blood, and lymph nodes of patients with T-cell leukemias and
lymphomas. Clonal T-cell populations have also been found in cases of
benign disorders such as lymphomatoid papulosis and pityriasis lichenoides
et varioliformis acuta. Although these disorders usually have a benign
outcome, they may represent dysplastic clonal lymphoid expansions with a
high incidence of spontaneous regression. CONCLUSIONS: Molecular genetic
techniques have added to our ability to diagnose, characterize, and monitor
the course of T-cell lymphomas and leukemias. In addition, they may provide
insight into the pathogenesis of certain benign disorders.
============================================================
33.)Lymphomatoid papulosis associated with pityriasis lichenoides et
varioliformis acuta with transition in a large-cell anaplastic cutaneous
Ki-1 lymphoma. Treatment with alpha-interferon
============================================================
AU: Hilbert-E; Detmar-M; Gollnick-H; Bruchhauser-U; Orfanos-CE
SO: Z-HAUTKR. 67/9 (832) 1992
CO: ZHKRA
PY: 1992
LA: German
CP: Federal-Republic-of-Germany
PT: Journal-Article
============================================================
34.) Pityriasis lichenoides chronica with acral distribution mimicking
palmoplantar syphilid.
============================================================
Acta Derm Venereol 1999 May;79(3):239
Chung HG, Kim SC
Publication Types:
Letter
============================================================
============================================================
35.) Pityriasis lichenoides and acquired toxoplasmosis.
============================================================
Int J Dermatol 1999 May;38(5):372-4
Rongioletti F, Delmonte S, Rebora A
Department of Dermatology, University of Genoa, Italy.
============================================================
============================================================
36.) Paraneoplastic pityriasis lichenoides chronica.
============================================================
J Eur Acad Dermatol Venereol 1999 Mar;12(2):189-90
Lazarov A, Lalkin A, Cordoba M, Lishner M
Letter
============================================================
============================================================
37.) Cutaneous T-cell lymphoma presenting with 'segmental pityriasis lichenoides
chronica'.
============================================================
Clin Exp Dermatol 1998 Sep;23(5):232
Child FJ, Fraser-Andrews EA, Russell-Jones R
Publication Types:
Letter
============================================================
============================================================
38.) Successful long-term use of cyclosporin A in HIV-induced pityriasis
lichenoides chronica [letter]
============================================================
Author
Griffiths JK
Source
J Acquir Immune Defic Syndr Hum Retrovirol, 18(4):396-7 1998 Aug 1
============================================================
============================================================
39.) Pityriasis lichenoides chronica resolving after tonsillectomy.
============================================================
Br J Dermatol 1993 Sep;129(3):353-4
Takahashi K, Atsumi M
Publication Types:
Letter
============================================================
============================================================
40.) Segmental pityriasis lichenoides chronica.
============================================================
Clin Exp Dermatol 1996 Nov;21(6):464-5
Cliff S, Cook MG, Ostlere LS, Mortimer PS
Publication Types:
Letter
============================================================
============================================================
41.) Pityriasis lichenoides et varioliformis acuta and group-A beta
hemolytic streptococcal infection.
============================================================
AU: English-JC-3rd; Collins-M; Bryant-Bruce-C
AD: Department of Primary Care and Community Medicine, USA MEDDAC, Ft.
Campbell, Kentucky 42223-5349, USA.
SO: Int-J-Dermatol. 1995 Sep; 34(9): 642-4
==================================================================
DATA-MEDICOS/DERMAGIC-EXPRESS No 2-(85) 11/12/1.999 DR. JOSE
LAPENTA R.
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