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cytic atypia

Pathophysiology:

■ Lichen planus-like keratosis is thought to represent the spontaneous involution of a solar lentigo, large cell acanthoma, or reticulated seborrheic keratosis via a cell-mediated immunologic reaction

References:

1. Laur WE, Posey RE, Waller JD. Lichen planus-like keratosis. A clinicohistopathologic correlation. J Am Acad Dermatol 1981; 4:329-336.

2. Goldenhersh MA, Barnhill RL, Rosenbaum HM, Stenn KS. Documented evolution of a solar lentigo into a solitary lichen planus-like keratosis. J Cutan Pathol 1986: 13:308-311.

LICHENOID PIGMENTED PURPURA Clinical Presentation:

■ Variants: pigmented purpuric lichenoid dermatosis of Gougerot and Blum

■ Clinically presents as symmetric, bilaterally-distributed, purpuric, and flat-topped papules that coalesce into plaques on the lower extremities

■ Variants: lichen aureus

■ Clinically presents as unilateral group of macules or papules with a rusty, golden color; sites of predilection are the lower extremities and trunk

■ Associated rarely with hepatitis C seropositivity

Histology:

■ Band-like, mixed infiltrate does not obscure the dermo-epidermal junction (the "noninterface interface" dermatosis) (Fig. 11A)

■ The mixed infiltrate includes variable numbers of extravasated erythrocytes and/or hemosiderin-laden macrophages (siderophages) (Figs. 11B and C)

■ There may also be hemosiderin pigment deposition in the dermis (Fig. 11C)

Differential Diagnosis:

Pathophysiology:

■ Increased capillary fragility, possibly related to venous hypertension, is thought to lead to the extravasation of lymphocytes and erythrocytes from the vessels.

References:

1. Rao BK, Igwegbe I, Wiederkehr M, et al. Gougerot-Blum disease as a manifestation of hepatitis C infection. J Cutan Pathol 2000; 27:569.

2. English J. Lichen aureus. J Am Acad Dermatol 1985; 12:377-378.

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