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Keratosis lichenoides chronica |
European Journal of Dermatology. Volume 9, Number 4, 319-20, June 1999, Votre diagnostic !
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 Free Article
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Author(s) : R. Chikama, T. Terui, M. Tanita, H. Tagami |
Summary : A 60-year old Japanese man was at first seen at a local public hospital 5 years previously because of a 6 month-history of non-pruritic, multiple, firm erythematous papules and nodules on his lower legs. They gradually increased in number and size. His family history showed no similar skin conditions. He had had hypertension for the past 10 years, but had not been under medication. He had been treated with various therapeutic modalities including topical steroids, PUVA, systemic administration of diphenylsulfone, cyclosporine, prednisone, etretinate, and griseofulvin. Since, despite these treatments, the eruptions gradually enlarged and increased in number, he was referred to our hospital, and was hospitalized in July 1994. Physical examination on admission showed multiple papules, some arranged in a linear pattern (Fig. 1), and verrucous nodules, some of which had centrally keratin-filled craters as shown in Fig. 2. Several verrucous keratotic eruptions were also found on the soles. Examinations of the internal organs did not disclose any particular changes. Although the PPD test was strongly positive, no active tuberculous lesion was found. Serum antibody against human immunodeficiency virus (HIV) was negative. His total peripheral white blood cell count was 5,000 cells/mm3, with the ratio of CD4/CD8 was 1.2. Skin biopsy specimens taken from the verrucous nodules on the left thigh and over the Achilles' tendon showed acanthotic epidermis consisting of hypertrophic epidermal cells with pale, eosinophilic and glassy cytoplasms, wedgelike hypergranulosis, focal liquefaction degeneration, and exocytosis of mononuclear cells (Fig. 3). |
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