Case of keratosis lichenoides chronica with atypical sarcoidal granulomatous inflammation

ABSTRACT Keratosis lichenoides chronica (KLC) is a rare chronic disease characterized by violaceous, papular and nodular lesions typically arranged in a linear and reticulate pattern. The etiology of KLC is unknown, but it may be associated with internal diseases such as hypothyroidism, glomerulonep...

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Published in:Journal of dermatology 2007-01, Vol.34 (1), p.41-47
Main Authors: MANSUR, Ayşe Tülin, AYDINGÖZ, İkbal Esen, KOCAAYAN, Nurhan, GÜNDÜZ, Sevil, ÖZŞEKER, Nihal, HAZAR, Armağan, YILDIZ, Kürşat
Format: Article
Language:English
Subjects:
Adult
Chronic Disease
Granuloma - pathology
Humans
Keratosis - pathology
keratosis lichenoides chronica
lichenoid dermatosis
Lichenoid Eruptions - pathology
Male
sarcoidal granulomatous reaction
sarcoidosis
Sarcoidosis - pathology
Skin - pathology
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Summary:ABSTRACT Keratosis lichenoides chronica (KLC) is a rare chronic disease characterized by violaceous, papular and nodular lesions typically arranged in a linear and reticulate pattern. The etiology of KLC is unknown, but it may be associated with internal diseases such as hypothyroidism, glomerulonephritis and lymphoproliferative disorders. Herein, we describe the case of 44‐year‐old male patient with characteristic lesions of KLC on the trunk and extremities, present for 12 years. The clinical diagnosis was proven by histopathological examination on several occasions. In the years following the diagnosis of KLC, he developed bilateral hilar and multiple mediastinal, cervical and inguinal lymphadenopathies and hepatosplenomegaly. In 2000, diffuse interstitial and then reticulonodular pulmonary infiltrates associated with fever, weight loss, malaise and subcutaneous nodules developed. Biopsies taken from peripheral and mediastinal lymph nodes, pulmonary parenchyma, pleural tissue, bone marrow and skin showed non‐necrotizing granulomas, indicating a sarcoidal granulomatous reaction. Characteristic histopathological findings and the absence of atypical cells, clonality and a high proliferative index excluded lymphomas. Furthermore, detailed tests showed no evidence of an infectious granulomatous disease. As far as we know, this is the first reported case of KLC associated with a sarcoidal granulomatous reaction.
ISSN:0385-2407
1346-8138
DOI:10.1111/j.1346-8138.2007.00214.x