Pityriasis lichenoides is an immune reactionary self-limiting benign disease

Authors

  • Khalifa E. Sharquie Department of Dermatology, College of Medicine, University of Baghdad. Medical City Teaching Hospital.
  • Inas K. Sharquie Department of Microbiology & Immunology, College of Medicine, University of Baghdad, Baghdad, Iraq.

Keywords:

Pityriasis lichenoides, PLEVA, PLC, immune reaction, triggering factors.

Abstract

Objective Pityriasis ichenoides consists of Pityriasis Lichenoides et Varioliformis Acuta and Pityriasis Lichenoides Chronica. It might resolve spontaneously and without important sequelae such as lymphoma. This study aims to evaluate the demographic and clinical pictures of both types of pityriasis lichenoides.  Methods This is a clinical descriptive study on a long-term basis, in which patients with a clinical picture of pityriasis lichenoides were collected during the period between 2012 and 2020. Any triggering factors before the onset of the disease were noted and biopsies for histopathological evaluation were carried out.  Results Fifty-six patients with pityriasis lichenoides were evaluated; no obvious triggering factors were elucidated in both types. The acute form consisted of 16 (80%) males and 4 (20%) females. Their age range was from 5 to30 years with a median of around 17years. All presented with acute generalized erythematous necrotic lesions with burning and itching, simulating chicken pox that left hyperpigmentation after recovery. The chronic form consisted of 36 cases. Their age range was from 3 to 12 years with a median of 7 years; 31 (86%) were males and 5 (13.8%) were females. All cases had a slow course of progression over months and years. Fourteen patients (38.8%) were seen with generalized non-itchy erythematous papules with mica-like scales whereas 24 (66.66%) presented with hypopigmented lesions.  Conclusion Both acute and chronic forms are self-limiting conditions that stay for weeks to years and remit spontaneously. They are considered as an immune reaction to specific triggering factors such as an infection.  

References

Bowers S, Warshaw EM. Pityriasis lichenoides and its subtypes. J Am Acad Dermatol. 2006;55(4):557-72

Aytekin S, Balci G, Duzgun OY. Febrile ulceronecrotic Mucha-Habermann disease: a case report and a review of the literature. Dermatol Online J. 2005;11(3):31

Nofal A, Alakad R, Assaf M, Nofal E. A fatal case of febrile ulceronecrotic Mucha-Habermann disease in a child. JAAD Case Rep. 2016;2(2):181-5

Tversky JR, Le TV, Bieneman AP, Chichester KL, Hamilton RG, Schroeder JT. Human blood dendritic cells from allergic subjects have impaired capacity to produce interferon-alpha via Toll-like receptor 9. Clin Exp Allergy. 2008;38(5):781-8

Karouni M, Rahal JA, Kurban M, Kibbi AG, Abbas O. Possible role of plasmacytoid dendritic cells in pityriasis lichenoides. Clin Exp Dermatol. 2018;43(4):404-9

Tomasini D, Tomasini CF, Cerri A, Sangalli G, Palmedo G, Hantschke M, et al. Pityriasis lichenoides: a cytotoxic T-cell-mediated skin disorder. Evidence of human parvovirus B19 DNA in nine cases. J Cutan Pathol. 2004;31(8):531-8

Castro BA, Pereira JM, Meyer RL, Trindade FM, Pedrosa MS, Piancastelli AC. Pityriasis lichenoides et varioliformis acuta after influenza vaccine. An Bras Dermatol. 2015;90(3 Suppl 1):181-4

Khachemoune A, Blyumin ML. Pityriasis Lichenoides. Am J Clin Dermatol. 2007;8(1):29-36

Machan M, Loren R, Fraga G, Liu D. Pityriasis lichenoides et varioliformis acuta associated with subcutaneous immunoglobulin administration. J Am Acad Dermatol. 2012;67(4):151-52

Almagro M, Del Pozo J, Martinez W, Silva JG, Pena C, Yebra-Pimentel MT, et al. Pityriasis lichenoides-like exanthem and primary infection by Epstein-Barr virus. Int J Dermatol. 2000;39(2):156-9

Gonzalez Rodriguez AJ, Montesinos Villaescusa E, Jorda Cuevas E. Pityriasis lichenoides chronica associated with herpes simplex virus type 2. Case Rep Dermatol Med. 2012;2012:737428

Zechini B, Teggi A, Antonelli M, Persechino S, Pranteda G, Versace I, et al. A case report of pityriasis lichenoides in a patient with chronic hepatitis C. J Infect. 2005;51(2):E23-5

Kim JE, Yun WJ, Mun SK, Yoon GS, Huh J, Choi JH, et al. Pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica: comparison of lesional T-cell subsets and investigation of viral associations. J Cutan Pathol. 2011;38(8):649-56

Longley J, Demar L, Feinstein RP, Miller RL, Silvers DN. Clinical and histologic features of pityriasis lichenoides et varioliformis acuta in children. Arch Dermatol. 1987;123(10):1335-9

Haeberle MT, Callen JP, Wells MJ, DS L. Pityriasis Lichenoides Clinical Presentation. 2018.Available from: https://emedicine.medscape.com/article/1099078-clinical#b3.

Ngan V. Pityriasis lichenoides. . DermNet NZ 1998.Available from: https://www.dermnetnz.org/topics/pityriasis-lichenoides/.

Nair PS. A clinical and histopathological study of pityriasis lichenoides. Indian J Dermatol Venereol Leprol. 2007;73(2):100-2

Patel DG, Kihiczak G, Schwartz RA, Janniger CK, Lambert WC. Pityriasis lichenoides. Cutis. 2000;65(1):17-20, 3

Downloads

Published

2022-04-10

How to Cite

1.
Sharquie KE, Sharquie IK. Pityriasis lichenoides is an immune reactionary self-limiting benign disease. J Pak Assoc Dermatol [Internet]. 2022Apr.10 [cited 2024Jun.17];31(3):328-33. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/1612

Issue

Section

Original Articles

Most read articles by the same author(s)