Eruptive lichen planus‐like keratoses induced during R‐CHOP 21 chemotherapy for diffuse large B‐cell (gastric) lymphoma

Abstract

evidence of invasion. The nasal cartilage had undergone severe atrophy from compressive effects of the lesion. The resultant defect diameter was 1.5 cm which was reconstructed with a bilobed flap and cartilage graft (Fig. 1b). In view of the benign histological characteristics from the punch biopsy and the well-encapsulated nature of the lesion, the decision was made intraoperatively not to aggressively pursue wider margins. Cheah et al in a 33 patient case series demonstrated that SCLs can have infiltrative borders and exhibit skeletal muscle infiltration (focally or extensively). 8 There was also infiltration of dermal collagen and around adnexal structures in that series. CONCLUSIONSCLs arising from the face at the nasal alar aspect are rare and presents diagnostic and management challenges, especially where excision can potentially result in larger skin defects requiring more extensive reconstruction. Available literature suggests that even if SCLs are incompletely excised from the face, recurrence rate is low. Meticulous evaluation of morphology and use of ancillary studies can assist with diagnosis of SCL and distinction from more aggressive, infiltrative mimics such as a liposarcoma.

Lichen planus-like keratosis: what do we know about it?

“…In patients with the diffuse form numerous LPLK foci develop at sites of existing seborrhoeic keratoses or lentigines. 4,9,10 There are reports showing LPLK as a skin manifestation of graft-versus-host disease. 11 For many years biopsy was needed to make the correct diagnosis, especially for flat erythematous or pigmented lesions, which can clinically and dermoscopically mimic amelanotic melanoma or pigmented carcinomas.…”

“…Diffuse LPLK can be observed as a chemotherapy or immune therapy‐associated adverse reaction. In patients with the diffuse form numerous LPLK foci develop at sites of existing seborrhoeic keratoses or lentigines 4,9,10 . There are reports showing LPLK as a skin manifestation of graft‐versus‐host disease 11 …”