Hyperkeratosis lenticularis perstans (Flegel’s disease): our experience and review of the literature

Abstract

Hyperkeratosis lenticularis perstans (HLP), or Flegel's disease (FD), is a rare disorder of keratinization first described in 1958 by Flegel. HLP is characterized by asymptomatic small papules distributed symmetrically on the dorsal feet and lower part of the legs. It typically presents in the fourth or fifth decade of life. FD has been reported more commonly in women, and little is known about the pathogenesis of this rare dermatosis. Histological examination is mandatory to confirm the diagnosis, and the characteristic features are: focal compact hyperkeratosis, thinned stratum malpighii, epidermal atrophy, and a dense, band-like lymphocytic infiltrate in the papillary dermis. The treatment of FD is challenging, and a fully effective standard therapy does not exist. We report four cases of HLP that have been diagnosed at the Dermatology Unit of IRCCS Ca' Granda Ospedale Maggiore Policlinico in Milan, Italy, and a literature review is enclosed.

Hyperkeratosis lenticularis perstans: a case report of a rare entity

“…4 Furthermore, topical steroids can be useful only in treating early lesions. 4 Systemic retinoids can improve the clinical picture, while topical retinoids have been reported as not successful. 4 Ablative treatments, such as CO2 laser, dermabrasion, and cryotherapy, seem to be the most effective because they remove the defective keratinocytes.…”

“…However, because of the multiple number of lesions, these treatments are often unpractical. 4 Dario Skin biopsy from a subcutaneous nodule over the forehead revealed a dermal cyst having scolex and fibrosis (Fig. 1b).…”

“…4 Systemic retinoids can improve the clinical picture, while topical retinoids have been reported as not successful. 4 Ablative treatments, such as CO2 laser, dermabrasion, and cryotherapy, seem to be the most effective because they remove the defective keratinocytes. However, because of the multiple number of lesions, these treatments are often unpractical.…”

“…Ablative treatments, such as CO2 laser, dermabrasion, and cryotherapy, seem to be the most effective because they remove the defective keratinocytes. However, because of the multiple number of lesions, these treatments are often unpractical 4 …”

“…The therapy is challenging, and several local therapies have been proposed. Topical 5‐FU and vitamin D analogs have been reported as successful therapies 4 . Furthermore, topical steroids can be useful only in treating early lesions 4 .…”