Lichenoid and granulomatous dermatitis associated with atypical mycobacterium infections

Abstract

The differential diagnosis of lichenoid and granulomatous dermatitis should also encompass primary cutaneous Mycobacterium infection in addition to the other more characteristic entities associated wtih this distinctive reaction pattern. Infection with Mycobacterium induces a TH1 dominant response which would hence produce an infiltrate.

An outbreak of Mycobacterium chelonae infections in tattoos

“…Folliculitis, furuncles, abscesses, cellulitis, nodules, draining lesions, ulcers, and fistulae have also been described. [31][32][33] Our patients presented with multiple papules, pustules, plaques, plaques with scale, granulomatous papules, and lichenoid papules and plaques. This variable morphology makes prompt diagnosis challenging.…”

A Rare Form of Lichenoid Tissue Reaction: Lichenoid Granulomatous Dermatitis

“…It may be associated with hepatobiliary diseases, endocrinopathies, Crohn's disease, infections and drugs [1]. The most common clinical presentation of the disease is lichen planus, lichen nitidus and lichen striatus [2]. We present a case diagnosed histopathologically with lichenoid granulomatous dermatitis with severe skin involvement accompanied by myasthenia gravis and thymoma.…”

“…Lichenoid granulomatous dermatitis can be observed in relation to hepatobiliary diseases, rheumatoid arthritis, endocrinopathies, Crohn's disease, autoimmune diseases, infections and drugs [1,2,5]. This type of infiltration may also develop as an idiopathic response against active infection or microbial antigens [1].…”

“…A review of the literature reveals the patients who had been diagnosed with histopathological lichenoid granulomatous dermatitis presenting with a clinical picture similar to lichen planus, lichen striatus, lichen nitidus, drug eruption, erythroderma, necrobiosis lipoidica, psoriasis, granulomatous dermatitis, cutaneous T-cell lymphoma, tinea capitis, pityriasis lichenoides, secondary syphilis or tuberculoid leprosy [1]. The lesions may be generalized or localized [2,[5][6][7]. Our case is very special as it shows lichenoid granulomatous dermatitis specifications at histopathological findings with diffuse sclerotic plaques, purple papules and plaques on all over the body.…”

“…It may be accompanied by degenerative epithelial changes in the form of vasculopathy, dyskeratosis, and colloid body formation. Histiocytic infiltration can be seen as one of five patterns: 1) superficially disposed, loose small histiocytic aggregates amidst a band-like lymphocytic infiltrate; 2) small epithelioid granulomata within and subjacent to the areas of band-like lymphocytic infiltration; 3) an interstitial array between collagen fibers reminiscent of interstitial granuloma annulare (GA); 4) scattered singly disposed Langhans and/or foreign body type giant cells; and 5) granulomatous vasculitis [1][2][3][4]. Histopathologic features in our case were consisted with second type of histiocytic infiltration.…”