Squamous Cell Carcinoma Versus Hypertrophic Lichen Planus; a Difficult Differential Diagnosis of Great Significance in Approach to Treatment

Dietert, Jessica B.; Rabkin, Michael S.; Joseph, Aaron K.

doi:10.1097/dss.0000000000000886

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…A study has described rare or no eosinophil HLP similar to CLP and plenty eosinophil HLP that resemble lichenoid drug eruption and established no significant variation in the quantity of eosinophil in biopsies about the location of the lesions (9). We found the HLP is more likely to start and localize to the lower limbs; this observation is in keeping with several isolated reports on HLP (8)(9)(10)(11)(12). The HLP involvement of the lower legs in the present study (94.5%) is close to 88.9% described by Alomari et al (9).…”

Section: Discussionsupporting

confidence: 91%

“…Saw-tooth appearance is described as profound hyperplasia of the epidermis with invagination into the dermis. The classic pseudoepitheliomatous hyperplasia described in several reports (8)(9)(10)(11)(12) was not seen in the present histologic review. Other features of LP including a dense band of lymphocyte infiltration, vacuolar degeneration of dermoepidermal junction, granular hyperkeratosis, and the presence of melanophages were observed but there were no differences in their occurrence in the the variants.…”

Section: Discussioncontrasting

confidence: 63%

“…The insulin signaling effect of the inflammatory mediators and the inflammation-induced insulin resistance may be responsible for the development of the systemic insulin-resistant state in LP patients. Apart from dysmetabolism associated with the HLP, HLP has been associated with development of squamous cell carcinoma (SCC) (10)(11)(12). A study has shown an SCC incidence of 0.27% per annum in HLP lesions, and chronic inflammation (38,39) explained the association between SCC and HLP.…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of HLP has been related to the eosinophils (9) and Koebner phenomenon (5). In recent time, HLP has been associated or called a mimicker of squamous cell carcinoma (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Epidemiologic and Clinical Differences Between Classic and Hypertrophic Lichen Planus in Nigeria

Ifeanyi

Akinboro

Ezejoifor

et al. 2019

Serbian Journal of Dermatology and Venereology

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Introduction. Lichen planus is a chronic inflammatory skin disease known to have several clinical variants with attended variable clinical outcomes. Certain complications have been observed in the hypertrophic type, which were not found in association with the classic variant. Objective: To identify the epidemiologic and clinical differences between the classic and hypertrophic lichen planus and clinical correlates. Material and Methods. Of 104 participants with lichen planus included in the study, 49 had classic and 55 hypertrophic lichen planus. Demographic and clinical information was obtained. Diagnosis of lichen planus was made clinically and confirmed with histology. The participants were screened for metabolic syndrome, hepatitis B, and C. Results: Mean age of all patients was 37.20±13.39 years, with no age and gender differences between the participants with classic and hypertrophic lichen planus. Classic lichen planus was more likely to be painful, (8.2% vs 0.0, p=0.046), generalized (95.9% vs 16.4%, p<0.001), involve the oral mucosa (38.8% vs 0.0, p<0.001), the nails (38.8% vs 1.8, p<0.001), present with kobnerisation (55.1% vs 5.5%,<0.001), Wickhiam striae (69.4% vs 16.4%, p<0.001), associated with Hepatitis B vaccination (16.3% vs 3.6%, p<0.028) and anti HCV positivity (16.3% vs 0.0%, p=0.002). Hypertrophic lichen planus was significantly associated with impaired glucose tolerance/diabetes mellitus (16.4% vs 2.0%, p=0.013), dyslipidemia (74.5% vs 40.8%, p=0.001) and saw-tooth histologic appearance compared to classic type. Conclusion: Hypertrophic lichen planus is more likely to be associated with metabolic complications compared to the classic type. Further studies are needed to loink this difference t chronic inflamation.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epidemiologic and Clinical Differences Between Classic and Hypertrophic Lichen Planus in Nigeria

Ifeanyi

Akinboro

Ezejoifor

et al. 2019

Serbian Journal of Dermatology and Venereology

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“…HLP may masquerade as SCC and complicate diagnosis, particularly when few lesions are present. Histological findings of HLP often mimic SCC [7, 8]. Examination of HLP may demonstrate irregular acanthosis, horn cyst formation, and moderate dyskeratosis, making it difficult to distinguish from SCC [1].…”

Section: Discussionmentioning

confidence: 99%

Widespread Hypertrophic Lichen Planus following Programmed Cell Death Ligand 1 Blockade

2020

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Hypertrophic lichen planus (HLP) may not have the typical histological findings of lichen planus and often mimics squamous cell carcinoma (SCC). Distinguishing between the two can pose a diagnostic challenge. Here, we present a case of eruptive HLP mimicking SCC in the context of programmed cell death ligand 1 (PD-L1) immune checkpoint inhibition. A 73-year-old woman recently treated with durvalumab, an anti-PD-L1 antibody, presented to our clinic with diffuse hyperkeratotic papules and plaques previously thought to be eruptive SCC. The lesions did not respond to topical fluorouracil and continued to appear despite discontinuation of immunotherapy. Further histological analysis revealed intraepidermal epithelial proliferation with lichenoid inflammation. Subsequent treatment with topical corticosteroids significantly improved the size and number of lesions. The diagnosis of HLP was made based on histological features and response to topical steroids in the context of recent immunotherapy. This case reveals HLP as a potential adverse effect of PD-L1 inhibition and highlights the need for additional diagnostic assessment in patients presenting with eruptive hyperkeratotic lesions, especially on the lower extremities.

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Liquen plano hipertrófico: importancia del seguimiento y de la correlación clinicopatológica

Guillén-Climent¹,

Saura²,

Monteagudo³

et al. 2021

Actas Dermo-Sifiliográficas

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Squamous Cell Carcinoma Versus Hypertrophic Lichen Planus; a Difficult Differential Diagnosis of Great Significance in Approach to Treatment

Cited by 5 publications

References 5 publications

Epidemiologic and Clinical Differences Between Classic and Hypertrophic Lichen Planus in Nigeria

Epidemiologic and Clinical Differences Between Classic and Hypertrophic Lichen Planus in Nigeria

Widespread Hypertrophic Lichen Planus following Programmed Cell Death Ligand 1 Blockade

Liquen plano hipertrófico: importancia del seguimiento y de la correlación clinicopatológica

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