Lichen planus

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief:  Kiran Singh, M.D. [2]

Synonyms and keywords: Ruber planus; Wickham striae

## Overview

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Lichen planus is an inflammatory disease that affects the skin and the oral mucosa.

## Historical Perspective

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## Classification

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Lichen Planopilaris is the specific name given to lichen planus on the scalp that may cause permanent, scarring alopecia. If left untreated the scarring will cause permanent hair loss. The Cicatricial Alopecia Research Foundation is a non-profit organization that provides support and resources for people with lichen planopilaris.

## Pathophysiology

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## Causes

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### Common Causes

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The cause of lichen planus is not known; however, there are cases of lichen planus-type rashes (known as lichenoid reactions) occurring as allergic reactions to medications for high blood pressure, heart disease and arthritis. These lichenoid reactions are referred to as lichenoid mucositis (of the mucosa) or dermatitis (of the skin). Lichen planus has been reported as a complication of chronic hepatitis C virus infection and can be a sign of chronic graft-versus-host disease of the skin. It has been suggested that true lichen planus may respond to stress, where lesions may present on the mucosa or skin during times of stress in those with the disease.

### Causes in Alphabetical Order

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* Allergic reactions to medications for high blood pressure
* Arthritis
* Bendrofluazide
* Chloroquine
* Gold salts
* Graft-versus-host disease
* Heart disease
* Hepatitis C
* Hydrochlorothiazide
* Lichen planopilaris
* Lichen ruber moniliformis
* Mepacrine
* Methyldopa
* Methyldopate
* Penicillamine
* Stress

## Differentiating lichen planus from other Diseases

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The clinical presentation of lichen planus may also resemble other conditions, including:

* Lichenoid drug reaction
* Discoid lupus erythematosus
* Chronic ulcerative stomatitis
* Pemphigus vulgaris
* Benign mucous membrane pemphigoid
* Oral leukoplakia
* Frictional keratosis

A biopsy is useful in identifying histological features that help differentiate lichen planus from these conditions.

## Epidemiology and Demographics

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### Age

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Lichen planus in children is rare, and it occurs most often in middle-aged adults.

### Gender

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Lichen planus affects women more than men (at a ratio of 3:2).

## Risk Factors

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Some of the risk factors for lichen planus are as follows:

* Exposure to medications, dyes, and other chemical substances (including gold, antibiotics, arsenic, iodides, chloroquine, quinacrine, quinide, phenothiazines, and diuretics)
* Disorders such as hepatitis C

## Natural History, Complications, and Prognosis

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Lichen planus is usually not harmful and may get better with treatment. It usually clears up within 18 months. However it may last for weeks to months, and may come and go for years. If lichen planus is caused by a medication, the rash should go away once the medicine is stopped.

A possible complication that is associated with lichen planus is that mouth ulcers that are there for a long time may develop into oral cancer.

## Diagnosis

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### Symptoms

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The microscopic appearance of lichen planus is pathognomonic for the condition

* Hyperparakeratosis with thickening of the granular cell layer
* Development of a "saw-tooth" appearance of the rete pegs
* Degeneration of the basal cell layer
* Infiltration of inflammatory cells into the subepithelial layer of connective tissue

Other symptoms such as:

* Cicatricial alopecia
* Genital ulcer
* Gum pathology
* Hyperkeratosis
* Koebner phenomenon
* Lichenoid dermatitis
* Mucosal leucoplakia
* Nail pitting
* Oral ulceration
* Pruritis
* Tongue abnormality

### Physical Examination

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The typical rash of lichen planus is well-described by the "5 P's": well-defined pruritic, planar, purple, polygonal papules. The commonly affected sites are near the wrist and the ankle. The rash tends to heal with prominent blue-black or brownish discoloration that persists for a long time. Besides the typical lesions, many morphological varieties of the rash may occur. The presence of cutaneous lesions is not constant and may wax and wane over time. Oral lesions tend to last far longer than cutaneous lichen planus lesions.

The following images show good examples of how lichen planus manifests on the body.

* Lichen planus close up

* Lichen planus on the arm

* Lichen planus on the oral mucosa

* Lichen planus on the hands

#### Skin

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##### Trunk

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* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

##### Extremity

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* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

##### Oral cavity

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* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

##### Face

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* Lichen planus. Adapted from Dermatology Atlas.[1]

##### Lichen Planus Actinicus

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###### Face

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* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

###### Trunk

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* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

###### Extremity

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* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

* Lichen planus actinicus. Adapted from Dermatology Atlas.[1]

##### Lichen planus annular

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###### Trunk

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* Lichen planus annular. Adapted from Dermatology Atlas.[1]

* Lichen planus annular. Adapted from Dermatology Atlas.[1]

##### Lichen Planus Follicularis

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###### Neck

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* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

###### Extremity

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* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

###### Scalp

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* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

* Lichen planus follicularis. Adapted from Dermatology Atlas.[1]

##### Lichen Planus Linearis

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###### Trunk

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* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

###### Extremity

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* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

* Lichen planus linearis. Adapted from Dermatology Atlas.[1]

###### Lichen Planus Verrucosus

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* Lichen planus verrucosus . Adapted from Dermatology Atlas.[1]

* Lichen planus verrucosus . Adapted from Dermatology Atlas.[1]

##### Lichen Planus Vesicular

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###### Trunk

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* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

###### Extremity

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* Lichen planus vesicular. Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular. Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

* Lichen planus vesicular . Adapted from Dermatology Atlas.[1]

##### Mucosal Lichen Planus

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###### Oral cavity

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* Mucosal lichen planus. Adapted from Dermatology Atlas.[1]

* Mucosal lichen planus . Adapted from Dermatology Atlas.[1]

* Mucosal lichen planus . Adapted from Dermatology Atlas.[1]

## Differential diagnosis

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Lichen planus must be differentiated from other diseases that cause ust be differentiated from other diseases that cause rash and eczema such as secondary syphilis and pityriasis rosea.

Disease  | Rash Characteristics  | Signs and Symptoms  | Associated Conditions  | Images

|
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Cutaneous T cell lymphoma/Mycosis fungoides[2] |

* Premycotic phase: A scaly, red rash in areas of the body that usually are not exposed to the sun. This rash does not cause symptoms and may last for months or years.
* Patch phase: Thin, erythematous, eczema-like rash.
* Plaque phase: Small raised bumps (papules) or hardened lesions on the skin, which may be erythematous.
* Tumor phase: Tumors form on the skin. Infection secondary to ulcers.

* Epidermal atrophy or poikiloderma

* Generalized itching (pruritus)
* Pain in the affected area of the skin
* Insomnia
* Red (erythematous) patches scattered over the skin of the trunk and the extremities
* Tumor-like lobulated outgrowths form on the skin in the latter phase of the disease
* Weight loss
* Lymphadenopathy
* Malaise and fatigue
* Anemia
* May progress to Sezary syndrome (skin involvement plus hematogenous dissemination)

* Sezary syndrome

|  By Bobjgalindo - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=7139812
Pityriasis rosea[3] |

* Pink or salmon in color, which may be scaly; referred to as "herald patch"
* Oval shape
* Long axis oriented along the cleavage lines
* Distributed on the trunk and proximal extremities
* Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on posterior trunk
* Secondary to viral infections
* Resolves spontaneously after 6-8 weeks

* Preceded by a prodrome of:
* Sore throat
* Gastrointestinal disturbance
* Fever
* Arthralgia

* Infection by any of the following:[4]
* HHV-6
* HHV-7
* HHV-8

|  By James Heilman,MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16305230
Pityriasis lichenoides chronica |

* Recurrent lesions are usually less evenly scattered than in cases of psoriasis
* Brownish red or orange-brown in color
* Lesions are capped by a single detachable, opaque, mica-like scale
* Often leave hypopigmented macules

* High fever
* Malaise
* Myalgias
* Paraesthesia
* Pruritus

* Infection by any of the following:[5]
* Epstein-Barr virus (EBV)
* Toxoplasma gondii
* Human immunodeficiency virus (HIV)

Nummular dermatitis[6] |

* Multiple coin-shaped eczematous lesions
* Commonly affecting the extremities (lower>upper) and trunk
* May ooze fluid and become dry and crusty

* Often appears after a skin injury, such as a burn, abrasion (from friction), or insect bite

* Lesions commonly relapse after occasional remission or may persist for long periods
* Pruritus

* Associated with:
* Dry skin
* Emotional stress
* Allergens (rubber chemicals, formaldehyde, neomycin, chrome, mercury, and nickel)
* Staphylococcus infection
* Seasonal variation
* Alcohol
* Drugs
* Atopy

Secondary syphilis[7] |

* Round, coppery, red colored lesions on palms and soles
* Papules with collarette of scales

* Fever
* Generalized lymphadenopathy
* Sore throat
* Patchy hair loss
* Headache
* Weight loss
* Myalgia
* Fatigue

* Associated with:
* Condylomata lata
* Corona verinata
* Positive VDRL test

|  By James Heilman,MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16305230
Bowen’s disease[8] |

* Erythematous, small, scaly plaque, which enlarges erratically over time
* Scale is usually yellow or white and it is easily detachable without any bleeding
* Well-defined margins

* Pruritus
* Pain
* Bleeding lesions

* Associated with:[9]
* Erythroplasia of Queyrat (Bowen's disease of the penis)
* Squamous cell carcinoma
* Solar radiation and ultraviolet (UV) exposure
* Radiotherapy
* Immunosuppression
* Arsenic exposure
* Human papilloma virus (HPV) type 16
* Merkel cell polyomavirus
* Sjögren’s syndrome

|  By Klaus D. Peter, Gummersbach, Germany - Own work (own photograph), CC BY 3.0 de, https://commons.wikimedia.org/w/index.php?curid=6839115
Exanthematous pustulosis[10] |

* Numerous small, primarily non-follicular, sterile pustules, arising within large areas of edematous erythema

* Fever
* Leukocytosis
* Intracorneal, subcorneal, and/or intraepidermal pustules with papillary dermal edema containing neutrophils and eosinophils

* Associated with:[11]
* Antibiotics (penicillins, sulfonamides, tetracyclines)
* Carbamazepine
* Calcium channel blockers (Diltiazem)
* Hydroxychloroquine

|  By See below - (2010). "Acute generalized exanthematous pustulosis: an unusual side effect of meropenem". Indian J Dermatol 55 (2): 176–7. DOI:10.4103/0019-5154.62759. PMID 20606889. PMC: 2887524., CC BY 1.0, https://commons.wikimedia.org/w/index.php?curid=52979729
Hypertrophic lichen planus[12] |

* Classically involves shin and ankles and is characterized by hyperkeratotic plaques and nodules covered by a scale
* Lesions may transform into hyperkeratotic thickened, elevated, purplish or reddish plaques and nodules

* Chronic pruritus
* Scaling
* May be asymptomatic

* Associated with Hepatitis C virus infection[13]

|  Di James Heilman, MD - Opera propria, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11509003
Sneddon–Wilkinson disease[14] |

* Flaccid pustules that are often generalized and have a tendency to involve the flexural areas
* Annular configuration

* Pruritus
* May be asymptomatic

* Associated with:
* Monoclonal gammopathy, usually an IgA paraproteinemia[15]
* Crohn's disease[16]
* Osteomyelitis
* Adalimumab[17]

Small plaque parapsoriasis[18] |

* Erythematous plaques with fine scaly surface
* May present with elongated, finger-like patches
* Symmetrical distribution on the flanks
* Known as digitate dermatosis

* Lesions may be asymptomatic
* May be mildly pruritic
* May fade or disappear after sun exposure during the summer season, but typically recur during the winter

* May progress to mycosis fungoides[19]

Intertrigo[20] |

* Red and fleshy looking lesion in skin folds
* Itching
* Oozing
* May be sore

* Pruritus
* Musty odor

* Associated with:
* Infections (Fungal, bacterial, viral)
* Allergies
* Diabetes
* Obesity

|  Source: https://www.cdc.gov/
Langerhans cell histiocytosis[21] |

* Scaling and crusting of scalp

* Pathological fractures[22]
* Visceromegaly (hepatomegaly, spleenomegaly)
* Chronic cough
* Dyspnea[23]
* Lymphadenopathy

* Associated with:
* Diabetes insipidus[24]
* Pancytopenia

Tinea manuum/pedum/capitis[25] |

* Scaling, flaking, and sometimes blistering of the affected areas
* Hair loss with a black dot on scalp in case of tinea capitis

* Pruritus
* KOH preparation of the lesions confirms fungal infection

* Associated with:
* Diabetes
* Immunosupression
* Intimate contact with infected person
* May lead to asthma exacerbation

Seborrheic dermatitis |

* Papulosquamous, scaly, flaky, itchy, and red rash found particularly at sebaceous gland-rich areas of the body

* Pruritus

* Associated with:[26]
* AIDS
* Stress[27]
* Fungal infection
* Fatigue
* Sleep deprivation
* Change of season
* Parkinson's disease
* Biotin deficiency

|  By Roymishali - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=27267929

#### Head

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Oral lichen planus may present in one of three forms.

* The reticular form is the most common presentation and manifests as white lacy streaks on the mucosa (known as Wickham's striae) or as smaller papules (small raised area). The lesions tend to be bilateral and are asymptomatic. The lacy streaks may also be seen on other parts of the mouth, including the gingiva (gums), the tongue, palate and lips.
* The bullous form presents as fluid-filled vesicles which project from the surface.
* The erosive form presents with erythematous (red) areas that are ulcerated and uncomfortable. The erosion of the thin epithelium may occur in multiple areas of the mouth, or in one area, such as the gums, where they resemble desquamative gingivitis. Wickham's striae may also be seen near these ulcerated areas. This form may undergo malignant transformation.

#### Throat

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Rarely, lichen planus shows esophageal involvement, where it can present with erosive esophagitis and stricturing. It has also been hypothesized that it is a precursor to squamous cell carcinoma of the esophagus.

#### Genitals

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Lichen planus may also affect the genital mucosa - vulvovaginal-gingival lichen planus. It can resemble other skin conditions such as atopic dermatitis and psoriasis.

Clinical experience suggests that Lichen planus of the skin alone is easier to treat as compared to one which is associated with oral and genital lesions.

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

* Lichen planus. Adapted from Dermatology Atlas.[1]

## Treatment

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Currently there is no cure for lichen planus but there are certain types of medicines used to reduce the effects of the inflammation. Lichen planus may go into a dormant state after treatment. There are also reports that lichen planus can flare up years after it is considered cured.

### Medical Therapy

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#### Pharmacotherapy

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##### Acute Pharmacotherapies

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* Oral and topical steroids.
* Hydroxychloroquine
* Tacrolimus
* Dapsone

##### Chronic Pharmacotherapies

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* Oral retinoids
* Immunosuppressant medications

### Surgery

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### Prevention

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## References

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1. ↑ 1.000 1.001 1.002 1.003 1.004 1.005 1.006 1.007 1.008 1.009 1.010 1.011 1.012 1.013 1.014 1.015 1.016 1.017 1.018 1.019 1.020 1.021 1.022 1.023 1.024 1.025 1.026 1.027 1.028 1.029 1.030 1.031 1.032 1.033 1.034 1.035 1.036 1.037 1.038 1.039 1.040 1.041 1.042 1.043 1.044 1.045 1.046 1.047 1.048 1.049 1.050 1.051 1.052 1.053 1.054 1.055 1.056 1.057 1.058 1.059 1.060 1.061 1.062 1.063 1.064 1.065 1.066 1.067 1.068 1.069 1.070 1.071 1.072 1.073 1.074 1.075 1.076 1.077 1.078 1.079 1.080 1.081 1.082 1.083 1.084 1.085 1.086 1.087 1.088 1.089 1.090 1.091 1.092 1.093 1.094 1.095 1.096 1.097 1.098 1.099 1.100 1.101 1.102 1.103 1.104 1.105 1.106 1.107 1.108 1.109 1.110 1.111 1.112 1.113 1.114 1.115 1.116 1.117 1.118 1.119 1.120 1.121 1.122 1.123 1.124 1.125 1.126 1.127 1.128 1.129 1.130 1.131 1.132 1.133 1.134 1.135 1.136 1.137 "Dermatology Atlas".
2. ↑ "Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute".
3. ↑ Mahajan K, Relhan V, Relhan AK, Garg VK (2016). "Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects". Indian J Dermatol. 61 (4): 375–84. doi:10.4103/0019-5154.185699. PMC 4966395. PMID 27512182.
4. ↑ Prantsidis A, Rigopoulos D, Papatheodorou G, Menounos P, Gregoriou S, Alexiou-Mousatou I, Katsambas A (2009). "Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea". Acta Derm. Venereol. 89 (6): 604–6. doi:10.2340/00015555-0703. PMID 19997691.
5. ↑ Smith KJ, Nelson A, Skelton H, Yeager J, Wagner KF (1997). "Pityriasis lichenoides et varioliformis acuta in HIV-1+ patients: a marker of early stage disease. The Military Medical Consortium for the Advancement of Retroviral Research (MMCARR)". Int. J. Dermatol. 36 (2): 104–9. PMID 9109005.
6. ↑ Jiamton S, Tangjaturonrusamee C, Kulthanan K (2013). "Clinical features and aggravating factors in nummular eczema in Thais". Asian Pac. J. Allergy Immunol. 31 (1): 36–42. PMID 23517392.
7. ↑ "STD Facts - Syphilis".
8. ↑ Neagu TP, Tiglis M, Botezatu D, Enache V, Cobilinschi CO, Vâlcea-Precup MS, GrinTescu IM (2017). "Clinical, histological and therapeutic features of Bowen's disease". Rom J Morphol Embryol. 58 (1): 33–40. PMID 28523295.
9. ↑ Murao K, Yoshioka R, Kubo Y (2014). "Human papillomavirus infection in Bowen disease: negative p53 expression, not p16(INK4a) overexpression, is correlated with human papillomavirus-associated Bowen disease". J. Dermatol. 41 (10): 878–84. doi:10.1111/1346-8138.12613. PMID 25201325.
10. ↑ Szatkowski J, Schwartz RA (2015). "Acute generalized exanthematous pustulosis (AGEP): A review and update". J. Am. Acad. Dermatol. 73 (5): 843–8. doi:10.1016/j.jaad.2015.07.017. PMID 26354880.
11. ↑ Schmid S, Kuechler PC, Britschgi M, Steiner UC, Yawalkar N, Limat A, Baltensperger K, Braathen L, Pichler WJ (2002). "Acute generalized exanthematous pustulosis: role of cytotoxic T cells in pustule formation". Am. J. Pathol. 161 (6): 2079–86. doi:10.1016/S0002-9440(10)64486-0. PMC 1850901. PMID 12466124.
12. ↑ Ankad BS, Beergouder SL (2016). "Hypertrophic lichen planus versus prurigo nodularis: a dermoscopic perspective". Dermatol Pract Concept. 6 (2): 9–15. doi:10.5826/dpc.0602a03. PMC 4866621. PMID 27222766.
13. ↑ Shengyuan L, Songpo Y, Wen W, Wenjing T, Haitao Z, Binyou W (2009). "Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis". Arch Dermatol. 145 (9): 1040–7. doi:10.1001/archdermatol.2009.200. PMID 19770446.
14. ↑ Lutz ME, Daoud MS, McEvoy MT, Gibson LE (1998). "Subcorneal pustular dermatosis: a clinical study of ten patients". Cutis. 61 (4): 203–8. PMID 9564592.
15. ↑ Kasha EE, Epinette WW (1988). "Subcorneal pustular dermatosis (Sneddon-Wilkinson disease) in association with a monoclonal IgA gammopathy: a report and review of the literature". J. Am. Acad. Dermatol. 19 (5 Pt 1): 854–8. PMID 3056995.
16. ↑ Delaporte E, Colombel JF, Nguyen-Mailfer C, Piette F, Cortot A, Bergoend H (1992). "Subcorneal pustular dermatosis in a patient with Crohn's disease". Acta Derm. Venereol. 72 (4): 301–2. PMID 1357895.
17. ↑ Sauder MB, Glassman SJ (2013). "Palmoplantar subcorneal pustular dermatosis following adalimumab therapy for rheumatoid arthritis". Int. J. Dermatol. 52 (5): 624–8. doi:10.1111/j.1365-4632.2012.05707.x. PMID 23489057.
18. ↑ Lambert WC, Everett MA (1981). "The nosology of parapsoriasis". J. Am. Acad. Dermatol. 5 (4): 373–95. PMID 7026622.
19. ↑ Väkevä L, Sarna S, Vaalasti A, Pukkala E, Kariniemi AL, Ranki A (2005). "A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides". Acta Derm. Venereol. 85 (4): 318–23. doi:10.1080/00015550510030087. PMID 16191852.
20. ↑ Janniger CK, Schwartz RA, Szepietowski JC, Reich A (2005). "Intertrigo and common secondary skin infections". Am Fam Physician. 72 (5): 833–8. PMID 16156342.
21. ↑ Satter EK, High WA (2008). "Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society". Pediatr Dermatol. 25 (3): 291–5. doi:10.1111/j.1525-1470.2008.00669.x. PMID 18577030.
22. ↑ Stull MA, Kransdorf MJ, Devaney KO (1992). "Langerhans cell histiocytosis of bone". Radiographics. 12 (4): 801–23. doi:10.1148/radiographics.12.4.1636041. PMID 1636041.
23. ↑ Sholl LM, Hornick JL, Pinkus JL, Pinkus GS, Padera RF (2007). "Immunohistochemical analysis of langerin in langerhans cell histiocytosis and pulmonary inflammatory and infectious diseases". Am. J. Surg. Pathol. 31 (6): 947–52. doi:10.1097/01.pas.0000249443.82971.bb. PMID 17527085.
24. ↑ Grois N, Pötschger U, Prosch H, Minkov M, Arico M, Braier J, Henter JI, Janka-Schaub G, Ladisch S, Ritter J, Steiner M, Unger E, Gadner H (2006). "Risk factors for diabetes insipidus in langerhans cell histiocytosis". Pediatr Blood Cancer. 46 (2): 228–33. doi:10.1002/pbc.20425. PMID 16047354.
25. ↑ Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G (2004). "Dermatology for the practicing allergist: Tinea pedis and its complications". Clin Mol Allergy. 2 (1): 5. doi:10.1186/1476-7961-2-5. PMC 419368. PMID 15050029.
26. ↑ Schwartz RA, Janusz CA, Janniger CK (2006). "Seborrheic dermatitis: an overview". Am Fam Physician. 74 (1): 125–30. PMID 16848386.
27. ↑ Misery L, Touboul S, Vinçot C, Dutray S, Rolland-Jacob G, Consoli SG, Farcet Y, Feton-Danou N, Cardinaud F, Callot V, De La Chapelle C, Pomey-Rey D, Consoli SM (2007). "[Stress and seborrheic dermatitis]". Ann Dermatol Venereol (in French). 134 (11): 833–7. PMID 18033062.CS1 maint: Unrecognized language (link)

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Diseases of the skin and subcutaneous tissue (integumentary system) (L, 680-709)

Infections|

Template:Navbox subgroup

Bullous disorders|

acantholysis (Pemphigus, Transient acantholytic dermatosis) * Pemphigoid (Bullous, Cicatricial, Gestational) * Dermatitis herpetiformis

Inflammatory|

Template:Navbox subgroup

Radiation-related disorders|

Sunburn * actinic rays (Actinic keratosis, Actinic cheilitis) * Polymorphous light eruption (Acne aestivalis) * Radiodermatitis * Erythema ab igne

Pigmentation disorder|

hypopigmentation (Albinism, Vitiligo) * hyperpigmentation (Melasma, Freckle, Café au lait spot, Lentigo/Liver spot, Acanthosis nigricans, Acral acanthotic anomaly)

Other skin|

keratosis/hyperkeratosis (Seborrheic keratosis, Callus) * other epidermal thickening (Ichthyosis acquisita, Palmoplantar keratoderma)

skin ulcer (Pyoderma gangrenosum, Bedsore)

Cutaneous Markers of Internal Malignancy (Florid cutaneous papillomatosis, acanthosis nigricans, sign of Leser-Trelat)

atrophic (Lichen sclerosus, Acrodermatitis chronica atrophicans)

necrobiosis (Granuloma annulare, Necrobiosis lipoidica) * other granuloma (Granuloma faciale, Pyogenic granuloma)

cutaneous vasculitis (Livedoid vasculitis, Erythema elevatum diutinum)

Connective tissues|

collagen disease: Keloid
localized connective tissue disorders: Lupus erythematosus (Discoid lupus erythematosus, Subacute cutaneous lupus erythematosus) * Scleroderma/Morphea * Linear scleroderma * Calcinosis cutis * Sclerodactyly * Ainhum

see also congenital, neoplasia

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