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February 1991

Classical and Ulcerative Lichen Planus With Plasma Cell Infiltrate

Author Affiliations

Department of Dermatology University Hospital Rijnsbergerweg 10 2333 AA Leiden, the Netherlands; Department of Dermatology Free University Boelelaan 1117 1081 HV Amsterdam, the Netherlands

Arch Dermatol. 1991;127(2):264-265. doi:10.1001/archderm.1991.01680020136023

To the Editor.—  One of the clinical variants of lichen planus (LP) is the ulcerative form, which shows bullae, erosions, and ulcerations of the feet and toes, and results in atrophic scarring and permanent loss of toenails. Cicatricial alopecia of the scalp and mucosal lesions may be present.1 The histologic picture of this variant is similar to other forms of LP with lymphocytes dominating the dermal inflammatory infiltrate. Plasma cells, if present, are sparse in number.From the literature we know of only one case of LP with an infiltrate of 40% to 50% plasma cells2 and two cases of lichen nitidus.3 We describe a patient with long-standing classical and ulcerative LP, whose lesions are histologically characterized by an inflammatory infiltrate that predominantly contains plasma cells.

Report of a Case.—  In January 1989 an 86-year-old woman presented with ulcerations of her feet. In 1940 she developed a

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