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Lichen Planus Circumfollicularis Corneus Comedoniformis? Presented by Dr. Bernard F. Ryan.
A 48-year-old woman has had a slowly spreading eruption for nine years. The first lesions were on the lateral aspect of the right heel and extended over the foot. Subsequently there has been roughly symmetrical involvement of the upper arms, sacroiliac region, legs, feet, hands, and forearms. The lesions become more erythematous when the patient is nervous and at the menses. There is no itching.
There is mild icthyosis of the thighs. Mostly on the extremities are large atrophic placques with multiple pinhead and larger red-to-violaceous papules. The lesions have a brownish color on diascopy. On the dorsum of the wrist are macular erythematous areas. The lesions on the feet are peculiar, having violaceous hyperkeratotic plugs and atrophic scarring. On the ankles there are depigmented atrophic patches. The sections show questionable changes of lichen planus. Other laboratory
Allington RR, Behling RT, Joseph HL. SAN FRANCISCO DERMATOLOGICAL SOCIETY. AMA Arch Derm. 1959;79(4):497–499. doi:10.1001/archderm.1959.01560160115018
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