Lichen planus (LP) is a chronic mucocutaneous inflammatory condition that typically affects middle-aged adults. Esophageal involvement in LP is rare and underrecognized, often leading to delayed diagnosis and treatment of LP. Herein, we describe three cases of esophageal LP (ELP) in clinically symptomatic patients with endoscopic lesions in the upper to mid-esophagus. This case series suggests that ELP is be more common than was previously thought and emphasizes that clinicians should have a high index of suspicion for this diagnosis, particularly when evaluating proximal esophageal lesions in patients presenting with dysphagia. The series also highlights the successful treatment of our patients with budesonide-honey slurry.
Adult ; Deglutition Disorders ; Delayed Diagnosis ; Diagnosis ; Humans ; Lichen Planus ; Lichenoid Eruptions ; Lichens ; Skin Diseases, Papulosquamous

Pityriasis rubra pilaris (PRP) is a chronic papulosquamous disorder of unknown etiology, which may pose therapeutic challenges. There is currently no universally effective treatment for PRP, and some cases are resistant to multiple topical and systemic therapies. Systemic retinoids, methotrexate, several immunosuppressive agents and phototherapy have all been used with varying degrees of success. Recently, a few reports have appeared in the literature, concerning the use of biologics in combination therapies and/or in refractory PRP cases. We report a case of PRP similar to type II with juvenile onset, which was recalcitrant to traditional topical and systemic therapy. He was successfully treated with anti-TNF-alpha monoclonal antibody, infliximab. The patient showed resolution with minimal disease activity, and was maintained on acitretin and emollients. The response to infliximab in our patient and in the previously reported cases confirms a role of anti-TNF-alpha therapy as an effective option in the treatment of PRP.
Acitretin ; Antibodies, Monoclonal ; Biological Agents ; Emollients ; Humans ; Immunosuppressive Agents ; Methotrexate ; Phototherapy ; Pityriasis ; Pityriasis Rubra Pilaris ; Retinoids ; Skin Diseases, Papulosquamous ; Infliximab

BACKGROUND: Pityriasis rosea is a common, acute self-limiting papulosquamous disorder in which many studies suggest viral causative factors in its pathogenesis. Recently, the link between pityriasis rosea and the reactivation of human herpes virus-6 (HHV-6) and HHV-7 infection has been suggested. This evidence suggests that targetting HHV-6 or HHV-7 may be an effective treatment for pityriasis rosea. OBJECTIVE: We treated pityriasis rosea patients with oral famciclovir to investigate the effect of oral famciclovir in pityriasis rosea. METHODS: A case group of seventeen patients with pityriasis rosea were treated with oral famciclovir (250 mg 3 times daily for 7 days). Clinical evaluation at 0, 1 & 2 weeks was undertaken. A skin biopsy and polymerase chain reaction analysis of HHV-6 from a skin specimen were performed. We analyzed 19 patients with pityriasis rosea who were treated with topical steroid and oral antihistamines retrospectively and considered them as the control group. RESULTS: On the 7th day after oral famciclovir treatment was started, pityriasis rosea had regressed completely in 3 patients (17.6%) and had regressed partially in 9 patients (52.9%). On the 14th day, 12 patients (70.6%) had achieved more than partial regression. On the 7th day, systemic symptoms had improved in all 9 patients. Clearance of skin lesions was achieved in average 7.57 days in patients who had regressed completely after 14 days' treatment. Histological examination of patients was compatible with pityriasis rosea and polymerase chain reaction analysis of HHV-6 was negative in all 8 patients. Compared with the control group, the treatment for patients in the case group seemed to have better effects, but statistical analysis failed to show any significant differences between the two groups. CONCLUSION: Famciclovir was not effective in the treatment of pityriasis rosea, but further investigation is needed.
Biopsy ; Herpesvirus 6, Human ; Herpesvirus 7, Human ; Histamine Antagonists ; Humans ; Pityriasis Rosea* ; Pityriasis* ; Polymerase Chain Reaction ; Retrospective Studies ; Skin ; Skin Diseases, Papulosquamous

BACKGROUND: Pityriasis rubra pilaris (PRP)is a rare papulosquamous disorder of unknown etiology. Although the clinical and histopathologic features of PRP are relatively well known in western patients, there are few available studies in Korea. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathologic features of pityriasis rubra pilaris(PRP) in Korea METHODS: The clinical charts, photographies and skin biopsy slides of patients clinically diagnosed as PRP at the initial visit were reviewed. Finally 30 patients were diagnosed as PRP. They were classified into 5 groups according to the Griffiths classification. And then the evaluation of age at onset, sex distribution, clinical feature of the skin lesion, associated symptoms, clinical course and histopathologic features were conducted. RESULTS: 1) The male to female ratio was 1:1.14. The age of onset was varied from 1 to 65 years with two peaks in first and fifth decades. The average ages of onset in adult type and juvenile type were 40.1 and 5.1 years respectively. 2) According to the Griffiths classification, 14(47%) of the patients had type I, 4(13%) had type III, 7(23%) had type IV, and 3(10%) had type V. However, 2(7%)patients could not be classified under any of these five types due to atypical clinical feature or insufficient follow-up periods. 3) The common clinical features during the disease course were follicular hyperkeratosis(83%), knee and/or elbow involvement(83%), palm and/or sole hyperkeratosis(80%). Erythroderma was present in 5 patients(17%) during the disease course. 4) There were no specific symptoms in most cases, but 9 patients had ben suffered from mild itching. 5) 3 patients had a positive family history, and were thought to have inherited autosomal dominant trait. 6) The frequent histopathologic findings were alternating parakeratosis and orthokeratosis (100%), superficial perivascular infiltration(100%), broad rete ridge(97%), acanthosis(93%), hypergranulosis (87%), follicular plugging(73%). CONCLUSION: We investigated the clinical and histopathological features of PRP in Korea. In our study, the clinical and histopathological features of PRP were not different from those observed in western patients.
Adult ; Age of Onset ; Biopsy ; Classification ; Dermatitis, Exfoliative ; Elbow ; Female ; Follow-Up Studies ; Humans ; Knee ; Korea ; Male ; Parakeratosis ; Photography ; Pityriasis Rubra Pilaris* ; Pityriasis* ; Pruritus ; Sex Distribution ; Skin ; Skin Diseases, Papulosquamous

Pityriasis amiantacea is a disease of scalp that presents with asbestos-like thick scales attached to the hair shaft proximal portion. It is considered to reaction of scalp to many inflammatory processes, such as psoriasis, seborrheic dermatitis, tinea capitis, atopic dermatitis, lichen planus, bacterial infection, and pityriasis rubra pilaris. The control of underlying disease is important to treat pitryriasis amiantacea, and there are no guidelines. Here, we report a case of a 17-year-old female who had no improvement for the general seborrheic dermatitis treatments, but displayed remarkable results after isotretinoin.
Adolescent ; Bacterial Infections ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Female ; Hair ; Humans ; Isotretinoin ; Lichen Planus ; Pityriasis ; Pityriasis Rubra Pilaris ; Psoriasis ; Scalp ; Tinea Capitis ; Weights and Measures

Lichen nitidus (LN) is an uncommon, usually asymptomatic cutaneous eruption characterized by the presence of multiple, small, flesh-colored papules. The epidemiologic and pathophysiologic characteristics of LN have not yet been defined. Furthermore, LN has rarely been described in association with other cutaneous diseases. We herein report 3 cases of LN associated with various cutaneous diseases, including lichen striatus, oral lichen planus, and psoriasis vulgaris.
Lichen Nitidus* ; Lichen Planus ; Lichen Planus, Oral ; Lichens ; Mouth ; Psoriasis

Acantholytic dyskeratosis is seen in Darier's disease, transient acantholytic dermatosis and warty dyskeratoma. It is also occasionally observed incidental histological finding in pityriasis rosea, pityriasis rubra pilaris and is occasionally found in linear epidermal nevus. A 10-month-old boy presented linear hyperkeratotic plaques on the right sole and the left hand along with erythematous scaly papules on the posterior neck, the left axilla and the face. Histological findings showed acantholytic dyskeratosis with common histopathological findings of epidermal nevus. Acantholytic dyskeratosis is an occasional finding in linear epidermal nevus, but has been rarely reported in an infant(5 cases reported in 20 years). We report a case of linear epidermal nevus with acantholytic dyskeratosis in an infant.
Axilla ; Darier Disease* ; Hand ; Humans ; Infant ; Male ; Neck ; Nevus ; Pityriasis Rosea ; Pityriasis Rubra Pilaris ; Skin Diseases

No abstract available.
Keratosis, Seborrheic ; Skin Diseases ; Skin Diseases, Papulosquamous

BACKGROUND: Pityriasis rosea is an acute inflammatory dermatosis with an unproven etiology. The typical clinical feature consists of an initial, single herald patch followed by development of smaller, disseminated, papulosquamous, ovoid macules. However, an unusual papular type of pityriasis rosea is relatively common in children and it shows similar clinical characteristics to pityriasis lichenoides. OBJECTIVES: Our purpose was to observe the clinical and histologic features of pityriasis rosea and pityriasis lichenoides, and differentiate two diseases in children. METHODS: Sixteen children with pityriasis rosea and nineteen children with pityriasis lichenoides were investigated clinically and histologically. RESULTS: 1. Clinically, pityriasis rosea may be differentiated from pityriasis lichenoides by the existence of herald patch, short duration, the uniformity of size and shape, and residual pigmentation. 2. Focal parakeratosis, intraepidermal vesicle and papillary derma edema are more common in pityriasis rosea. In contrast, deep dermal infiltration, dyskeratosis, epidermal necrosis and confluent parakeratosis are more common in pityriasis lichenoides. 3. Comparing to the plaque type, a papular type of pityriasis rosea shows more involvement in the extremities with longer duration. Histologically, parakeratosis and papillary dermal edema are less and spongiosis is more commonly observed in papular type. CONCLUSIONS: Pityriasis rosea in children often shows papules especially on the extremities, similar to that of pityriasis lichenoides. However, from the results in this study, we believe that two diseases can be differentiated if both clinical and histologic findings are carefully studied.
Child* ; Edema ; Extremities ; Humans ; Necrosis ; Parakeratosis ; Pigmentation ; Pityriasis Lichenoides* ; Pityriasis Rosea* ; Pityriasis* ; Skin Diseases

Puraotix-C(0.1% Clocortolone Picalats Cream) is a new di-halogenated topical corticosteroid, and used in trial for treating several kinds of dermatoses. We treated 30 patients with Purantix-C who had one of the following dermatoses; atopic dermatitis, neurodermatitis, pustulosis palmaris et plantsris, seborrheic dermatitis, pityriasis rosea, nummular eczema, psoriasis vulgaris, pruritus ani and pompolyx. Among these 30 patients, Purantix-C showed excellent or good result (66.7%) either unoccluded or occluded application, 2~3 times daily for 7~10 days. Comparing with Lidex(0.05% fluorocinonide cream) and purantix-C, both of them had similar effect on eczema and psoriatic groups but Lidex was more effective than Purantix-C for treating the patients with the pustulosis palmaris et plantaris. Purantix-C without containing perfume and coloring substapce was less irritative.
Dermatitis, Atopic ; Dermatitis, Seborrheic ; Eczema ; Fluocinonide ; Humans ; Neurodermatitis ; Perfume ; Pityriasis Rosea ; Pruritus Ani ; Psoriasis ; Skin Diseases