Jump to content

Dr. Mona Abdel Halim's Blog

  • entries
  • comments
  • views

The sometimes challenging lichenoid reaction pattern

Dr. Mona Abdel-Halim


The lichenoid reaction pattern is commonly encountered in our daily signing out routine. it comprises a wide range of diseases from benign simple conditions like lichen planus to malignant serious conditions like lichenoid MF.
A common mistake, that many beginners in dermatopathology can fall in, is the misinterpretation of interface lymphocytes as epidermotropic cells of MF especially in the context of lichenoid drug reactions for example where lymphocytes may become activated and appear slightly atypical. Also solitary lesions of LPLK may show an MF like pathological pattern. Moreover, lichenoid MF may show necrotic keratinocytes and vacuolar degeneration together with the band like infiltrate making differentiation from LP difficult, however in such cases the epidermis usually does not show the characteristic esinophilic staining or the squamatization of basal cells typical of LP. Also assessment of lymphocyte atypia may be difficult in cases suspicious of MF. Wiry fibroplasia of the papillary dermal collagen is an important clue favoring lichenoid MF over other benign causes of lichenoid reaction.
It is important to pay attention to the clinical presentation before rushing to the diagnosis in such conditions. An MF like LPLK will not be reached as a diagnosis without knowing that the lesion is a solitary papule !! Clinical correlation is important as it may save you the embarrassment of a wrong diagnosis !!!!


Recommended Comments

There are no comments to display.

  • Create New...