Lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion

Lichen planus-like keratosis (LPLK) is an involuting cutaneous lesion often presenting between the fifth and seventh decades of life. These lesions typically appear abruptly as a solitary macule, papule, or plaque that continuously evolves as it undergoes regression. Clinical and dermoscopic featur...

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Autores principales:	Nicole Nagrani, Natalia Jaimes, Margaret Olivero, Harold S Rabinovitz
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2018
Materias:	lichen planus-like keratosis reflectance confocal microscopy lichenoid keratosis lichenoid dermatoses Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/da005871fd8c4232a7d69aab3916b990
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spelling	oai:doaj.org-article:da005871fd8c4232a7d69aab3916b9902021-11-17T08:30:01ZLichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion2160-9381https://doaj.org/article/da005871fd8c4232a7d69aab3916b9902018-07-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/478https://doaj.org/toc/2160-9381 Lichen planus-like keratosis (LPLK) is an involuting cutaneous lesion often presenting between the fifth and seventh decades of life. These lesions typically appear abruptly as a solitary macule, papule, or plaque that continuously evolves as it undergoes regression. Clinical and dermoscopic features of LPLK can mimic both benign and malignant lesions, often prompting biopsy for accurate diagnosis. We describe a case of LPLK developing in a patient with a history of multiple skin cancers, including melanoma. Dermoscopy revealed peripheral granules and a central area with pinkish-brown pigmentation and a disorganized pattern with shiny white structures and rosettes. Handheld reflectance confocal microscopy (RCM) showed a typical honeycomb pattern with millia-like cysts and comedo-like openings, and lacked pagetoid and dendritic cells. Based on the benign features seen with RCM, the lesion was followed until complete regression was observed. In conclusion, we describe a case of LPLK with clinically and dermoscopically indeterminate features that was successfully monitored with RCM. We intend to highlight the utility of RCM as a diagnostic aid in equivocal lesions in order to prevent unnecessary excisional procedures. Nicole NagraniNatalia JaimesMargaret OliveroHarold S RabinovitzMattioli1885articlelichen planus-like keratosisreflectance confocal microscopylichenoid keratosislichenoid dermatosesDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 8, Iss 3 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	lichen planus-like keratosis reflectance confocal microscopy lichenoid keratosis lichenoid dermatoses Dermatology RL1-803
spellingShingle	lichen planus-like keratosis reflectance confocal microscopy lichenoid keratosis lichenoid dermatoses Dermatology RL1-803 Nicole Nagrani Natalia Jaimes Margaret Olivero Harold S Rabinovitz Lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion
description	Lichen planus-like keratosis (LPLK) is an involuting cutaneous lesion often presenting between the fifth and seventh decades of life. These lesions typically appear abruptly as a solitary macule, papule, or plaque that continuously evolves as it undergoes regression. Clinical and dermoscopic features of LPLK can mimic both benign and malignant lesions, often prompting biopsy for accurate diagnosis. We describe a case of LPLK developing in a patient with a history of multiple skin cancers, including melanoma. Dermoscopy revealed peripheral granules and a central area with pinkish-brown pigmentation and a disorganized pattern with shiny white structures and rosettes. Handheld reflectance confocal microscopy (RCM) showed a typical honeycomb pattern with millia-like cysts and comedo-like openings, and lacked pagetoid and dendritic cells. Based on the benign features seen with RCM, the lesion was followed until complete regression was observed. In conclusion, we describe a case of LPLK with clinically and dermoscopically indeterminate features that was successfully monitored with RCM. We intend to highlight the utility of RCM as a diagnostic aid in equivocal lesions in order to prevent unnecessary excisional procedures.
format	article
author	Nicole Nagrani Natalia Jaimes Margaret Olivero Harold S Rabinovitz
author_facet	Nicole Nagrani Natalia Jaimes Margaret Olivero Harold S Rabinovitz
author_sort	Nicole Nagrani
title	Lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion
title_short	Lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion
title_full	Lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion
title_fullStr	Lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion
title_full_unstemmed	Lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion
title_sort	lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion
publisher	Mattioli1885
publishDate	2018
url	https://doaj.org/article/da005871fd8c4232a7d69aab3916b990
work_keys_str_mv	AT nicolenagrani lichenplanuslikekeratosisclinicalapplicabilityofinvivoreflectanceconfocalmicroscopyforanindeterminatecutaneouslesion AT nataliajaimes lichenplanuslikekeratosisclinicalapplicabilityofinvivoreflectanceconfocalmicroscopyforanindeterminatecutaneouslesion AT margaretolivero lichenplanuslikekeratosisclinicalapplicabilityofinvivoreflectanceconfocalmicroscopyforanindeterminatecutaneouslesion AT haroldsrabinovitz lichenplanuslikekeratosisclinicalapplicabilityofinvivoreflectanceconfocalmicroscopyforanindeterminatecutaneouslesion
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Lichen planus-like keratosis: clinical applicability of in vivo reflectance confocal microscopy for an indeterminate cutaneous lesion

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