Archive
Summer 2018, Vol. 26 No. 2
Hong Kong J. Dermatol. Venereol. (2018) 26, 94
Answers to Dermato-venereological Quiz
Answers to Dermato-venereological Quiz
SM Wong 黃思敏, RCW Su 蘇志慰, ETY Cheung 張天恩
- The clinical diagnosis is Lichen planus. Differential diagnoses include cutaneous lupus erythematosus (discoid lupus erythematosus), lichen simplex chronicus, and actinic dermatitis/cheilitis.
- The typical histopathological findings include: irregular epidermal acanthosis, accentuation of the granular layer, liquefactive degeneration of the basal layer, and a band-like dermal infiltrate of lymphocytes.
- The physician should examine the oral cavity and genitalia (mons pubis, labia majora, labia minora) to look for lacy-white reticulation/Wickham striae and erosions.
- The treatment options include: topical potent corticosteroids, topical calcineurin-inhibitors, intra-lesional corticosteroids to hypertrophic lesions. For more severe or recalcitrant disease, immunosuppressants such low-dose weekly methotrexate can be considered.