Lichen spinulosum

Lichen spinulosum is an uncommon dermatosis manifested by large patches of follicular papules covered with thorns keratoses. Aceasta conditie cutanata a fost asociata mai demult cu administrarea de arsfebamina, taliu, aur si toxina difterica. This skin condition has been associated more recently with the administration of arsfebamina, thallium, gold and diphtheria toxin. Mai recent sa observant o asociere cu HIV si boala Crohn . More recently there was an association with HIV and Crohn's disease .

Lichenul spinulosum afecteaza doar pielea si nu se cunoaste a fi asociat cu anomalii ale organelor interne. Lichen spinulosum affects only the skin and is not known to be associated with abnormalities of internal organs. Ocazional pacientii acuza prurit. Occasionally patients accuse itching. Afectiunea este semnificativa doar din punct de vedere cosmetic. The condition is significant only in terms of cosmetics.
Nu exista tratament pentru acest tip de lichen, dar unele medicamente amelioreaza manifestarile clinice. There is no cure for this type of lichen, but some drugs improve clinical manifestations. Se folosesc keratolitice . Use keratolytic. Se raporteaza cazuri de remisie spontana in timp. The reported cases of spontaneous remission over time. Cele mai multe cazuri se remit in 1-2 ani. Most cases resolve in 1-2 years.

Patogenie si cauze Pathogenesis and causes
Leziunea clasica a lichenului spinulosum este un dop keratozic localizat intrun orificiu follicular dilatat . The classic lesion is a plug keratosis lichen spinulosum meet localized dilated follicular orifice. Histologic in jurul foliculului si in derma pare un infiltrate inflamator histiolimfocitar. Hiperkeratoza, parakeratoza si acantoza sunt vizibile in folicul. Histologically around follicle and inflammatory infiltrates in the dermis seems a histiolimfocitar. Hyperkeratosis, and acanthosis parakeratoza are visible in the follicle.
Cauza lichenului spinulosum este necunoscuta. Sa propus infectia dar nu exista date pentru a sustine aceasta ipoteza. The cause is unknown lichen spinulosum. Infection has been proposed but no data to support this hypothesis. Unii autori au sugerat ca lichenul spinulosum este parte a atopiei. Some authors have suggested that lichen is part of atopiei spinulosum.

Semne si simptome Signs and symptoms
Lichenul spinulosum este o afectiune care apare din copilarie pina in adolescenta. Lichen spinulosum is a condition that occurs from childhood until adolescence. Incidenta de virf tinde sa se situeze in adolescent. Incidence tends to peak in adolescent fall. Conditia poate persista pentru decade. The condition may persist for decades. La cei mai multi pacienti aceasta se remite spontan in 1-2 ani. In most patients it resolves spontaneously in 1-2 years. Lichenul spinulosum tinde sa prezinte un debut brusc si nu este acompaniat de alte semne sau simptome. Lichen spinulosum tends to produce a sudden onset and is not accompanied by other signs or symptoms. Papulele keratozice se grupeaza in placi mari care se pot extinde rapid afectind zone mari de piele. Papules keratoses are grouped into large plates that can expand rapidly affecting large areas of skin.

Petele si placile cu papule foliculare au un diametru intre 2-5 cm . Stains follicular papules and plaques with a diameter of 2-5 cm . Petele sunt distribuite simetric pe tegument. The spots are distributed symmetrically on the skin. Acestea afecteaza gitul, coapsele, abdomenul, trohanterul, calciiul si suprafetele extensoare ale bratelor. They affect the neck, thighs, abdomen, trochanter, heel and extensor surfaces of the arms. Papulele individuale sunt plate sau conice. Individual papules are flat or conical. Sunt de obicei mici cu diametru intre 1-3 mm. They are usually small in diameter between 1-3 mm. au un corn sau un virh care se extinde 1 mm in jurul virfului papulei. have a horn or a virh that extends around the tip 1 mm papule.

Diagnostic Diagnosis
Examen histologic. Se observa foliculii de par umpluti cu un dop keratozic. Histological examination. Note the hair follicles filled with a plug keratosis. Se observa un infiltrate inflamator limfocitic in jurul foliculului si in derm. An inflammatory infiltrate is observed around the follicle lymphoma and dermis. Hiperkeratoza, parakeratoza si acantoza sunt prezente in folicul. Hyperkeratosis, and acanthosis parakeratoza are present in the follicle.
Diagnosticul diferential se face cu urmatoarele afectiuni: lichen scrofulosum, hipovitaminoza A, eruptive lichenoida de frictiune, dermatofitoza , keratoza pilara . The differential diagnosis is made with the following conditions: lichen scrofulosum, Hypovitaminosis A lichenoid eruption friction, dermatophyte , Pilar keratosis .

Tratament Treatment

Nu exista vindecare pentru aceasta conditie , dar unele medicamente pot ameliora manifestarile clinice. There is no cure for this condition, but some drugs may improve the clinical manifestations. Datorita dopului keratolitic se folosesc ca terapie keratoliticele. Because cork is used as therapy keratoliticele keratolytic. Acestea include acidul salicylic, acidul lactic, crème cu uree, faina de ovaz, geluri si lotiuni. S-au raportat remisiuni spontane in timp, cele mai multe cazuri se remit in 1-2 ani. These include salicylic acid, lactic acid, urea cream, oatmeal, gels and lotions. There have been reports of spontaneous remission over time, most cases resolve in 1-2 years.