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LICHEN CORNEUS HYPERTROPHICUS (LICHEN OCREAFORMIS, LICHEN OBTUSUS): An Analysis of the Conditions with Which This Is Confused

LICHEN CORNEUS HYPERTROPHICUS (LICHEN OCREAFORMIS, LICHEN OBTUSUS): An Analysis of the Conditions... Abstract THERE is a skin condition affecting the legs almost exclusively which has been described under various and confusing names. It offers many difficulties in differential diagnosis from well-recognized diseases, and though not seldom seen is rarely discussed adequately, either because it is wrongly diagnosed or because it is uncritically passed over. THE CLINICAL PICTURE The dermatosis we refer to consists of irregular, but rather sharply defined, raised plaques of various sizes, composed of hemispherical, closely set, but usually discrete papules. The latter are split-pea-to-bean-sized, sometimes in bead-like arrangement, flesh-colored, dirty-gray-brown, ivory, or sometimes pinkish, chronic and recalcitrant to treatment, and intensely pruritic. The surface of the papules may be smooth or rough or even verrucous. They are set in plaques, often forming a mosaic, beyond which outlying papules may be found. The lesions are usually found on the ankles, particularly on the malleoli, shins, and calves, and rarely in the References 1. Lieberthal, D.: Shinguard Type or Lichen Planus Ocreaformis , J. A. M. A. 67:1582 ( (Nov. 25) ) 1916.Crossref 2. Lieberthal, D.: Unusual Case of Lichen Planus , J. Cutan. Dis. 33:395 ( (May) ) 1915. 3. Sutton, R. L., and Sutton, R. L., Jr.: Diseases of the Skin , ed. 10, St. Louis, C. V. Mosby Company, 1939, p. 313. 4. Darier, J.; Civatte, A., and Tzanck, A.: Précis de dermatologie , ed. 5, Paris, Masson & Cie, 1947, p. 201. 5. Pautrier, L. M.: Lichénifications anormales, in Nouvelle pratique dermatologique , edited by J. Darier, Paris, Masson & Cie, 1936, Vol. 7, p. 521. 6. Wise, F., and Rein, C. R.: Lichen Ruber Moniliformis (Morbus Moniliformis Lichenoides) , Arch. Dermat. & Syph. 34:830 ( (Nov.) ) 1936. 7. "Obtuse" or blunt as applied to a papule conveys the sense of it being hemispherical or dome-shaped, not acuminate or pointed, not planus or flat. 8. Lailer and Brocq, cited by Pusey, W. A.: The History of Dermatology , Springfield, Ill., Charles C Thomas, Publisher, 1933, p. 202. 9. Darier, J.; Civatte, A., and Tzanck, A.: Précis de dermatologie , ed. 5, Paris, Masson & Cie, 1947, p. 710. 10. Gans, O.: Histologie der Hautkrankheiten , Berlin, Julius Springer, 1925, Vol. 1, p. 233. 11. Footnotes 1 and 2. 12. Fisher, J. E.: Lichen Planus Ocreaformis , Arch. Dermat. & Syph. 26:586 ( (Sept.) ) 1932. 13. Sweitzer, S. E.: Lichen Planus Ocreaformis , Arch. Dermat. & Syph. 26:1131 ( (Dec.) ) 1932. 14. Greenhouse, C. A.: Lichen Planus Ocreaformis , Arch. Dermat. & Syph. 32:513 ( (Sept.) ) 1935. 15. Greenhouse, C. A.: Personal communication to the authors. 16. Canada balsam quickly destroys the metachromatic staining of amyloid, which may therefore be overlooked although actually present. Sections should be mounted in ``abopon'' (a sodium borophosphate, according to the manufacturers, Glyco Products Company, Inc., Brooklyn), and the Nomland test for local staining of amyloid by Congo red should be performed. Unfortunately Congo red is no longer available. 17. Ebert, M. H., for Ormsby, O. S.: Lichen Corneus Hypertrophicus , Arch. Dermat. & Syph. 35:330 ( (Feb.) ) 1937. 18. Heisel, E. B., and Krause, M. E.: A Case for Diagnosis (Amyloidosis Cutis? Lichen Planus Ocreaformis [Lieberthal]?) , Arch. Dermat. & Syph. 45:607 ( (March) ) 1942. 19. Sweitzer, S. E.: Lichen Planus Ocreaformis , Arch. Dermat. & Syph. 49:450 ( (June) ) 1944. 20. Obermayer, M. E.: A Case for Diagnosis: Lichen Ruber Moniliformis (?), Dermatitis Actinica from Roentgen Ray Therapy of Legs , Arch. Dermat. & Syph. 56:404 ( (Sept.) ) 1947. 21. Kaposi, M.: Lichen ruber monileformis , Vrtljschr. Dermat. 13:571 and plates 19, 20, and 21, 1886. 22. Rothman, S.: A Case for Diagnosis (Lichen Obtusus? Prurigo Nodularis?) , Arch. Dermat. & Syph. 57:477 (March, Pt. (2) ) 1948. 23. Bechet, P. E.: Lichen Planus Ocreaformis (Lieberthal) , Arch. Dermat. & Syph. 57:496 (March, Pt. (2) ) 1948. 24. Freudenthal, W.; Gutmann, C., and Koenigstein, H., cited by Michelson, H. E., and Lynch, F. W.: Systematized Amyloidosis of the Skin and Muscles , Arch. Dermat. & Syph. 29:806 ( (June) ) 1934. 25. Miller, H. E.: Lichen Verrucosus et Reticularis (Kaposi); Porokeratosis Striata (Nékàm); Morbus Moniliformis Lichenoides (Wise and Rein) , Arch. Dermat. & Syph. 52:129 ( (Aug.) ) 1945. 26. Andrews, G. C.: Diseases of the Skin , ed. 3, Philadelphia, W. B. Saunders Company, 1946, p. 87. 27. Pautrier, L. M.: Les lichénifications , in Nouvelle pratique dermatologique , edited by J. Darier, Paris, Masson & Cie, 1936, Vol. 7, pp. 494-495, 497-500, 521-535, 544-559. 28. Juliusberg, F.: ruber und Pityriasis rubra pilaris , in Jadassohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1931, Vol. 7 (Pt. (2) ) p. 17. 29. Winkler, M.: Prurigo, Strophulus, Pruritus , in Jadssohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1929, Vol. 6 (Pt. (1) ) p. 322. 30. Alexander, A.: Neurodermatitis , in Jadassohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1929, Vol. 6 (Pt. (1) ) p. 387. 31. Winkler, F., and Unna, P. G.: Das seborrhoische Eczem , in Jadassohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1929, Vol. 6 (Pt. (1) ) p. 476. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Dermatology & Syphilology American Medical Association

LICHEN CORNEUS HYPERTROPHICUS (LICHEN OCREAFORMIS, LICHEN OBTUSUS): An Analysis of the Conditions with Which This Is Confused

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Publisher
American Medical Association
Copyright
Copyright © 1951 American Medical Association. All Rights Reserved.
ISSN
0096-5979
DOI
10.1001/archderm.1951.01570110058009
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Abstract

Abstract THERE is a skin condition affecting the legs almost exclusively which has been described under various and confusing names. It offers many difficulties in differential diagnosis from well-recognized diseases, and though not seldom seen is rarely discussed adequately, either because it is wrongly diagnosed or because it is uncritically passed over. THE CLINICAL PICTURE The dermatosis we refer to consists of irregular, but rather sharply defined, raised plaques of various sizes, composed of hemispherical, closely set, but usually discrete papules. The latter are split-pea-to-bean-sized, sometimes in bead-like arrangement, flesh-colored, dirty-gray-brown, ivory, or sometimes pinkish, chronic and recalcitrant to treatment, and intensely pruritic. The surface of the papules may be smooth or rough or even verrucous. They are set in plaques, often forming a mosaic, beyond which outlying papules may be found. The lesions are usually found on the ankles, particularly on the malleoli, shins, and calves, and rarely in the References 1. Lieberthal, D.: Shinguard Type or Lichen Planus Ocreaformis , J. A. M. A. 67:1582 ( (Nov. 25) ) 1916.Crossref 2. Lieberthal, D.: Unusual Case of Lichen Planus , J. Cutan. Dis. 33:395 ( (May) ) 1915. 3. Sutton, R. L., and Sutton, R. L., Jr.: Diseases of the Skin , ed. 10, St. Louis, C. V. Mosby Company, 1939, p. 313. 4. Darier, J.; Civatte, A., and Tzanck, A.: Précis de dermatologie , ed. 5, Paris, Masson & Cie, 1947, p. 201. 5. Pautrier, L. M.: Lichénifications anormales, in Nouvelle pratique dermatologique , edited by J. Darier, Paris, Masson & Cie, 1936, Vol. 7, p. 521. 6. Wise, F., and Rein, C. R.: Lichen Ruber Moniliformis (Morbus Moniliformis Lichenoides) , Arch. Dermat. & Syph. 34:830 ( (Nov.) ) 1936. 7. "Obtuse" or blunt as applied to a papule conveys the sense of it being hemispherical or dome-shaped, not acuminate or pointed, not planus or flat. 8. Lailer and Brocq, cited by Pusey, W. A.: The History of Dermatology , Springfield, Ill., Charles C Thomas, Publisher, 1933, p. 202. 9. Darier, J.; Civatte, A., and Tzanck, A.: Précis de dermatologie , ed. 5, Paris, Masson & Cie, 1947, p. 710. 10. Gans, O.: Histologie der Hautkrankheiten , Berlin, Julius Springer, 1925, Vol. 1, p. 233. 11. Footnotes 1 and 2. 12. Fisher, J. E.: Lichen Planus Ocreaformis , Arch. Dermat. & Syph. 26:586 ( (Sept.) ) 1932. 13. Sweitzer, S. E.: Lichen Planus Ocreaformis , Arch. Dermat. & Syph. 26:1131 ( (Dec.) ) 1932. 14. Greenhouse, C. A.: Lichen Planus Ocreaformis , Arch. Dermat. & Syph. 32:513 ( (Sept.) ) 1935. 15. Greenhouse, C. A.: Personal communication to the authors. 16. Canada balsam quickly destroys the metachromatic staining of amyloid, which may therefore be overlooked although actually present. Sections should be mounted in ``abopon'' (a sodium borophosphate, according to the manufacturers, Glyco Products Company, Inc., Brooklyn), and the Nomland test for local staining of amyloid by Congo red should be performed. Unfortunately Congo red is no longer available. 17. Ebert, M. H., for Ormsby, O. S.: Lichen Corneus Hypertrophicus , Arch. Dermat. & Syph. 35:330 ( (Feb.) ) 1937. 18. Heisel, E. B., and Krause, M. E.: A Case for Diagnosis (Amyloidosis Cutis? Lichen Planus Ocreaformis [Lieberthal]?) , Arch. Dermat. & Syph. 45:607 ( (March) ) 1942. 19. Sweitzer, S. E.: Lichen Planus Ocreaformis , Arch. Dermat. & Syph. 49:450 ( (June) ) 1944. 20. Obermayer, M. E.: A Case for Diagnosis: Lichen Ruber Moniliformis (?), Dermatitis Actinica from Roentgen Ray Therapy of Legs , Arch. Dermat. & Syph. 56:404 ( (Sept.) ) 1947. 21. Kaposi, M.: Lichen ruber monileformis , Vrtljschr. Dermat. 13:571 and plates 19, 20, and 21, 1886. 22. Rothman, S.: A Case for Diagnosis (Lichen Obtusus? Prurigo Nodularis?) , Arch. Dermat. & Syph. 57:477 (March, Pt. (2) ) 1948. 23. Bechet, P. E.: Lichen Planus Ocreaformis (Lieberthal) , Arch. Dermat. & Syph. 57:496 (March, Pt. (2) ) 1948. 24. Freudenthal, W.; Gutmann, C., and Koenigstein, H., cited by Michelson, H. E., and Lynch, F. W.: Systematized Amyloidosis of the Skin and Muscles , Arch. Dermat. & Syph. 29:806 ( (June) ) 1934. 25. Miller, H. E.: Lichen Verrucosus et Reticularis (Kaposi); Porokeratosis Striata (Nékàm); Morbus Moniliformis Lichenoides (Wise and Rein) , Arch. Dermat. & Syph. 52:129 ( (Aug.) ) 1945. 26. Andrews, G. C.: Diseases of the Skin , ed. 3, Philadelphia, W. B. Saunders Company, 1946, p. 87. 27. Pautrier, L. M.: Les lichénifications , in Nouvelle pratique dermatologique , edited by J. Darier, Paris, Masson & Cie, 1936, Vol. 7, pp. 494-495, 497-500, 521-535, 544-559. 28. Juliusberg, F.: ruber und Pityriasis rubra pilaris , in Jadassohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1931, Vol. 7 (Pt. (2) ) p. 17. 29. Winkler, M.: Prurigo, Strophulus, Pruritus , in Jadssohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1929, Vol. 6 (Pt. (1) ) p. 322. 30. Alexander, A.: Neurodermatitis , in Jadassohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1929, Vol. 6 (Pt. (1) ) p. 387. 31. Winkler, F., and Unna, P. G.: Das seborrhoische Eczem , in Jadassohn, J.: Handbuch der Haut- und Geschlechtskrankheiten , Berlin, Julius Springer, 1929, Vol. 6 (Pt. (1) ) p. 476.

Journal

A.M.A. Archives of Dermatology & SyphilologyAmerican Medical Association

Published: Nov 1, 1951

References