Selda Pelin Kartal DURMAZLAR, Fatma ESKİOĞLU, Semih TATLICAN, Özlem BİLGİÇ, Murat OKTAY

VEZİKÜL BENZERİ PAPÜLLER ŞEKLİNDE GÖRÜLEN PALMOPLANTAR LİKEN PLANUS

Palmoplantar liken planus izole olarak görüldüğünde teşhiste zorluk oluşturan hastalığın nadir görülen sınırlı tipidir. Biz, bir aydan beri avuç içi ve ayak tabanında kaşıntılı kırmızı papülleri nedeniyle daha önce tinea pedis tanısı almış olan 47 yaşında erkek hastayı sunmaktayız. Dermatolojik incelemede avuç içi ve ayak tabanında kırmızı ve sarı papüller ve ayakların medial bölgesinde bazıları veziküle benzeyen kırmızı-mor papüller gözlemlendi. Teşhis liken planusun tipik histopatolojik görünümü ile kondu. Topikal kortikosteroide direnç göstermesine rağmen, hasta sistemik kortikosteroid tedavisine iyi cevap verdi. Bu olgu dikkatli fizik inceleme ve biyopsinin benzer görünümlü olgulardaki önemini vurgulamaktadır

Anahtar Kelimeler:

Deri hastalıkları, liken planus

PALMOPLANTAR LICHEN PLANUS PRESENTING WITH VESICLE-LIKE PAPULES

Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. We present a 47-year-old man with a one-month history of pruritic, red papules on his palms and soles that had previously been diagnosed as tinea pedis. Dermatologic examination revealed red and yellow papules on his palms and soles and red-purple papules on the medial aspect of the feet, some of them resembling vesicles. The diagnosis was established by the typical histopathological features of lichen planus. Although resistant to topical corticosteroids, the patient responded well to systemic corticosteroid therapy. This case emphasizes the role of careful physical examination and the biopsy when presented such cases

Keywords:

Skin diseases, lichen planus,

PDF

___

Daoud MS, Pittelkow MR. Lichen planus. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz S eds. Fitzpatricks’ Dermatology in General Medicine. 6th ed. Newyork: McGraw-Hill; 2003.p. 463-77.
Gunduz K, Inanır I, Turkdogan P, Sacar H. Palmoplantar lichen planus presenting with vesicle-like papules. J Dermatol 2003;30: 40.
Sanchez-Perez J, Rios Buceta L, Fraga J, Garcia-Diez A. Lichen planus with lesions on the palms and/or soles: prevalance and clinicopathological study of 36 patients. Br J Dermatol 2000;142: 310-4.
Bhattachorya M, Kaur I, Kumar B. Lichen planus: a clinical and epidemiological study. J Dermatol 2000;27: 576-82.
De Jong EM, Van De Kerkhof PC. Coexistance of palmoplantar lichen planus and lupus erythematosus with response to treatment using acitretin. Br J Dermatol 1996;134: 538-41.
Rotunda AM, Craft N, Haley JC. Hyperkeratotic plaques on the palms and soles. Palmoplantar lichen planus, hyperkeratotic variant. Arch Dermatol 2004;140: 1275-80.
Feuerman EJ, Ingber A, David M, Weissman-Katzenelson V. Lichen ruber planus beginning as a dyshidrosiform eruption. Cutis ;30: 401-4. French LE, Masgrau E, Chavaz P, Saurat JH. Ecrine syringofibroadenoma in a patient with erosive palmaplantar lichen planus. Dermatology 1997;195: 399-401.
Micalizzi C, Tagliapietra G, Farris A. Ulcerative lichen planus of the sole with rheumatoid arthritis. Int J Dermatol 1998;37: 862-3.
Pacj M, Silva R. Treatment of plantar erosive lichen planus with topical cyclosporin. J Eur Acad Dermatol Venereol 2001;15: 79
Grundmann-Kollmann M, Behrens S, Peter RU, Kerscher M. Treatment of severe recalcitrant dermatoses of the palms and soles with PUVA-bath versus PUVA-cream therapy. Photodermatol Photoimmunol Photomed 1999;15: 87-9.
Moss AL, Harman RR. Surgical treatment of painful lichen planus of the hand and foot. Br J Plast Surg 1986;39: 402-7.
Laurberg G, Geiger JM, Hjorth N, Holm P, Hou Jensen K, Jacobsen KU et al. Treatment of lichen planus with acitretin. A double- blind, placebo-controlled study in 65 patients. J Am Acad Dermatol 1991;24: 434-7.