Fisher Valerie, Fernandez Martin P, Krejci-Manwaring Jennifer
Audie L. Murphy Memorial Veterans Hospital, 7400 Merton Minter Blvd, San Antonio, TX 78229, USA.
Cutis. 2013 Sep;92(3):136-9.
Hypertrophic lichen planus (LP), also known as LP verrucosus, is a rare disorder that presents as verrucous plaques, typically on the lower extremities and ankles. This variant differs from the common presentation of LP, which appears as flat, polygonal, pink-purple papules spread diffusely on the flexor wrists, trunk, shins, and dorsal aspects of the feet, frequently involving the oral mucosa. Clinically, hypertrophic LP can be confused with psoriasis and usually does not respond to therapy with biologics. We present a case of hypertrophic LP in a 42-year-old woman who had been treated extensively for psoriasis. Although the morphology and location of the hyperkeratotic plaques mimicked psoriasis, biopsy results exhibited characteristic features of hypertrophic LP, and the lesions responded to treatment with acitretin, clobetasol propionate ointment, hydroxychloroquine, and simple wound care. The hypertrophic variant of LP can be extremely challenging to differentiate from psoriasis. Physicians who treat patients with scaly plaques should think beyond psoriasis and consider the hypertrophic variant of LP as a potential diagnosis.
肥厚性扁平苔藓（LP），也称为疣状扁平苔藓，是一种罕见的疾病，表现为疣状斑块，通常出现在下肢和脚踝。这种变体与扁平苔藓的常见表现不同，后者表现为扁平的、多边形的、粉紫色丘疹，广泛分布于屈侧手腕、躯干、小腿和足背，常累及口腔黏膜。临床上，肥厚性扁平苔藓可能与银屑病混淆，通常对生物制剂治疗无反应。我们报告一例42岁女性肥厚性扁平苔藓病例，该患者曾接受过广泛的银屑病治疗。尽管角化过度斑块的形态和位置类似银屑病，但活检结果显示出肥厚性扁平苔藓的特征性表现，病变对阿维A、丙酸氯倍他索软膏、羟氯喹和简单伤口护理治疗有反应。肥厚性扁平苔藓变体与银屑病的鉴别极具挑战性。治疗鳞屑性斑块患者的医生应跳出银屑病的思维，考虑肥厚性扁平苔藓变体作为潜在诊断。
