Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.
Department of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, Gainesville, Florida.
J Am Acad Dermatol. 2019 Nov;81(5):1157-1164. doi: 10.1016/j.jaad.2019.05.100. Epub 2019 Aug 1.
Lichenoid granulomatous dermatitis (LGD) is an uncommon reaction pattern for which clinical correlates can be difficult to establish. LGD combines vacuolar degeneration with variable types of granulomas.
To determine clinical correlates of LGD.
The laboratory information systems at the University of Florida, the Medical College of Wisconsin, and Inform Diagnostics Research Institute were queried to identify 56 cases of LGD. Cases were reviewed for information regarding eosinophils, plasma cells, deep perivascular infiltrates, granuloma subtype, parakeratosis, epidermal atrophy, psoriasiform epidermal changes, pseudoepitheliomatous hyperplasia, periadnexal inflammation, vasculitis, and red blood cell extravasation.
The most common clinical correlates were drug eruption (39.3%, n = 22) and lichenoid keratosis (19.6%, n = 11). Tattoo reaction, postherpetic dermatitis, and scabies or postscabietic dermatitis each accounted for 7.1% (n = 4) of cases. Pigmented purpuric dermatosis and lichen striatus each accounted for 5.4% (n = 3) of cases. Dermal eosinophils (P = .005) and psoriasiform epidermal changes (P = .055) were associated with drug hypersensitivity. Perineural (P = .049) and perifollicular (P = .003) inflammation were associated with tattoo reaction and postherpetic dermatitis. Red blood cell extravasation was helpful in cases of pigmented purpuric dermatosis (P = .049).
This study is limited by its retrospective nature and statistical power.
Dermal eosinophilia, psoriasiform epidermal changes, periadnexal inflammation, and red blood cell extravasation might aid in the clinical diagnosis of patients with LGD.
苔藓样肉芽肿性皮炎（LGD）是一种不常见的反应模式，其临床相关性可能难以确定。LGD 结合空泡变性和各种类型的肉芽肿。
确定 LGD 的临床相关性。
在佛罗里达大学、威斯康星医学院和 Inform Diagnostics 研究所以及实验室信息系统中查询了 56 例 LGD 病例。对病例进行了回顾，以获取有关嗜酸性粒细胞、浆细胞、深血管周围浸润、肉芽肿亚型、角化不全、表皮萎缩、银屑病样表皮改变、假上皮瘤样增生、附属器周围炎症、血管炎和红细胞外渗的信息。
最常见的临床相关性是药物疹（39.3%，n=22）和苔藓样角化病（19.6%，n=11）。纹身反应、带状疱疹后皮炎和疥疮或疥疮后皮炎各占 7.1%（n=4）。色素性紫癜性皮炎和线状苔藓各占 5.4%（n=3）。真皮嗜酸性粒细胞（P=0.005）和银屑病样表皮改变（P=0.055）与药物超敏反应有关。神经周围（P=0.049）和毛囊周围（P=0.003）炎症与纹身反应和带状疱疹后皮炎有关。红细胞外渗对色素性紫癜性皮炎（P=0.049）有帮助。
本研究受其回顾性和统计能力的限制。
真皮嗜酸性粒细胞增多、银屑病样表皮改变、附属器周围炎症和红细胞外渗可能有助于 LGD 患者的临床诊断。
