Prieto V G, Casal M, McNutt N S
Department of Pathology, New York Hospital, New York 10021.
Am J Surg Pathol. 1993 Mar;17(3):259-63. doi: 10.1097/00000478-199303000-00006.
Lichen planus-like keratosis (LPLK) is a common skin lesion that has some morphologic features of lichen planus (LP) and lichenoid actinic keratosis (LAK). Although most authors consider LPLK to be a distinct lesion, surgical pathologists are often unfamiliar with it. We examined in detail the clinical and histologic features of LPLK in 100 consecutive cases. In our series, LPLK lesions occurred mostly in late-middle-aged individuals, on the trunk (64%) and extremities (31%) and predominantly in women (73%). Among the 14 histologic parameters that were studied, most LPLK had hyperkeratosis (81%) with hypergranulosis (77%), focal acanthosis (75%), and focal parakeratosis (59%). Solar elastosis was observed in 48% of the cases. Only a few cases had eosinophils (15%) or plasma cells (7%) in the inflammatory infiltrate. The adjacent skin was available for study in 71% of the specimens, and only 26.8% of the cases had an adjacent lesion, most frequently seborrheic keratosis (8.4%), solar lentigo (7%), and actinic keratosis (5.6%). According to our results, the most consistent features observed in LPLK are a lichenoid lymphocytic infiltrate with hyperkeratosis, hypergranulosis, focal acanthosis, and focal parakeratosis, without prominent atypia of keratinocytes.
扁平苔藓样角化病（LPLK）是一种常见的皮肤损害，具有扁平苔藓（LP）和光化性苔藓样角化病（LAK）的一些形态学特征。尽管大多数作者认为LPLK是一种独特的损害，但外科病理学家通常对其并不熟悉。我们详细检查了连续100例LPLK的临床和组织学特征。在我们的系列研究中，LPLK损害大多发生于中老年个体，主要位于躯干（64%）和四肢（31%），且以女性为主（73%）。在所研究的14项组织学参数中，大多数LPLK有角化过度（81%）伴颗粒层增厚（77%）、局灶性棘层肥厚（75%）和局灶性角化不全（59%）。48%的病例观察到日光性弹力组织变性。炎症浸润中仅有少数病例有嗜酸性粒细胞（15%）或浆细胞（7%）。71%的标本可对相邻皮肤进行研究，仅有26.8%的病例有相邻损害，最常见的是脂溢性角化病（8.4%）、日光性雀斑样痣（7%）和光化性角化病（5.6%）。根据我们的结果，LPLK中最一致的特征是伴有角化过度、颗粒层增厚、局灶性棘层肥厚和局灶性角化不全的苔藓样淋巴细胞浸润，且角质形成细胞无明显异型性。
