-
Journal of the American Academy of... Oct 2006Pityriasis lichenoides represents a unique group of inflammatory skin disorders that include pityriasis lichenoides et varioliformis acuta (PLEVA), febrile... (Review)
Review
Pityriasis lichenoides represents a unique group of inflammatory skin disorders that include pityriasis lichenoides et varioliformis acuta (PLEVA), febrile ulceronecrotic Mucha-Habermann disease (a subtype of PLEVA), and pityriasis lichenoides chronica. The history, epidemiology, clinical features, pathophysiology, and treatment of this group of conditions are reviewed in this manuscript.
Topics: Humans; Pityriasis Lichenoides
PubMed: 17010734
DOI: 10.1016/j.jaad.2005.07.058 -
Journal of the European Academy of... Nov 2019Pityriasis lichenoides (PL) represents a spectrum of inflammatory skin diseases comprising pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis...
Pityriasis lichenoides (PL) represents a spectrum of inflammatory skin diseases comprising pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). This study aimed to provide a summary of effective treatments for PL. A systematic review was performed according to PRISMA guidelines for studies investigating PL treatment including ≥3 subjects and published in English between 1 January 1970 and 15 April 2019. A total of 441 papers were screened, and 37 original manuscripts meeting the inclusion and exclusion criteria were found, including 12 case series, 18 reviews, four prospective studies, two comparative studies and a single randomized controlled study. In most studies, ultraviolet (UV) phototherapy (narrow-band UVB, broadband UVB, UVA1 or PUVA) was used. Clearance rates with the different modalities are hardly comparable between different studies, ranging approximately between 70% and 100%. Narrow-band UVB showed an efficacy similar to PUVA as such as the combination of UVA and UVB vs. PUVA. Oral erythromycin showed clearance rates ranging between 66% and 83%, whereas methotrexate up to 100% but in small and dated studies. Evidence for other treatments is scarce. There is a lack of high level of evidence studies on PL treatment. The interpretation of the results is biased by the possible auto-resolution of the disease, the sample heterogeneity between children and adults and the short follow-up period of the studies. Only some studies investigated how results were durable after cessation of therapy. Quality of life and the impact of treatment were never assessed. According to the results of this review, we suggest narrow-band UVB phototherapy as first-line treatment. Oral erythromycin with or without topical corticosteroids and low-dose methotrexate as second-line therapies. High-powered studies and randomized controlled trials are needed to establish the optimal treatment for PL.
Topics: Administration, Topical; Adrenal Cortex Hormones; Anti-Bacterial Agents; Calcineurin Inhibitors; Humans; Phototherapy; Pityriasis Lichenoides
PubMed: 31318465
DOI: 10.1111/jdv.15813 -
Pediatric Dermatology 2024Pityriasis lichenoides (PL) is an uncommon skin rash. PL has two main forms: Pityriasis lichenoides et varioliformis acuta (PLEVA): this "acute" (fast) form comes on...
Pityriasis lichenoides (PL) is an uncommon skin rash. PL has two main forms: Pityriasis lichenoides et varioliformis acuta (PLEVA): this "acute" (fast) form comes on quickly. Pityriasis lichenoides chronica (PLC): this "chronic" (long) form often develops slowly and lasts longer.
Topics: Humans; Pityriasis Lichenoides; Child; Diagnosis, Differential
PubMed: 38743416
DOI: 10.1111/pde.15645 -
Cutis Jan 2000
Review
Topics: Adult; Age Factors; Child; Diagnosis, Differential; Humans; Incidence; Pityriasis Lichenoides
PubMed: 10664870
DOI: No ID Found -
Seminars in Dermatology Mar 1992The clinical features, histopathology, immunopathology, and management of pityriasis lichenoides and lymphomatoid papulosis are discussed, with particular emphasis on... (Review)
Review
The clinical features, histopathology, immunopathology, and management of pityriasis lichenoides and lymphomatoid papulosis are discussed, with particular emphasis on the pediatric aspects of these conditions. The difficulties in logically separating pityriasis lichenoides into an acute (pityriasis lichenoides et varioliformis acuta) and a chronic (pityriasis lichenoides chronical) form are addressed. The development of lymphoreticular malignancy in patients with lymphomatoid papulosis has been well documented, but pityriasis lichenoides has characteristically been regarded as a benign condition. However, recent reports of the development of large plaque parapsoriasis in patients with pityriasis lichenoides have led to a reconsideration. Some of these patients were in the pediatric age group. Although there are significant clinical, histopathological, and immunopathological differences between pityriasis lichenoides and lymphomatoid papulosis, the demonstration of similar clonal T cell receptor gene rearrangements and the confirmation of the potentially premalignant nature of both suggests that there may indeed be an interrelationship between these two controversial entities. Close follow-up of patients with both of these conditions is recommended, with observation being discontinued only when the patient has been free of lesions for several years.
Topics: Child; Humans; Lymphoproliferative Disorders; Parapsoriasis; Pityriasis; Skin; Skin Diseases
PubMed: 1550718
DOI: No ID Found -
Indian Pediatrics Nov 2012
Topics: Abdomen; Child, Preschool; Humans; Male; Pityriasis Lichenoides; Skin
PubMed: 23255714
DOI: 10.1007/s13312-012-0212-4 -
International Journal of Clinical and... 2021Pityriasis lichenoides-like drug reactions simulate pityriasis lichenoides clinically and histopathologically, though important differences exist. As a rule, pityriasis...
Pityriasis lichenoides-like drug reactions simulate pityriasis lichenoides clinically and histopathologically, though important differences exist. As a rule, pityriasis lichenoides has minimal to no eosinophils. However, this case illustrates that pityriasis lichenoides-like drug reaction can present with numerous eosinophils. This, in our experience is not rare, but contrasts with clinical reports in the literature that describe pityriasis lichenoides-like drug reactions with minimal to no eosinophils in the infiltrate. While similar, distinguishing these diseases is important given that pityriasis lichenoides is a lymphoproliferative disorder with a more protracted clinical course that is difficult to treat. We provide histopathological clues to aid in this important distinction.
PubMed: 34646420
DOI: No ID Found -
Pediatric Dermatology 2015Pityriasis lichenoides (PL) is a skin condition of unclear etiology that occurs not uncommonly in childhood. It is often classified into the acute form, pityriasis... (Review)
Review
Pityriasis lichenoides (PL) is a skin condition of unclear etiology that occurs not uncommonly in childhood. It is often classified into the acute form, pityriasis lichenoides et varioliformis acuta (PLEVA), and the chronic form, pityriasis lichenoides chronica (PLC). We performed a comprehensive review of the English-language literature using the PubMed database of all cases of childhood PL reported from 1962 to 2014 and summarized the epidemiology, clinical features, treatment options, and prognosis of this condition in children. The proposed etiologies are discussed, including its association with infectious agents, medications, and immunizations and evidence for PL as a lymphoproliferative disorder. We found an average age of PL onset of 6.5 years, with a slight (61%) male predominance. We also found that PLEVA and PLC tend to occur with equal frequency and that, in many cases, there is clinical and histopathologic overlap between the two phenotypes. When systemic therapy is indicated, we propose that oral erythromycin and narrowband ultraviolet B phototherapy should be first-line treatment options for children with PL since they have been shown to be effective and well tolerated. In most cases, PL follows a benign course with no greater risk of cutaneous T-cell lymphoma, although given the rare case reports of transformation, long-term follow-up of these patients is recommended.
Topics: Adolescent; Age Factors; Biopsy, Needle; Child; Clindamycin; Combined Modality Therapy; Female; Humans; Immunohistochemistry; Male; Pityriasis Lichenoides; Prognosis; Risk Assessment; Severity of Illness Index; Sex Factors; Treatment Outcome; Ultraviolet Therapy
PubMed: 25816855
DOI: 10.1111/pde.12581 -
Pediatric Dermatology Mar 2018Pityriasis lichenoides is an uncommon papulosquamous disorder of unknown etiology. The objective of this study was to review the clinical features and treatment...
BACKGROUND/OBJECTIVES
Pityriasis lichenoides is an uncommon papulosquamous disorder of unknown etiology. The objective of this study was to review the clinical features and treatment responses of individuals with pityriasis lichenoides seen at a tertiary referral center.
METHODS
Seventy-five patients diagnosed with pityriasis lichenoides between 1997 and 2013 were reviewed, and 46 had long-term follow-up via telephone interviews.
RESULTS
Fifty (67%) patients were diagnosed with pityriasis lichenoides chronica, 22 (29%) with pityriasis lichenoides et varioliformis acuta, and 3 (4%) with mixed pityriasis lichenoides chronica and pityriasis lichenoides et varioliformis acuta features. Mean ± standard deviation age at onset was 12 ± 13 years (median 8 years). Disease duration was significantly shorter for patients with pityriasis lichenoides et varioliformis acuta (35 ± 35 months) than for those with pityriasis lichenoides chronica (at least 78 ± 48 months). At long-term follow-up, 23 of 28 (82%) patients with pityriasis lichenoides chronica and 3 of 16 (19%) with pityriasis lichenoides et varioliformis acuta had active disease. None progressed to lymphomatoid papulosis or cutaneous T-cell lymphoma. Ten of 23 active pityriasis lichenoides chronica cases had residual pigmentary change independent of race and lasted at least 35 ± 20 months. The most effective treatments were phototherapy (47% response rate), heliotherapy (33%), topical corticosteroids (27%), and antibiotics (25%).
CONCLUSION
Pityriasis lichenoides is a predominantly pediatric disorder. The time course of pityriasis lichenoides chronica is significantly longer than that of pityriasis lichenoides et varioliformis acuta. Pityriasis lichenoides chronica may persist with pigmentary alterations in the absence of other signs of active inflammation. Treatment response is often limited, particularly for patients with pityriasis lichenoides chronica.
Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Female; Follow-Up Studies; Glucocorticoids; Humans; Infant; Male; Phototherapy; Pityriasis Lichenoides; Prognosis; Treatment Outcome
PubMed: 29315771
DOI: 10.1111/pde.13396 -
American Journal of Clinical Dermatology Dec 2016Pityriasis lichenoides (PL) is a dermatologic disorder that manifests in either the acute (pityriasis lichenoides et varioliformis acuta) or the chronic form (pityriasis... (Review)
Review
BACKGROUND
Pityriasis lichenoides (PL) is a dermatologic disorder that manifests in either the acute (pityriasis lichenoides et varioliformis acuta) or the chronic form (pityriasis lichenoides chronica, also known as parapsoriasis chronica). Traditional first-line therapy consists of corticosteroids or antibiotics; however, these treatments are often accompanied with multiple side effects and may be ineffective.
OBJECTIVE
The goal of this study was to review the use of phototherapy for treating PL in the pediatric population.
MATERIALS AND METHODS
We performed a systematic review of the literature in the National Library of Medicine's PubMed database and the SCOPUS database discussing phototherapy for treatment of PL in the pediatric population. The following search terms were used: 'pityriasis lichenoides', 'pityriasis lichenoides chronica', 'pityriasis lichenoides et varioliformis acuta', and 'febrile ulceronecrotic Mucha-Habermann disease'.
RESULTS
The systematic search and screening of articles resulted in 14 articles including a total of 64 patients with PL treated with phototherapy. Three different modalities were utilized, with five studies using broadband ultraviolet B (BB-UVB) radiation, nine studies utilizing narrowband UVB (NB-UVB), and two studies employing psoralen with ultraviolet A (PUVA) therapy. Overall, the use of BB-UVB had an initial clearance rate of 89.6 % with 23.1 % recurrence, whereas NB-UVB cleared 73 % of the lesions with no recurrence, and PUVA therapy initially cleared 83 % of the lesions with 60 % recurrence. The side-effect profiles were similar and revealed limited toxicity.
CONCLUSION
Phototherapy shows promising results and a favorable side-effect profile in the treatment of PL. Ultimately, large randomized controlled trials are needed to determine optimal treatments.
Topics: Adrenal Cortex Hormones; Child; Humans; Pityriasis Lichenoides; Treatment Outcome; Ultraviolet Therapy
PubMed: 27502793
DOI: 10.1007/s40257-016-0216-2