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Annular lichenoide dermatitis of youthL28.1

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 28.12.2023

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Synonym(s)

ALDY; Annular lichenoid dermatitis of youth; Anular lichenoid dermatitis of childhood; Anular lichenoid dermatosis of childhood; Dermatitis anular lichenoids of childhood

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HistoryThis section has been translated automatically.

Annessi 2003

DefinitionThis section has been translated automatically.

Etiologically unexplained, chronic, lichenoid dermatitis with truncated, large, reddish or brownish, asymptomatic or slightly itchy patches or tender, barely palpable, scale-free plaques, which are homogeneously or annularly configured and may have central hypopigmentation.

Occurrence/EpidemiologyThis section has been translated automatically.

Rarely. There is no epidemiological data available.

EtiopathogenesisThis section has been translated automatically.

The aetiopathogenesis of ALDY is currently unknown (Annessi G et al. 2022), although immunohistochemical findings suggest that the disease could be caused by a cytotoxic T-cell-mediated immune response, as is the case with other lichenoid skin reactions. A Borrelia infection has been discussed.

ManifestationThis section has been translated automatically.

Mainly occurring in adolescents and children. In adults the clinical picture has not yet been described.

LocalizationThis section has been translated automatically.

Occurring exclusively on the stem.

Clinical featuresThis section has been translated automatically.

Chronic, low dynamic disease that can be active over a period of several years. No general signs of disease. Clinical leading symptom is usually large, roundish or oval, red or brownish, homogeneously filled or anular, spots or barely palpable plaques, which do not show any epidermal involvement (scaling or crust formation). The centre of the anular foci is often hypopigmented, whereas the rim is hyperpigmented.

HistologyThis section has been translated automatically.

Mild or severe (psoriasiform) acanthosis. Orthokeratosis. Prominent, lichenoid interface dermatitis, which is mainly detectable at the tips of the retele ridges, but also in bands. Immunohistologically, CD8/TIA-1- and CD4-positive T-lymphocytes are particularly impressive. CD8/TIA-1-positive cells are mainly found intraepithelially. The analysis of the TCR-γ chain gene rearrangement showed polyclonality in all cases examined.

DiagnosisThis section has been translated automatically.

Asymptomatic bland clinic; age of the patients; histological pattern.

Differential diagnosisThis section has been translated automatically.

Mycosis fungoides: Rarely found at the preferred age of childhood anular lichenoid dermatosis. Histologically, MF shows an inverse pattern of CD4-positive T-lymphocytes intraepithelially to the lichenoid dermatosis.

Erythema anulare centrifugum: Dynamic course, clearly palpable anular plaques (consistency of a wet wool thread). Histologically a lichenoid pattern is missing.

Tinea corporis: Dynamic course, always epidermal component with scaling, blister or pustular formation. Fungal detection is successful in non-pretreated flocks.

Erythema chronicum migrans: Dynamic course, detection of Borrelia bacteria! Histology: No interface dermatitis.

Erythema anulare rheumaticum: Volatile skin component in rheumatic fever (general symptoms are always present). Clinically there are borderline, polycyclic, reddish-brownish, non-pruritic erythema.

TherapyThis section has been translated automatically.

Local therapy with glucocorticoids. The disease proves to be very steroid-sensitive. Recurrence after discontinuation of steroidal therapy is probable.

Progression/forecastThis section has been translated automatically.

After years self-limiting.

LiteratureThis section has been translated automatically.

  1. Annessi G et al. (2022) Annular Lichenoid Dermatitis (of Youth). Dermatopathology (Basel) 9:23-31.
  2. Annessi G et al. (2003) Annular lichenoid dermatitis of youth. J Am Acad Dermatol 49: 1029-1036
  3. Cesinaro AM et al. (2009) Annular lichenoid dermatitis of youth... and beyond: A series of 6 cases. Am. J. Dermatopathol 31: 263-267.
  4. Fabroni C et al (2010) Annular lichenoid dermatitis. Clin Exp Dermatol 35: 921-923.
  5. Huh W et al. (2010) Annular lichenoid dermatitis of youth: Report of the first Japanese case and published work review. J Dermatol 37: 531-533.
  6. Kleikamp S et al. (2010) Annular lichenoid dermatosis of childhood - another case in a 12-year-old girl. JDDG 6: 653-656
  7. Tsoitis G et al (2009) Annular lichenoid dermatitis of youth. J Eur Acad Dermatol Venereol 23, 1339-1340.

Authors

Last updated on: 28.12.2023

Author: Prof. Dr. med. Peter Altmeyer