Lichen spinulosus Q82.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 15.09.2022

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Synonym(s)

keratosis follicularis spinulosa; keratosis spinulosa; lichen spinulosus

History
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Adamson, 1908

Definition
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Chronic follicular keratosis disorder with follicular skin-colored papules with central, spine-like hyperkeratosis that clearly protrude above the skin level. This is a rarer, and more severe variant of keratosis pilaris simplex .

Etiopathogenesis
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Follicular cornification disorder of unknown etiology.

Manifestation
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Children, mean age of onset 16 years; in adolescence improvement of sympotmatic (compare keratosis follicularis).

Localization
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Neck, buttocks, abdomen, shoulder region, extensor sides of extremities (pattern of affection as in keratosis follicularis).

Clinical features
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Acquired, usually indistinct, not pruritic but only cosmetically disturbing, 5.0-6.0 cm, slightly scaly, dry areas characterized by multiple, disseminated, 0.1-0.2 cm, skin-colored, follicular papules that often become denser centrally in the affected areas and thin out peripherally. Image resembling lichen simplex chronicus. Associations with systemic diseases (Crohn's disease, HIV infection, early syphilis) have been described (Kano Y et al. 1995).

Histology
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Follicular keratosis with low perifollicular inflammatory infiltrate.

Therapy
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Note(s)
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The terms "spinulosism" or "spinulosimus" (Storck) for acquired, reactive follicular keratinization disorders are probably synonymous with the lichen spinulosus.

Literature
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  1. Adamson HG (1908) On a form of chronic superficila dermatitis in circumscribed patches with symmetrical distribution occurring in children. Br J Dermatol 20:109-122
  2. Cohen SJ et al (1991) Generalized lichen spinulosus in an HIV-positive man. J Am Acad Dermatol 25:116-118.
  3. Friedman SJ (1990) Lichen spinulosus. Clinicopathologic review of thirty-five cases. J Am Acad Dermatol 22:261-264.
  4. Forman SB et al (2007) Lichen spinulosus: excellent response to tretinoin gel and hydroactive adhesive applications. Arch Dermatol 143:122-123
  5. Kano Y et al (1995) Lichen spinulosus in a patient with Crohn's disease. Int J Dermatol 34:670-671
  6. Sahni VN et al (2021) Lichen spinulosus: insights into treatment. Dermatol Online J 15:27(10).
  7. Storck H (1953) Spinulosism after febrile infection. Dermatologica 107:276-277
  8. Venkatesh A et al (2012) Generalized lichen spinulosus in a 4-year-old boy without systemic disease. Arch Dermatol 148:865-866

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Last updated on: 15.09.2022