biopsy reveals pityriasis lichenoides

[luvumason]

   Hi, I am a 23 yr old female that was recently diagnosed with pityriasis lichenoides from a biopsy. I have had these small bumps that just keep spreading even though my dermatologist has tried just about every cream and oral medication. I hear this is a rare disease and I can't find much out about it. What is this and how did I get it?

[Rowena Santos, MD]

Hi,

How are you?  Pityriasis lichenoides is a condition that can range from a relatively mild chronic form to a more severe acute eruption. The mild chronic form, known as pityriasis lichenoides chronica, presents with gradual development of small, scaling papules that spontaneously flatten and resolve over a period of weeks. On the other hand, the acute form, pityriasis lichenoides et varioliformis acuta,  is characterised by the abrupt eruption of small scaling papules that develop into blisters and crusted red-brown spots.

Pityriasis lichenoides most often affects adolescents and young adults, usually appearing before the age of 30. The cause of pityriasis lichenoides is not yet known but this could be associated with an inflammatory reaction triggered by infectious agents, a relatively benign form of T-cell lymphoproliferative disorder or  an immune-complex-mediated hypersensitivity vasculitis. Pityriasis lichenoides may not always respond to treatment and recurs when treatment is discontinued.

If the rash is not causing symptoms, treatment may not be necessary. In cases where treatment is necessary, there are several different therapies available such as sun exposure; topical steroids to reduce irritation; topical immunomodulators; oral antibiotics, or phototherapy. Pityriasis lichenoides is generally harmless and may persist for some years.It is,however recommended that you have regular follow-ups because of rare occurrences of malignant transformation. Take care and regards.

[Terra129]

I was told today that it is most likely this  pityriasis  Lichenoides that I have will turn into lympnoma... Is this true?

[Rowena Santos, MD]

Hi,

As have been mentioned, there are rare occurrences of malignant transformation. One theory being considered in the cause of this condition is that it is a  relatively benign form of T-cell lymphoproliferative disorder. Lymphoproliferative disorders are conditions in which there excessive numbers of lymphocytes, including lymphoma,  a malignant growth of lymphocytes.(ref: http://dermnetnz.org/scaly/pityriasis-lichenoides.html) Further studies of your T cells will help and regular follow-up with your doctor  is highly recommended. Take care and keep us posted.