Lichen aureus pathology

Introduction

Lichen aureus is a distinct subtype of pigmented purpuric skin disease. Clinically, it generally affects children or young adults and presents as a persistent rust color. plates in the lower extremities.

Histology lichen aureus

In lichen aureus, sections generally show a different pattern of infiltration in all kinds of purpuric pigments dermatitis, with infiltration around the small vessels of the superficial plexus and minimal epidermal reaction (figure 1). At higher power, the infiltrate It mainly consists of lymphocytes with a pretty impressive ratio of histiocytes (Figure 2). The vessels may have some prominence of the endothelial cells but there is no evidence of vascular to damage. A key feature of all types of pigmented purpuric dermatitis is the presence of hemosmosin within the superficial dermis, which results from chronic leakage of red blood cells from the vessels.

Special studies for lichen aureus

Perls' Prussian blue iron stain demonstrates the statement of hemosiderin in the superficial dermis (figure 3).

Differential diagnosis for lichen aureus

Other diagnoses to consider include:

• Other forms of pigmented purpuric dermatitis: some authorities no longer make the distinction between clinical forms of pigmented purpuric dermatitis; histopathologically, lichen aureus has a high percentage of histiocytes in the infiltrate
• Histiocytic disorders (eg, Langerhans cells histiocytosis) - these can be excluded by demonstration of dermal hemosiderin with Perls iron stain
• Mycosis fungoides: Pigmented purpuric dermatitis can sometimes mimic cutaneous T cell lymphoma histopathologically; dense histiocytic infiltrators and dermal hemosidein are unusual in mycosis fungoides.
• Leukocytoclastic vasculitis - This shows convincing damage to the glasses with neutrophilic infiltration and fragmentation.