Two Features of Annular Lichenoid Dermatitis of Youth (ALDY).

Skinmed Pub Date : 2024-09-17 eCollection Date: 2024-01-01
Elie Saliba, Amal Alawami, Ahmad Berjawi, Sara Yumeen, Zeina Tannous
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Abstract

A healthy 14-year-old boy presented with a 2-month history of two slowly expanding asymptomatic lesions on his right trunk. No etymology of any new medications, recent travel, or tick bites was reported. Physical examination demonstrated two 4.5×2.5- cm and 3.5×2-cm annular hyperpigmented plaques with slightly elicited red borders on the right lower abdomen and right inferior flank. No evidence of atrophy or sclerosis was noted (Figure 1A). A 4-mm punch biopsy revealed irregular epidermal hyperplasia with alteration of thinned and quadrangular rete ridges, a dense band-like lichenoid infiltrate in the papillary dermis admixed with numerous melanophages and occasional necrotic keratinocytes. No evidence of epidermotropism was observed (Figure 1B). The dermal infiltrate was predominantly composed of CD3+ T-lymphocytes admixed with rare CD20+ B-lymphocytes and increased CD8-CD4 ratio. The patient showed significant improvement following the application of a potent steroid ointment for several weeks.

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青年环状苔癣性皮炎(ALDY)的两个特征。
一名 14 岁的健康男孩在 2 个月前发现右侧躯干上有两个缓慢扩展的无症状皮损。未报告任何新药、近期旅行或蜱虫叮咬的病因。体格检查显示,他的右下腹部和右下腹部出现了两个分别为 4.5×2.5 厘米和 3.5×2 厘米的环状色素沉着斑块,斑块边缘略呈红色。未发现萎缩或硬化迹象(图 1A)。4 毫米冲孔活检显示表皮不规则增生,变薄的四角形齿状脊改变,乳头状真皮内有密集的带状苔藓样浸润,其中混杂着大量噬黑体和偶见的坏死角质细胞。没有观察到表皮生长的迹象(图 1B)。真皮浸润主要由 CD3+ T 淋巴细胞组成,其中混杂着罕见的 CD20+ B 淋巴细胞,CD8-CD4 比率增加。在使用强效类固醇软膏数周后,患者病情明显好转。
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