Lichen Simplex Chronicus

Background: There are very few population-based studies on the prevalence of eczema among older persons Aims: To estimate the prevalence and types of eczema in those aged 65 years or more in the community and to evaluate the effectiveness of community-based interventions for case finding. Methods: In the first stage of this cross-sectional survey, trained health workers of a non-governmental organization surveyed the eligible population and identified persons likely to have eczema. In the second stage, dermatologists examined such persons to ascertain the diagnosis. Statistical analysis was done using Epi Info software version 7. Prevalence of eczema was expressed in percentages. Chi-square test was used for comparing the difference in prevalence of eczema in various age groups and sex. Results: Health workers identified 98 persons as possible cases of eczema after interviewing 385 older persons in the community. Among them 95 persons were examined by dermatologists and 44 were confirmed to have eczema (diagnostic accuracy of health workers = 46.3%).Point prevalence of eczema was 11.4% (44/385). Prevalence was similar in males and females. It was greater (18.2 %) among persons aged 81 years or more. Asteatotic eczema, gravitational eczema and lichen simplex chronicus were the more common types of eczema. Limitations: Possible underestimation of the prevalence rates due to limited medical knowledge of health workers; limited facilities for examination and investigations at the medical camps and home visits. Conclusion: There appears to be a considerable burden of eczema among older persons in the community. A community-based approach involving non-governmental organizations has the potential to identify cases and offer care close to their homes.

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Hypertrophic Lichen Planus versus Well-Differentiated Squamous Cell Carcinoma: A Histological Challenge

SKIN The Journal of Cutaneous Medicine ◽

10.25251/10.25251/skin.1.2.6 ◽

2017 ◽

Vol 1 (2) ◽

pp. 91

Author(s):

Samuel P Haslam ◽

Lindy S Ross ◽

Alison C Lowe ◽

Brent C Kelly

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Multiplex Pcr ◽

Lichen Planus ◽

Squamous Cell ◽

Correct Diagnosis ◽

Pseudoepitheliomatous Hyperplasia ◽

Lichen Simplex Chronicus ◽

Well Differentiated

Differentiating hypertrophic lichen planus (LP) from well-differentiated squamous cell carcinoma (SCC) is a histological challenge given the numerous histopathologic similarities between SCC and pseudoepitheliomatous hyperplasia (PEH) arising in the setting of hypertrophic LP. Multiple reports have shown that SCC can arise from hypertrophic LP not infrequently, but that the LP-to-SCC sequence is poorly understood, and many cases defy diagnosis due to histologic similarities. However, there are several clinical clues and histopathologic details that have shown to have some value when trying to ascertain the correct diagnosis. To the contrary, immunohistochemical tests have shown little promise in differentiating hypertrophic LP from SCC. Although multiplex PCR has shown some potential in differentiating PEH from SCC, this has only been in the setting of patients diagnosed with prurigo and lichen simplex chronicus, but not necessarily in the case hypertrophic LP.

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