eMedicine Specialties > Dermatology > Reactive & Inflammatory Dermatoses

Lichen Spinulosus: Differential Diagnoses & Workup

Author: Stephen W White, MD, Clinical Assistant Professor, Department of Dermatology, George Washington University Hospital; Chief, Sub-section of Dermatology, Suburban Hospital
Coauthor(s): Christopher R Gorman, MD, Bethesda Dermatology, private practice
Contributor Information and Disclosures

Updated: Oct 30, 2009

Differential Diagnoses

Disseminate and Recurrent Infundibular Folliculitis
Pityrosporum Folliculitis
Frictional lichenoid dermatitis of children
Trichostasis spinulosa
Hypovitaminosis A phrynoderma
Keratosis Pilaris
Lichen nitidus

Other Problems to Be Considered

Dermatophytosis
Frictional lichenoid eruption
Lichen scrofulosorum
Lichen nitidus5
Lymphoproliferative disorders (folliculotropic cutaneous T-cell lymphoma/follicular mucinosis6
HIV-associated pityriasis rubra pilaris (type VI) demonstrates lichen spinulosus

Workup

Laboratory Studies

Diagnosis should be made on clinical grounds alone. At present, no laboratory tests are specific or diagnostic for lichen spinulosus.

Histologic Findings

Histologic findings of lichen spinulosus are similar to those observed in keratosis pilaris. In lichen spinulosus, dilated hair follicles are filled with a keratotic plug. An inflammatory lymphocytic infiltrate occurs around the follicle and in the dermis. Hyperkeratosis, parakeratosis, and acanthosis may be present in the follicle.

More on Lichen Spinulosus

Overview: Lichen Spinulosus
Differential Diagnoses & Workup: Lichen Spinulosus
Treatment & Medication: Lichen Spinulosus
Follow-up: Lichen Spinulosus
Multimedia: Lichen Spinulosus
References

References

  1. Friedman SJ. Lichen spinulosus. Clinicopathologic review of thirty-five cases. J Am Acad Dermatol. Feb 1990;22(2 Pt 1):261-4. [Medline].

  2. Cohen SJ, Dicken CH. Generalized lichen spinulosus in an HIV-positive man. J Am Acad Dermatol. Jul 1991;25(1 Pt 1):116-8. [Medline].

  3. Kano Y, Orihara M, Yagita A, Shiohara T. Lichen spinulosus in a patient with Crohn's disease. Int J Dermatol. Sep 1995;34(9):670-1. [Medline].

  4. Kabashima R, Sugita K, Kabashima K, Nakamura M, Tokura Y. Lichen spinulosus in an alcoholic patient. Acta Derm Venereol. 2009;89(3):311-2. [Medline].

  5. Tilly JJ, Drolet BA, Esterly NB. Lichenoid eruptions in children. J Am Acad Dermatol. Oct 2004;51(4):606-24. [Medline].

  6. Cömert A, Akin O, Demirkesen C. Follicular mucinosis mimicking lichen spinulosus in an 11-year-old boy. Eur J Dermatol. Nov-Dec 2007;17(6):544-5. [Medline].

  7. Maiocco KJ, Miller OF. Lichen spinulosus: response to therapy. Cutis. Feb 1976;17(2):294-99. [Medline].

  8. Forman SB, Hudgins EM, Blaylock WK. Lichen spinulosus: excellent response to tretinoin gel and hydroactive adhesive applications. Arch Dermatol. Jan 2007;143(1):122-3. [Medline].

  9. Boyd AS. Lichen spinulosus: case report and overview. Cutis. Jun 1989;43(6):557-60. [Medline].

  10. Tilly JJ, Drolet BA, Esterly NB. Lichenoid eruptions in children. J Am Acad Dermatol. Oct 2004;51(4):606-24. [Medline].

Further Reading

Keywords

lichen spinulosus, keratosis follicularis spinulosa, lichen pilaris seu spinulosus of Crocker, keratosis follicularis spinosa of Unna

Contributor Information and Disclosures

Author

Stephen W White, MD, Clinical Assistant Professor, Department of Dermatology, George Washington University Hospital; Chief, Sub-section of Dermatology, Suburban Hospital
Stephen W White, MD is a member of the following medical societies: American Academy of Dermatology, International Society of Dermatology, Society for Investigative Dermatology, and Society for Pediatric Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Christopher R Gorman, MD, Bethesda Dermatology, private practice
Christopher R Gorman, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Medical Editor

James J Nordlund, MD, Professor Emeritus, Department of Dermatology, University of Cincinnati College of Medicine
James J Nordlund, MD is a member of the following medical societies: American Academy of Dermatology, Sigma Xi, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Rosalie Elenitsas, MD, Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System
Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology
Disclosure: Nothing to disclose.

CME Editor

Catherine M Quirk, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania
Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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