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Lichen Spinulosus Workup

  • Author: Christopher R Gorman, MD; Chief Editor: William D James, MD  more...
 
Updated: Sep 23, 2015
 

Approach Considerations

Caccetta et al proposed an algorithm for a clinical approach to the diagnosis of digitate keratoses.[8]

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Laboratory Studies

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

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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.

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Contributor Information and Disclosures
Author

Christopher R Gorman, MD Avenues Dermatology, Private Practice

Christopher R Gorman, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster 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, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman 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, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

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, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Acknowledgments

Medscape Drugs & Diseases wishes to recognize Stephen W White, MD† for his original contributions to this article.

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

  2. Cohen SJ, Dicken CH. Generalized lichen spinulosus in an HIV-positive man. J Am Acad Dermatol. 1991 Jul. 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. 1995 Sep. 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. 2004 Oct. 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. 2007 Nov-Dec. 17(6):544-5. [Medline].

  7. Caccetta TP, Dessauvagie B, McCallum D, Kumarasinghe SP. Multiple minutedigitate hyperkeratosis: A proposed algorithm for the digitate keratoses. J Am Acad Dermatol. Nov 1/2010. [Epub ahead of print]. [Medline].

  8. Caccetta TP, Dessauvagie B, McCallum D, Kumarasinghe SP. Multiple minute digitate hyperkeratosis: a proposed algorithm for the digitate keratoses. J Am Acad Dermatol. 2012 Jul. 67 (1):e49-55. [Medline].

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

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

  11. Kim SH, Kang JH, Seo JK, Hwang SW, Sung HS, Lee D. Successful treatment of lichen spinulosus with topical tacalcitol cream. Pediatr Dermatol. Sep-Oct/2010. 27(5):546-7. [Medline].

  12. Uehara A, Abe M, Shimizu A, Motegi SI, Amano H, Ishikawa O. Successful treatment of lichen spinulosus with topical adapalene. Eur J Dermatol. 2015 Jun 17. [Medline].

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

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

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Lichen spinulosus on the abdomen.
Close-up view.
 
 
 
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