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Dermpath-India

Lichenoid (Interface) Tissue Reaction

Dr Sampurna Roy MD             

 

 

                                                                                                                      

 

 

Histopathology Images of Lichen Planus and diagram of variants of Lichen Planus :

 

    

                           

 

Visit: Lichen planus-like lesions

Interface dermatosis is a common form of inflammatory dermatosis.

 

A wide range of inflammatory skin diseases exhibit interface change with considerable overlap of histological features.

 

The term "lichenoid" is avoided by some pathologists because of clinical and histological difference in the definition of this term.
 

The following features are characteristic of Interface Dermatitis:

I-  Mild or dense inflammatory infiltrate composed of mainly mononuclear cells.

This feature is essential to make a diagnosis of an interface dermatitis.

 

II-  Vacuolar or hydropic change due to basal cell degeneration.

 

III- Colloid or civatte bodies are eosinophilic bodies formed as a result of apoptosis.

These may be present in the lower part of the epidermis (suprabasal) or in the dermis.

 

IV-  Pigment incontinence due to damage of basal keratinocytes and melanocytes.

 

Interface dermatitis is divided into five groups-   

I- Lichenoid (lichen planus-like) interface reactions:

Example-   Lichen planus  ;  Lichenoid keratosis ; Lichenoid drug eruption ; Lichen Nitidus ; Lichen Striatus.

 

II- Vacuolar (Erythema Multiforme-like) Reaction:

Example-   Erythema Multiforme ;  Toxic epidermal necrolysis ;  Acute graft vs host disease (Cutaneous lesions in graft versus host disease) ;    Pityriasis lichenoides ; Lupus erythematosus (acute & subacute) ;  Fixed drug eruption  (Drug induced cutaneous lesions).    

 

III- Atrophic (Poikilodermatous) Reaction:

Example- Atrophic lichen planus ; Systemic lupus erythematosus ; Dermatomyositis ;  Mycosis Fungoides.

 

IV-  Interface Reactions with Irregular Epidermal Hyperplasia:

Example: Hypertrophic lichen planus ; Rare lichenoid drug eruptions ; Verrucous lupus erythematosus.

 

V-  Interface Reactions with Psoriasiform Hyperplasia:

Example: Pityriasis lichenoides ;Mycosis fungoides ; Secondary syphilis; Lichen Aureus

 

Further reading:

Lichen planus and lichenoid reactions of the oral mucosa.

Lichenoid tissue reaction/interface dermatitis: clinical and histological perspectives.

T-cell-mediated injury to keratinocytes: insights from animal models of the lichenoid tissue reaction.

Lichenoid inflammation in vitiligo--a clinical and histopathologic review of 210 cases.

Subcellular activation site of caspase-3 in apoptotic keratinocytes observed in lichenoid tissue reaction.

Oral and cutaneous lichenoid reaction with nail changes secondary to imatinib: report of a case and literature review.

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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