Access Dermatology

Lichenoid drug reactions can be caused by many drugs. The typical skin lesions occur on the trunk and extremities as pruritic erythematous papules with confluence. The biopsy specimen shows band-like lymphocytic infiltrate in the upper dermis, hydropic degeneration of the basal cell layer, necrotic keratinocytes and lichenoid interface dermatitis with some eosinophils. The therapy involves discontinuation of the medication that initiated the reaction. The skin lesions are treated with topical agents containing corticosteroids. Most patients react well to systemic corticosteroid therapy. Oral antihistamines are often helpful to treat the itch. We present a case of an elderly woman with typical lesions, positive history, characteristic histology and a positive response to therapy...