Öz
Aim: The aim of this study is to analyze the clinical and demographic characteristics, histopathological findings, and treatment responses of patients with pityriasis lichenoides. Additionally, the study aims to investigate the differences between pediatric and adult patients.
Material and Method: The data of 47 patients with pityriasis lichenoides, followed up at the Dermatology Clinic of Ankara Training and Research Hospital between 01.08.2004 and 01.08.2024, were retrospectively analysed. The patients were classified as pityriasis lichenoides chronica and pityriasis lichenoides et varioliformis acuta. Clinical, demographic, and histopathological characteristics, as well as treatment responses, were evaluated. The patients were divided into pediatric (<18 years) and adult (>18 years) groups for comparison. In statistical analyses, a p-value of <0.05 was considered significant.
Results: Sixty-six percent of the patients were female, and 34% were male, with a mean age of 35.28±18.96 years. The median disease duration was 14 months, and the median time to diagnosis was 3 months. The most commonly affected areas were the trunk and extremities (68.1%). Relapses were observed in 42.6% of the patients. The most frequently detected histopathological findings were perivascular lymphocytic infiltration (87.8%) and lymphocytic exocytosis (80.5%). All patients were treated with topical corticosteroids, and 95.7% received narrow-band UVB phototherapy. The complete response rate was 40.4%, the partial response rate was 51.1%, and no response was observed in 8.5% of the patients. In pediatric patients, the disease duration was significantly shorter than in adults (p=0.026).
Conclusion: Pityriasis lichenoides has a longer duration in adults, while pediatric patients are diagnosed earlier. Narrow-band UVB phototherapy is an effective treatment option for both children and adults. More prospective studies are needed for the management of pityriasis lichenoides.
Anahtar Kelimeler
Kaynakça
- 1. Bellinato F, Maurelli M, Gisondi P, Girolomoni G. A systematic review of treatments for pityriasis lichenoides. J Eur Acad Dermatol Venereol. 2019 Nov;33(11):2039-2049. doi: 10.1111/jdv.15813. Epub 2019 Aug 8. PMID: 31318465.
- 2. Bowers S, Warshaw EM. Pityriasis lichenoides and its subtypes. J Am Acad Dermatol. 2006 Oct;55(4):557-72; quiz 573-6. doi: 10.1016/j.jaad.2005.07.058. PMID: 17010734.
- 3. Geller L, Antonov NK, Lauren CT, Morel KD, Garzon MC. Pityriasis Lichenoides in Childhood: Review of Clinical Presentation and Treatment Options. Pediatr Dermatol. 2015 Sep-Oct;32(5):579-92. doi: 10.1111/pde.12581. Epub 2015 Mar 26. PMID: 25816855.
- 4. Ersoy-Evans S, Hapa AA, Boztepe G, Sahin S, Kölemen F. Narrowband ultraviolet-B phototherapy in pityriasis lichenoides chronica. J Dermatolog Treat. 2009;20(2):109-13. doi: 10.1080/09546630802449088. PMID: 19016063.
- 5. Agaoglu E, Erdogan HK, Acer E, Saracoglu ZN, Bilgin M. Narrowband ultraviolet B phototherapy for pityriasis lichenoides: A real-life experience. Photodermatol Photoimmunol Photomed. 2023 Sep;39(5):520-526. doi: 10.1111/phpp.12895. Epub 2023 Jun 20. PMID: 37340660.
- 6. Hapa A, Ersoy-Evans S, Karaduman A. Childhood pityriasis lichenoides and oral erythromycin. Pediatr Dermatol 2012;29:719– 724.
- 7. Wahie S, Hiscutt E, Natarajan S, Taylor A. Pityriasis lichenoides: the differences between children and adults. Br J Dermatol. 2007 Nov;157(5):941-5. doi: 10.1111/j.1365-2133.2007.08163.x. Epub 2007 Sep 13. PMID: 17854375.
- 8. Farnaghi F, Seirafi H, Ehsani AH, Agdari ME, Noormohammadpour P. Comparison of the therapeutic effects of narrow band UVB vs. PUVA in patients with pityriasis lichenoides. J Eur Acad Dermatol Venereol. 2011 Aug;25(8):913-6. doi: 10.1111/j.1468- 3083.2010.03879.x. Epub 2010 Nov 4. PMID: 21054568.
- 9. Özdöl S, Boztepe G, Karaduman A, Gürer CK, Çak›r B, Erkin G, fiahin S. Pityriasis lichenoides: a retrospec tive study involving 75 patients. TÜRKDERM 2004; 38: 195-198.
- 10. Ersoy-Evans S, Greco MF, Mancini AJ et al. Pityriasis lichenoides in childhood: a retrospective review of 124 patients. J Am Acad Dermatol 2007;56:205–210.
- 11. Fatturi AL, Morgan MAP, Markus JR, Noguera-Morel L, Carvalho VO. Pityriasis lichenoides: assessment of 41 pediatric patients. J Pediatr (Rio J). 2024;100(5):527-532. doi:10.1016/j. jped.2024.03.011.
- 12. Zang JB, Coates SJ, Huang J, Vonderheid EC, Cohen BA. Pityriasis lichenoides: Long-term follow-up study. Pediatr Dermatol. 2018 Mar;35(2):213-219. doi: 10.1111/pde.13396. Epub 2018 Jan 9. PMID: 29315771.
- 13. Lazaridou E, Fotiadou C, Tsorova C et al. Resistant pityriasis lichenoides et varioliformis acuta in a 3-year old boy: successful treatment with methotrexate. Int J Dermatol 2010;49:215–217.
- 14. Tsai MC, Yang CC, Chao SC et al. Case of co morbidity of alopecia areata and pityriasis lichenoides in a five year old boy for two years. J Dermatol 2006;33:724–726.
- 15. Saltik-Temizel IN, Ersoy-Evans S, Demir H et al. Pityriasis lichenoides chronica: an association with autoimmunehepatitis. Pediatr Dermatol 2007;24:71–73.
- 16. Pasic S, Pavlovic M, Vojvodic D et al. Pityriasis lichenoides in a girl with the granulomatous form of common variable immunodeficiency. Pediatr Dermatol 2002;19:56–59. 29
- 17. Hrin ML, Bowers NL, Jorizzo JL, Feldman SR, Huang WW. Methotrexate for pityriasis lichenoides et varioliformis acuta (Mucha- Habermann disease) and pityriasis lichenoides chronica: A retrospective case series of 33 patients with an emphasis on outcomes. J Am Acad Dermatol. 2022;86(2):433-437. doi:10.1016/j. jaad.2021.09.045
- 18. Fernández-Guarino M, Aboin-Gonzalez S, Ciudad Blanco C, Velázquez Tarjuelo D, Lázaro Ochayta P. Treatment of adult diffuse pityriasis lichenoides chronica with narrowband ultraviolet B: experience and literature review. Clin Exp Dermatol. 2017;42(3):303-305. doi:10.1111/ced.13035
Öz
Amaç: Bu çalışmanın amacı, pityriasis likenoides hastalarının klinik ve demografik özelliklerini, histopatolojik bulgularını ve tedavi yanıtlarını analiz etmektir. Ayrıca, pediatrik ve erişkin hastalar arasındaki farklılıkların araştırılması hedeflendi.
Gereç ve Yöntem: 01.08.2004 -01.08.2024 tarihleri arasında Ankara Eğitim ve Araştırma Hastanesi Dermatoloji Polikliniği'nde takip edilen 47 pityriasis likenoides hastasının verileri retrospektif olarak incelendi. Hastalar pityriasis likenoides kronika ve pityriasis likenoides et varioliformis akuta olarak sınıflandırıldı. Klinik, demografik ve histopatolojik özellikler ile tedavi yanıtları değerlendirildi. Hastalar pediatrik (<18 yaş) ve erişkin (>18 yaş) gruplarına ayrılarak karşılaştırıldı. İstatistiksel analizlerde p<0.05 anlamlı kabul edildi.
Bulgular: Hastaların %66’sı kadın, %34’ü erkek olup yaş ortalaması 35.28±18.96 yıl idi. Medyan hastalık süresi 14 ay, medyan tanı süresi 3 ay olarak belirlendi. En sık etkilenen bölgeler gövde ve ekstremitelerdi (%68.1). Hastaların %42.6’sında relaps görüldü. En sık saptanan histopatolojik bulgular perivasküler lenfosit infiltrasyonu (%87.8) ve lenfosit ekzositozu (%80.5) idi. Hastaların tümüne topikal kortikosteroid tedavisi verildi; %95.7’sine dar bant UVB fototerapisi uygulandı. Tam yanıt %40.4, kısmi yanıt %51.1 olup %8.5’inde tedaviye yanıt alınamadı. Pediatrik hastalarda hastalık süresi erişkinlere göre anlamlı olarak daha kısa bulundu (p=0.026).
Sonuç: Pityriasis likenoides hastalığının erişkinlerde daha uzun sürdüğü, pediatrik hastaların daha erken tanı aldığı saptandı. Dar bant UVB fototerapisi, hem çocuk hem erişkinlerde etkili bir tedavi seçeneğidir. Pityriasis likenoides yönetimi için daha fazla prospektif çalışmaya ihtiyaç duyulmaktadır.
Anahtar Kelimeler
Kaynakça
- 1. Bellinato F, Maurelli M, Gisondi P, Girolomoni G. A systematic review of treatments for pityriasis lichenoides. J Eur Acad Dermatol Venereol. 2019 Nov;33(11):2039-2049. doi: 10.1111/jdv.15813. Epub 2019 Aug 8. PMID: 31318465.
- 2. Bowers S, Warshaw EM. Pityriasis lichenoides and its subtypes. J Am Acad Dermatol. 2006 Oct;55(4):557-72; quiz 573-6. doi: 10.1016/j.jaad.2005.07.058. PMID: 17010734.
- 3. Geller L, Antonov NK, Lauren CT, Morel KD, Garzon MC. Pityriasis Lichenoides in Childhood: Review of Clinical Presentation and Treatment Options. Pediatr Dermatol. 2015 Sep-Oct;32(5):579-92. doi: 10.1111/pde.12581. Epub 2015 Mar 26. PMID: 25816855.
- 4. Ersoy-Evans S, Hapa AA, Boztepe G, Sahin S, Kölemen F. Narrowband ultraviolet-B phototherapy in pityriasis lichenoides chronica. J Dermatolog Treat. 2009;20(2):109-13. doi: 10.1080/09546630802449088. PMID: 19016063.
- 5. Agaoglu E, Erdogan HK, Acer E, Saracoglu ZN, Bilgin M. Narrowband ultraviolet B phototherapy for pityriasis lichenoides: A real-life experience. Photodermatol Photoimmunol Photomed. 2023 Sep;39(5):520-526. doi: 10.1111/phpp.12895. Epub 2023 Jun 20. PMID: 37340660.
- 6. Hapa A, Ersoy-Evans S, Karaduman A. Childhood pityriasis lichenoides and oral erythromycin. Pediatr Dermatol 2012;29:719– 724.
- 7. Wahie S, Hiscutt E, Natarajan S, Taylor A. Pityriasis lichenoides: the differences between children and adults. Br J Dermatol. 2007 Nov;157(5):941-5. doi: 10.1111/j.1365-2133.2007.08163.x. Epub 2007 Sep 13. PMID: 17854375.
- 8. Farnaghi F, Seirafi H, Ehsani AH, Agdari ME, Noormohammadpour P. Comparison of the therapeutic effects of narrow band UVB vs. PUVA in patients with pityriasis lichenoides. J Eur Acad Dermatol Venereol. 2011 Aug;25(8):913-6. doi: 10.1111/j.1468- 3083.2010.03879.x. Epub 2010 Nov 4. PMID: 21054568.
- 9. Özdöl S, Boztepe G, Karaduman A, Gürer CK, Çak›r B, Erkin G, fiahin S. Pityriasis lichenoides: a retrospec tive study involving 75 patients. TÜRKDERM 2004; 38: 195-198.
- 10. Ersoy-Evans S, Greco MF, Mancini AJ et al. Pityriasis lichenoides in childhood: a retrospective review of 124 patients. J Am Acad Dermatol 2007;56:205–210.
- 11. Fatturi AL, Morgan MAP, Markus JR, Noguera-Morel L, Carvalho VO. Pityriasis lichenoides: assessment of 41 pediatric patients. J Pediatr (Rio J). 2024;100(5):527-532. doi:10.1016/j. jped.2024.03.011.
- 12. Zang JB, Coates SJ, Huang J, Vonderheid EC, Cohen BA. Pityriasis lichenoides: Long-term follow-up study. Pediatr Dermatol. 2018 Mar;35(2):213-219. doi: 10.1111/pde.13396. Epub 2018 Jan 9. PMID: 29315771.
- 13. Lazaridou E, Fotiadou C, Tsorova C et al. Resistant pityriasis lichenoides et varioliformis acuta in a 3-year old boy: successful treatment with methotrexate. Int J Dermatol 2010;49:215–217.
- 14. Tsai MC, Yang CC, Chao SC et al. Case of co morbidity of alopecia areata and pityriasis lichenoides in a five year old boy for two years. J Dermatol 2006;33:724–726.
- 15. Saltik-Temizel IN, Ersoy-Evans S, Demir H et al. Pityriasis lichenoides chronica: an association with autoimmunehepatitis. Pediatr Dermatol 2007;24:71–73.
- 16. Pasic S, Pavlovic M, Vojvodic D et al. Pityriasis lichenoides in a girl with the granulomatous form of common variable immunodeficiency. Pediatr Dermatol 2002;19:56–59. 29
- 17. Hrin ML, Bowers NL, Jorizzo JL, Feldman SR, Huang WW. Methotrexate for pityriasis lichenoides et varioliformis acuta (Mucha- Habermann disease) and pityriasis lichenoides chronica: A retrospective case series of 33 patients with an emphasis on outcomes. J Am Acad Dermatol. 2022;86(2):433-437. doi:10.1016/j. jaad.2021.09.045
- 18. Fernández-Guarino M, Aboin-Gonzalez S, Ciudad Blanco C, Velázquez Tarjuelo D, Lázaro Ochayta P. Treatment of adult diffuse pityriasis lichenoides chronica with narrowband ultraviolet B: experience and literature review. Clin Exp Dermatol. 2017;42(3):303-305. doi:10.1111/ced.13035
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Dermatoloji |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 4 Mayıs 2025 |
| Gönderilme Tarihi | 23 Şubat 2025 |
| Kabul Tarihi | 26 Nisan 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 58 Sayı: 1 |
