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Chapter 5: Pityriasis Lichenoides Chronica

INTRODUCTION

KEY POINTS

  • Pityriasis lichenoides chronica (PLC) is a lymphoproliferative papulosquamous condition with varying presentations.

  • In lighter skin, it tends to present with pink to red papules and macules with background erythema and variable scale.

  • In darker skin, presentation also includes scaly papules and macules but varies in color from violaceous and dark brown to hypopigmented. This often resolves with postinflammatory pigment alteration.

image

FIGURE 5-1.

Fuschia-pink papules scattered on the mid to lower back, lacking scale and with significant background erythema. (From Usatine RP, Smith MA, Mayeaux EJ Jr, et al. The Color Atlas and Synopsis of Family Medicine, 3rd ed. New York, NY: McGraw Hill; 2019, Figure 194-9. Reproduced with permission from Richard P. Usatine, MD.)

The image shows a photograph depicting lesions on the lower back of a woman with Pityriasis lichenoides chronic.
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FIGURE 5-2.

Anterior thighs showing diffuse hyperpigmented and hypopigmented patches with overlying scale and background erythema. (Reproduced with permission from Prose NS, Kristal L. Weinberg’s Color Atlas of Pediatric Dermatology, 5th ed. New York, NY: McGraw Hill; 2017, Figure 12-43.)

A patient with light brown hypopigmented and dark brown hyperpigmented patches on the anterior surface of both thighs. Some patches have grey scale.
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FIGURE 5-3.

Purple-brown papules and macules with diffuse overlying and background scale. (Reproduced with permission from Burgin S. Guidebook to Dermatologic Diagnosis. New York, NY: McGraw Hill; 2021, Figure 4-11C.)

A photo shows flat brown violaceous spots of pityriasis lichenoides chronica are scattered evenly over the limb of a patient.
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