Clinical profile and Histopathological spectrum of Interface Dermatitis
Keywords:
Interface Dermatitis (IFD), Dermo-epidermal junction (DEJ), Lichenoid infiltrate, Lichenoid tissue reaction (LTR)
Abstract
Background- Interface Dermatitis is an etiologically diverse and poorly understood group of skin diseases characterized by pathology at the dermo-epidermal junction. The prototype disease is Lichen Planus but there are many other disease entities that exhibit Lichenoid tissue reaction / Interface changes. Aims- To study the clinical profile and Histopathological spectrum of Interface Dermatitis. Materials & Methods- This was a prospective study conducted at a tertiary care hospital over a period of eighteen months. A total of Ninety-eight cases clinically suggestive of diseases believed to show interface changes on histology were studied. Clinical details were recorded. Skin biopsies were taken from representative lesions. H&E stained sections were studied in detail for diagnosis and subtyping. Analysis was done in percentages and proportions. Results- Fifty-three cases (54%) showed IFD on histopathological examination. The most common age range was between 11-40 years and both the sexes were equally affected. Majority of the cases clinically presented as papules and plaques. The most common type of IFD were LP and its variants (52.1%). The most consistent microscopic findings were vacuolar degeneration of basal layer, pigment incontinence and inflammatory infiltrate around DEJ and blood vessels. Conclusions- IFD includes various diseases which have overlapping clinical as well as histopathological features. A detailed histopathological examination and correlation of the interface changes with clinical diagnosis is helpful in arriving at a definitive diagnosis which is essential for predicting the course of the disease and its optimal management.References
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2. Fitzpatrick JE. New histopathologic findings in drug eruptions. Dermatol Clin, 1992;10:19-36.
3. Joshi R. Interface dermatitis. Indian J dermatol Venereol & Leprol 2013;79:349-59.
4. Tilly JJ, Drolet BA, Esterly NB. Lichenoid eruptions in children. J Am Acad Dermatol 2004;51:606-24.
5. Sehgal VN, Srivastava G, Sharma S, Sehgal S, Verma P. Lichenoid tissue reaction/Interface dermatitis: Recognition, classification, etiology and clinicopathological overtunes. Indian J Dermatol Venereol Leprol 2011;77:418-30.
6. Jyothi AR, Shweta SJ, Sharmila PS, Dhaval P, Mahantachar V,T Rajaram. Lichenoid Tissue Reaction/Interface dermatitis: A Histopathological Study. Int Journal of Medical & Applied sciences 2013;2:76-89.
7. Chauhan R, Srinath MK, Ali MN, Bhat MR, Sukumar D. Clinicopathological Study of Lichenoid Reactions: A Retrospective Analysis. Journal of Evolution of medical & dental sciences 2015;4:5551-62.
8. Banushree CS, Nagarajappa AH, Dayananda SB, Sacchidanand S. Clinico-Pathological Study of Lichenoid Eruptions of Skin. J Pharm Biomed Sci 2012;25:226-30.
9. Kumar UM, Yelikar BR, Inamadar AC, Umesh S, Singhal A, Kushtagi AV. Clinico-pathological study of lichenoid tissue reactions – a tertiary care experience. J Clin Diagn Res 2013;7:312-16.
10. Crowson AN, Magro CM, Mihm M Jr. Interface dermatitis. Arch Pathol Lab Med 2008;132:652–66.
11. Alsaad KO, Ghazarian D. My approach to superficial inflammatory dermatoses. J Clin Pathol 2005;58:1233-41.
12. Nasreen S, Ahmed I, Wahid Z. Associations of lichen planus: A study of 63 cases. Journal of Pakistan Association of Dermatologists 2007;17:17-20.
13. Kachhawa D, Kachhawa V, Kalla G, Gupta L. A clinico-aetiological profile of 375 cases of lichen planus. Indian J Dermatol Venereol Leprol 1995;61:276-9.
14. Knackstedt TJ, Collins LK, Li Z, Yan S, Samie FH. Squamous Cell Carcinoma Arising in Hypertrophic Lichen Planus: A Review and Analysis of 38 Cases. Dermatol Surg 2015;41:1411-8.
15. Boyd AS, Neldmar KH. Non Infectious Erythematous, Papular and Squamous diseases. In: Elder DE, Murphy GF, Elenitsas R, Johnson BL, Xu X, editors. Levers Histopathology of the skin, 10th edition. India: Lippincott Williams & Wilkins; 2009.p.185-97.
16. Alahlafi AM, Wordsworth P, Lakasing L, Davies D, Wojnarowska F. The basement membrane zone in patients with systemic lupus erythematosus: immunofluorescence studies in the skin, kidney and amniochorion. Lupus 2004;13:594-600.
17. Weyers W, Metze D. Histopathology of drug eruptions – general criteria, common patterns, and differential diagnosis. Dermatol Pract Concept 2011;1:33-47.
18. Kirtschig G. Lichen Sclerosus—Presentation, Diagnosis and Management. Deutsches Ärzteblatt International 2016;113:337-43.
19. Carlson JA, Lamb P, Malfetano J. Clinicopathologic comparison of vulvar and extragenital lichen sclerosus: histologic variants, evolving lesions, and etiology of 141 cases. Mod Pathol. 1998;11:844-54.
Published
2019-09-08
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