Case report: Lichenoid and granulomatous dermatitis

Introduction:Lichenoid and granulomatous dermatitis is a new entity of interface dermatitis that is definedhistologically by band-like lymphoytic infiltration in the upper portion of the dermis withobscuring the dermoepidermal junction and accompanied with granulomatous inflammation.Case presentation:We report a 53 years old Iranian woman with complains of multiples subcutaneous nodulesof her hands from two years ago. Physical examination showed multiple firm, non-tendernodules that were located on dorsal aspect of her hands (including DIP,PIP,MCP joints)measuring about 0.5-1cm. The patient has history of hyperthyroidism from ten years ago. Herlaboratory results are as follow; RA Factor (RF Latex) was negative, ACE (serum): 50(Normal: 8-52), Anti-TPO: 262.7 (Normal: up to 34), VDRL was negative, Tuberculin Test(PPD 48 hr): 2mm (Negative). Histopathologic examination revealed Lichenoid andgranulomatous dermatitis.Conclusion:Lichenoid and granulomatous dermatitis is a new entity of interface dermatitis thatassociated clinically with various systemic disorders such as crohn,s disease, rheumatoidarthritis, thyroiditis, Hepatitic C, diabetes mellitus, secondary syphilis, infectious diseaseand lichenoid drug eruption that accompanied with granulomatous inflammationhistopathologically. Reflecting to the case, history of thyroid disorder from 10 years agoand high titer of anti-TPO Ab, with Lichenoid and granulomatous dermatitis inhistopathologic examination, show the association of auto-immune disease with Lichenoidand granulomatous dermatitis. Management of the underlying disease can control cutaneouslesion.

Keywords:

Lichenoid granulomatous dermatitis , Thyroiditis