BSD SELF ASSESSMENT SESSION 2018

Dr Arti Bakshi,

Consultant

Dermatopathologist,

Royal Liverpool

University Hospital.

CASE 11

43/F, 2 year history of well defined papular

keratotic rash, initially appeared on ankles and

lower legs and then spread to thighs, arms and

neck.

Keratosis pilaris

Hyperkeratois lenticularis perstans (Flegel’s

disease)

Lichenoid drug eruption

Hyperkeratosis follicularis et parafollicularis in

cutem penetrans (Kyrle’s disease)

DIAGNOSIS??

Keratosis pilaris

Hyperkeratosis lenticularis perstans (Flegel’s

disease)

Lichenoid drug eruption

Hyperkeratosis follicularis et parafollicularis in

cutem penetrans (Kyrle’s disease)

Keratosis pilaris c/o

Weedon textbook Kyrle’s disease c/o

dermpedia

Lichenoid drug eruption Flegel’s disease c/o dermnet

Keratosis pilaris

Hyperkeratosis lenticularis perstans (Flegel’s

disease)

Lichenoid drug eruption

Hyperkeratosis follicularis et parafollicularis in

cutem penetrans (Kyrle’s disease)

FLEGEL’S DISEASE

Large numbers, small, discrete, grey-brown/red-brown, circular papules with a well-developed scale

Dorsum of foot, lower legs, upper arms, pinnae, buttocks, trunk, dorsal aspects of hands, palms & soles

Removal of the scale associated with pinpoint bleeding

c/o dermnet

Characterised by protracted clinical course (years

to decades)

Most cases sporadic, some evidence of AD

inheritance in a subset of cases

Unknown aetiology

HISTOLOGY

Another

differential of

a lichenoid

inflammatory

reaction

The clue is in

the keratin!!

CASE 11: FLEGEL’S DISEASE

Acknowledgements:

Dr Tapati Sinha, Consultant Dermatologist

Dr Jessica White, ST5 Histopathology

THANK YOU.