What are the other Names for this Condition? (Also known as/Synonyms)

• Chronic Pityriasis Lichenoides
• Dermatitis Psoriasiformis Nodularis
• Parapsoriasis Lichenoides Chronic

What is Pityriasis Lichenoides Chronica? (Definition/Background Information)

• Pityriasis Lichenoides Chronica (PLC) is a skin condition of unknown cause that affects young adults and adolescents. In this condition, the acute skin lesions go into chronicity. The papules develop scales and the skin is rendered flaky
• In general, pityriasis lichenoides may be acute or chronic. The acute form can be itchy and painful, while the chronic form is usually without such symptoms
• It can affect any part of the body, but it chiefly affects the chest, back, and in rare cases, the mouth and genitalia
• The skin lesions may 'come and go'; it may remain for a period of few months, and then spontaneously disappear. In the chronic state, they may return after a symptom-free period of many years
• In a majority of cases, there is no treatment for Pityriasis Lichenoides Chronica. In some individuals, the use of oral antibiotics and phototherapy may be beneficial. The prognosis of mild condition is typically excellent. However, severe cases are difficult to treat

Who gets Pityriasis Lichenoides Chronica? (Age and Sex Distribution)

• Pityriasis Lichenoides Chronica affects a wide age group, but is more common in adolescents, teenagers, and young adults. This condition is not commonly observed in infants or during old age
• There is a predilection for males, though both males and females are affected
• There is no racial or ethnic preference for this condition; it is observed worldwide

What are the Risk Factors for Pityriasis Lichenoides Chronica? (Predisposing Factors)

Risk factors identified for Chronic Pityriasis Lichenoides include infections by the following pathogens:

• HIV
• Staphylococcus aureus
• Parvovirus
• Epstein-Barr virus (EBV)
• Toxoplasma gondii

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pityriasis Lichenoides Chronica? (Etiology)

The exact cause of Pityriasis Lichenoides Chronica is not well-established or understood.

• The acute form of pityriasis lichenoides develops to become chronic and longstanding
• Even though, many infections can make one vulnerable to this skin condition, pityriasis lichenoides by itself is non-infectious. It does not spread by direct physical contact, from one individual to another

What are the Signs and Symptoms of Pityriasis Lichenoides Chronica?

The signs and symptoms of Pityriasis Lichenoides Chronica include the following:

• The papules on the skin develop scales; the surface becomes flaky (white flakes are observed) and dry
• There is no itchiness or pain associated with this condition
• The skin may be hypopigmented or hyperpigmented, once these lesions get better
• These lesions may be found on the chest, back, arms, palms, and soles. Rarely, the mouth and genital parts may be involved
• The skin lesions may be present for a few months and then disappear spontaneously. They may then return after many years of being symptom-free

How is Pityriasis Lichenoides Chronica Diagnosed?

• The diagnosis usually entails a good physical examination and comprehensive evaluation of one's medical history (including past history of pityriasis lichenoides)
• Examination of the skin by a dermatologist using a special magnified lens (dermoscopy)
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• A differential diagnosis may be undertaken to eliminate the following conditions:
  • Varicella infection
  • Guttate psoriasis
  • Lymphomatoid papulosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pityriasis Lichenoides Chronica?

The complications of Pityriasis Lichenoides Chronica may include the following:

• When the skin lesions heal, it may result in scar formation causing cosmetic issues
• The longstanding lesions can cause self-image issues, emotional stress, and psychological trauma in some individuals, leading to depression

How is Pityriasis Lichenoides Chronica Treated?

In many individuals, pityriasis lichenoides can be a self-limiting skin disorder that may not require any treatment. The condition subsides and goes away on its own. The symptoms may be mild and symptomatic treatment is also not required.

In those with significant, longstanding and recurrent symptoms, there is no definitive cure for Pityriasis Lichenoides Chronica. The treatment strategies that may be adopted may help some individuals more than others, and these may include:

• If the skin rashes do not cause any signs and symptoms, then observation may be the best treatment option
• Oral antibiotics
• Application of topical steroidal creams and topical tacrolimus
• Phototherapy, if oral antibiotics are not helpful
• The presence of chronic skin lesions may cause psychological discomfort; individuals may require reassurance to help with stress and anxiety
• Follow-up care with regular screening and check-ups are important

How can Pityriasis Lichenoides Chronica be Prevented?

There is currently no effective means to prevent Pityriasis Lichenoides Chronica, because the cause of this disorder is unknown. Nevertheless, the following measures may help mitigate risks and avoid the condition from becoming worse:

• Maintaining good personal hygiene and care
• Avoiding scratching of the ‘itchy’ lesions
• Avoiding or minimizing sun exposure
• Undertake proper treatment of Acute Pityriasis Lichenoides

What is the Prognosis of Pityriasis Lichenoides Chronica? (Outcomes/Resolutions)

• The skin lesions in Pityriasis Lichenoides Chronica are not life-threatening, but the prognosis depends upon the severity of the condition; severe disorders are difficult to treat
• In a majority of cases, the condition is asymptomatic or mild, which subsides on its own without the requirement for any treatment
• Since pityriasis lichenoides can be a longstanding condition, some individuals may concurrently have both acute and chronic form of the condition
• Close observation and follow-up visits may be effective

Additional and Relevant Useful Information for Pityriasis Lichenoides Chronica:

• It has not been observed that dietary factors contribute to pityriasis lichenoides development
• Cleaning the skin too hard with strong chemicals or soaps may aggravate the condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition