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Lichenoid drug reactions are rare compared to typical morbilliform drug exanthema or urticaria. They are associated with specific drugs or drug families like gold, antimalarial drugs, β‑blockers and angiotensin-converting-enzyme inhibitors. Recent observations included associations with novel drugs such as biologics (e. g. tumour necrosis factor antagonists) and immune checkpoint inhibitors (anti-programme cell death protein 1 antibodies). Lichenoid drug reactions most often resemble lichen planus mainly in areas of ultraviolet-light exposed skin, but also mucosal lichen planus and even bullous lesions may occur.

Summary Blaschkitis is an acquired, rare dermatitis that follows the lines of Blaschko. Many consider blaschkitis as a variant of lichen striatus, although authors felt that it is a separate entity. A 2½-year-old girl presented with multiple grouped papules along the lines of Blaschko on her trunk. The main differences to lichen striatus are illustrated. Our case supports the hypothesis that blaschkitis is an entity of its own.

Annular lichenoid dermatitis of youth was first described by Annessi et al. in 2003. Clinical criteria are persistent erythematous macules and annular lesions with a red-brown edge and a central hypopigmentation usually found on the flanks and groins of children and adolescents. Histologically, the disease is characterized by a lichenoid interface dermatitis with necrotic keratinocytes at the tip of the rete ridges. In our case a 12-year old girl developed annular red-brown macules with papules at the borders in an inframammary location. The histology of the lesion's border showed a lichenoid lymphocytic infiltrate with apoptotic keratinocytes at the tip of rete ridges. The lesions cleared with 0.03% tacrolimus ointment. Annular lichenoid dermatitis of youth is probably a new entity in the group of lichenoid dermatoses.

We describe the case of a 51-year-old male patient with characteristic lesions of keratosis lichenoides chronica confined to the back of his hands and feet. The lichenoid papules, linear hyperkeratotic ridges and erythematosquamous plaques appeared first in early childhood and recurred after a short episode of spontaneous remission. They didn't respond to various topical treatment modalities over the years. After a local PUVA therapy all lesions disappeared with no recurrence for over two years now. Our case report indicates a new promising indication for bath-PUVA-therapy.

Scleromyxedema is a rare mucinous disease without thyroid dysfunction, associated with a monoclonal gammopathy. The deposits of mucin in the skin and other organs such as the cardiovasculary system, determine the prognosis of the disease. A 74-year old patient with initial scleromyxedema is described, in whom a pulse therapy with melphalan was initiated already in the early stages of the disease. Four cycles of melphalan in combination with prednisolon led to a complete and sofar stable remission of the disease.

Graft-versus-host disease (GvHD) is a severe complication of allogeneic stem cell transplantation. GvHD can arise at various time points: acute GvHD occurs during the first 100 days after transplantation in up to 50% of graft recipients. Chronic GvHD develops less frequently in about 30% after the 3rd month following transplantation involving the skin, the liver, the gastrointestinal tract, the eyes, and the neuromuscular apparatus. Early diagnosis of GvHD can be difficult, as drug reactions, viral infections and cutaneous reactions to radiation therapy may have clinical and histological similarities. In this review, the various cutaneous manifestations of GvHD, the histopathologic features, prophylaxis, and therapies of acute and chronic GvHD are discussed according to the recent literature.

E. Grosshans and L. Marot first described blaschkitis in 1990 as a linear inflammatory dermatitis following lines of Blaschko in an adult patient. We report another case which occurred in a 38-year-old woman who developed an extensive, linear, erythematosquamous dermatitis involving the face, all limbs and the trunk. The patient's serum tested positive for antinuclear antibodies at a dilution of 1:640. The lesions regressed spontaneously within 4 weeks. Blaschkitis is a distinct entity which corresponds neither to a known inflammatory dermatitis in the lines of Blaschko nor to an hamartoma nor to an X-linked disease. Cutaneous antigenic mosaicism, the expression of which might be induced by a viral infection, could trigger this localized inflammatory T-cell response. This hypothesis relates blaschkitis to other cutaneous autoimmune diseases, as does the presence of antinuclear antibodies. We therefore suggest renaming this type of inflammatory dermatitis Grosshans-Marot disease in honour to the dermatologists who first described the entity.

A 64-year-old woman presented with extensive erythematous papulosquamous lesions along the lines of Blaschko on the right half of the trunk and the right leg. The clinical and histological features led to the diagnosis of lichen striatus, a dermatosis which usually appears during childhood. Treatment with acitretin led to marked improvement. Lichen striatus and its differential diagnoses--particularly "blaschkitis of adulthood" as first described in 1990--are discussed.

In 1986 Rongioletti introduced the term acral persistent papular mucinosis for persistent papules on the dorsum of the hands and distal forearms. Skin specimens reveal mucin deposits which resemble those in lichen myxedematosus (LM). Laboratory results are usually unremarkable. Our 54-year-old female patient showed a 2 1/2 year history of skin lesions in the typical acral distribution pattern. This entity appears to be an acral papular subtype of LM. In the classification of LM, acral papular lichen myxedematosus should replace the discrete papular form. This latter form has been well known for many years, but is not sufficiently definable and is of secondary clinical importance.

Der Lichen aureus ist eine besondere, lokalisierte Variante der Purpura pigmentosa chronica. Wir beschreiben hier eine Patientin mit einer ungewohnlichen, ausgedehnten, striaren bzw. segmental-zosteriformen Anordnung eines Lichen aureus an der linken unteren Extremitat und am Unterbauch. Histologisch zeigte sich das charakteristische Bild eines dichten bandformigen lymphomononuklearen Infiltrats mit massiven Hamosiderinablagerungen. Eine infektiose oder medikamentose Ursache lies sich nicht beweisen, und die Erkrankung sprach erwartungsgemas nur verhalten auf eine lokale Therapie mit Glukokortikoiden an.

Macular amyloidosis (MA) and lichen amyloidosus (LA) are the two major variants of the primary cutaneous amyloidoses which present with severe and therapy resistant itching. Various therapeutic modalities such as antihistamines, intralesional injection or topical application of corticosteroids, etretinate, UVB irradiation and dermoabrasion have been employed with variable success. Recently, in a few case reports authors have observed encouraging beneficial clinical effects by using topical dimethyl sulphoxide (DMSO). In our study 10 patients with either MA or LA or biphasic amyloidosis were treated with a 50% solution of DMSO in water. 9 of them showed marked clinical improvement at the end of 6-20 weeks of treatment. Degranulation and depletion of the mast cells by DMSO is the most probable explanation for the rapid improvement of itching beginning within the first week of therapy. Remarkable flattening of the lichenoid papules which was obtained within 11 weeks of treatment is interpreted as a result of the improvement of itching and the related scratch effect. Histological examination after treatment revealed no disappearance of amyloid deposits in the papillary dermis. In the follow-up period relapses of itching and papules were observed. Therefore further studies are needed to find out the optimal procedure of therapy.

Juvenile papular dermatosis is characterized by hypopigmented lichenoid flat papules with predilection for the dorsa of the hands, the elbows and the knees. The disease affects children in the summer months. Changes observed in biopsy specimens show hyperkeratosis, a moderate degree of acanthosis and a lymphocytic perivascular infiltrate in the upper dermis. The pathogenetic influence of such rough materials as sand and wool and of photosensitivity in atopic patients is suggested. We report on a 9-year-old boy who developed lesions of juvenile papular dermatitis (especially severe on the face and the back of the knee) and extreme pruritus for the first time in summer 1994.

We report on a 78-year-old woman with a 47-year-history of lichen sclerosus et atrophicus of the vulva on which squamous cell carcinoma developed. The lesion started as a small nodule that increased gradually in size and became eroded. The tumour and the inguinal lymph nodes on both sides were excised. Physical examination, chest X-ray and sonography of the abdomen 15 months later showed no local recurrence or distant metastases. Lichen sclerosus et atrophicus of the vulva should be considered a possible precancerous condition.