Lichenoid and granulomatous dermatitis associated with atypical mycobacterium infections.
BACKGROUND
Lichenoid and granulomatous dermatitis defines a distinctive pattern of cutaneous inflammation that may be part of the morphologic spectrum of idiopathic lichenoid reactions such as lichen planus and as well may be seen with lichenoid drug reactions, endogenous T-cell dyscrasias and as a feature of certain systemic diseases especially Crohn's disease and rheumatoid arthritis.


RESULTS
We encountered three cases of lichenoid and granulomatous dermatitis in which the basis was one of primary cutaneous Mycobacterium infection. In all three cases acid fast stains revealed pathogenic organisms and as well cultures were positive for Mycobacterium kansasii in one case and Mycobacterium marinum in another. Other features included a prominent perineural and periadnexal lymphocytic infiltrate.


CONCLUSIONS
The differential diagnosis of lichenoid and granulomatous dermatitis should also encompass primary cutaneous Mycobacterium infection in addition to the other more characteristic entities associated wtih this distinctive reaction pattern. Infection with Mycobacterium induces a TH1 dominant response which would hence produce an infiltrate.
S Breza
Thomas
T
College of Medicine, The Ohio State University, Columbus, OH 43221, USA.
Magro
Cynthia M
CM
D000293:Adolescent; D000328:Adult; D003872:Dermatitis / Q000382:microbiology / Q000473:pathology*; D005260:Female; D006099:Granuloma / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D017512:Lichenoid Eruptions / Q000382:microbiology / Q000473:pathology*; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications / Q000473:pathology*; D019909:Mycobacterium kansasii / Q000302:isolation & purification; D019910:Mycobacterium marinum / Q000302:isolation & purification; D012874:Skin Diseases, Infectious / Q000209:etiology / Q000473:pathology*