Histopathologically, LP shows orthokeratosis
, hypergranulosis, compact and lamellated hyperkeratosis, and elongation of rete ridges.
The commonest histopathological features recognized in our study were sawtooth rete ridges/ irregular acanthosis in 85%, vacuolar degeneration of basal layer in 81.7%, band-like infiltrate in 71.7%, hyperkeratosis/ orthokeratosis
in 63.3% and wedge-shaped hypergranulosis in 61.7% of cases (Figure 2).
There was marked orthokeratosis
, focal parakeratosis, papillomatosis, acanthosis and follicular plugging with focal hypergranulosis.
A skin biopsy demonstrated psoriasiform dermatitis with alternating areas of orthokeratosis
and parakeratosis (the presence of keratinocyte nuclei within the stratum corneum where nuclei typically aren't found).
Features include mild orthokeratosis
, papillomatosis, a heavily pigmented epidermis, liquefaction degeneration of the basal layer, dermal pigmentary incontinence, melanophages, interface dermatitis, and sparse, superficial perivascular inflammation .
Excluding molluscum and verruca, there were 2 other biopsy specimens with an infectious etiology, one of which was dermatophytosis interpreted as "basketweave orthokeratosis
with parakeratosis and superficial perivascular lymphocytic infiltrate" and phaeohyphomycosis called SCC.
There was mild orthokeratosis
and a few remaining hair follicles.
The malignant transformation of OSF ranges from 7-13%.18 Changes in epithelium observed in the patients with OSF shows mostly epithelial atrophy, or epithelial hyperplasia, keratosis with either hyper orthokeratosis
or hyper parakeratosis, pyknosis in basal layer nuclei, lack of glycogen in severe Grade III scenarios, intercellular edema, hyalinization occurring close to epithelium and collagen with diverse thickness19 vacuolization of prickle-cell layer, amplified mitotic activity, Increased levels of pro-inflammatory cytokines and reduced antifibrotic interferon have also been demonstrated in patients with OSF and atypical epithelium changes20 with moderate epithelial hyperplasia eventually resulting in squamous cell carcinoma.21
Skin biopsy revealed epidermal orthokeratosis
and dermis with perivascular and periadnexal infiltrate composed by lymphocytes, neutrophils and plasma cells.
Histopathologic features are diverse degrees of orthokeratosis
and parakeratosis besides thickness of spinous layer.
Epidermal changes in LP lesions include irregular epidermal hyperplasia with a jagged "sawtooth" appearance, compact hyperkeratosis or orthokeratosis
, foci of wedge-shaped hypergranulosis, basilar vacuolar degeneration, slight spongiosis in the spinous layer, and squamatization.
Skin histopathology revealed markedly thinned out epidermis, exhibiting orthokeratosis
and complete flattening of rete pegs.