Clinicopathological spectrum of pityriasis lichenoides: A case series of 19 patients

doi:10.5314/wjd.117337

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World Journal of Dermatology

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2218-6190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Dermatol. Sep 16, 2026; 12(1): 117337
Published online Sep 16, 2026. doi: 10.5314/wjd.117337

Clinicopathological spectrum of pityriasis lichenoides: A case series of 19 patients

Gökhan Kaya

Gökhan Kaya, Department of Dermatology, Sivas Medicana Hospital, Sivas 58000, Türkiye

Author contributions: Kaya G designed the study; collected, analyzed, and interpreted the data; performed the literature review; Kaya G drafted and revised the manuscript; and approved the final version of the manuscript.

AI contribution statement: An AI-assisted language tool, including ChatGPT, was used only for English language polishing, grammar correction, and improvement of academic clarity and readability. The main scientific content of the manuscript was not generated by AI. The Abstract, Introduction, Materials and Methods, Results, Discussion, and Conclusion were prepared by the author based on the original clinical data and were critically reviewed and approved by the author. An AI-assisted tool was used only for language editing, grammar correction, and improvement of academic writing style. No AI tool was used for translation or data analysis. The clinical data, descriptive statistics, and interpretation were performed and verified by the author. No AI tool was used in the study design, patient selection, clinical assessment, dermoscopic assessment, histopathological interpretation, statistical analysis, or interpretation of the results. These processes were performed by the author. None of the figures, clinical photographs, dermoscopic images, histopathological images, tables, or other visual materials included in the manuscript were generated by AI.

Institutional review board statement: The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. According to institutional policy, formal ethics committee approval was not required for this retrospective study using fully anonymized clinical data.

Informed consent statement: Written informed consent for the publication of anonymized clinical information, dermoscopic images, and histopathologic figures was obtained from all patients or their legal guardians.

Conflict-of-interest statement: The author declares no conflict of interest.

STROBE statement: The author has read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: No additional data are available.

Corresponding author: Gökhan Kaya, MD, Department of Dermatology, Sivas Medicana Hospital, Sivas 58000, Türkiye. gkhnkya@gmail.com

Received: December 8, 2025
Revised: December 19, 2025
Accepted: January 19, 2026
Published online: September 16, 2026
Processing time: 284 Days and 17.3 Hours

Abstract

BACKGROUND

Pityriasis lichenoides (PL) is considered a clinicopathologic continuum ranging from acute PL et varioliformis acuta to chronic PL chronica (PLC). Although histopathologic features are well defined, real-world clinicopathologic correlation and the adjunctive role of dermoscopy remain incompletely characterized.

AIM

To characterize the clinicopathologic spectrum of PL in a real-world adult cohort and to evaluate the adjunctive contribution of dermoscopy to disease assessment.

METHODS

We retrospectively reviewed 19 consecutive patients with biopsy-confirmed PL. Demographic data, clinical characteristics, histopathologic findings, treatment modalities, and outcomes were extracted from medical records. Dermoscopic features were analyzed in a subset of patients using a polarized handheld dermoscope. Descriptive statistical methods were applied.

RESULTS

PLC was the most frequent presentation, while a substantial proportion of patients exhibited overlapping clinicopathologic features, supporting the concept of a disease continuum. Dermoscopy, available in a subset of cases, revealed targetoid vascular patterns in acute and overlapping lesions, corresponding to histologic activity, whereas chronic lesions more commonly showed pigmentary background changes. Topical corticosteroids, narrowband ultraviolet B phototherapy, and low-dose methotrexate were the principal treatment approaches, with favourable clinical responses.

CONCLUSION

This case series highlights the dynamic and overlapping nature of PL. Dermoscopy may serve as a useful non-invasive adjunct to clinicopathologic correlation for assessing disease activity, while histopathologic confirmation remains essential.

Keywords: Pityriasis lichenoides; Pityriasis lichenoides et varioliformis acuta; Pityriasis lichenoides chronica; Dermoscopy; Clinicopathologic spectrum

Core Tip: Pityriasis lichenoides (PL) consists of overlapping clinicopathologic patterns rather than strictly separated PL et varioliformis acuta and PL chronica categories. This 19-patient series highlights the frequency of transitional forms and demonstrates how dermoscopy mirrors underlying histopathologic activity, offering a simple, noninvasive tool to distinguish acute from chronic lesions in routine practice. Recognizing these dynamic features may improve diagnostic accuracy and reduce unnecessary biopsies.