Annular Lichenoid Dermatitis of Youth is a skin condition that primarily affects young individuals and is characterized by the appearance of circular patches with a hypopigmented center on the trunk. ICD-10 Code: L30.9.
The disease occurs between the ages of 2 and 79, with an average age of 9-10 years. It is more common in males than in females, with a ratio of 1.6:1. Etiology and pathogenesis are unknown. The pathogenesis is thought to involve a T cell-mediated cytotoxic reaction against keratinocytes. No associations have been found with medications, infections, or chemical exposures, except in one case where the condition occurred after hepatitis B immunization.
The disease begins with the appearance of erythematous macules and papules that eventually become circular patches 5 to 15 cm in diameter with a reddish-brown border and a hypopigmented center. The surface of the lesions is smooth. The patches may be single or multiple (2 to 12 elements), unilateral or symmetric. Typical sites include the lateral surfaces of the trunk, abdomen, groin, and less commonly the axillary region, limbs, and neck.
In the early stages of the disease, the peripheral border is erythematous-red, while in later stages the border becomes brown. The disease follows a chronic course, and spontaneous resolution of the rash has been observed in some cases.
- Morphea
- Hypopigmented form of Mycosis fungoides
- Vitiligo with Inflammation
- Annular erythema of infancy
- Erythema annulare centrifugum
There is no optimal treatment. Remission may be achieved with systemic and topical corticosteroids, topical tacrolimus, PUVA/narrowband UVB phototherapy, but eruptions may recur after treatment is discontinued.