Annular atrophic lichen planus as a psychiatric problem

A case of annular atrophic lichen planus in a child and review of the literature

“…Lesions are clinically characterized by violaceous annular plaques with hyper‐ or hypopigmented central atrophy. While commonly distributed on the trunk and extremities, lesions arising on the mucosae, breast, genitalia, and folds have been reported 2,5‐10 . Our patient had a curious distribution in the flexural areas with lesions linearly oriented along skin cleavage lines, a pattern that may represent an isomorphic response to her previous diagnosis of pityriasis rosea.…”

“…(B) Loss of and marked reduction in the elastic tissue fibers in the papillary dermis (Verhoeff-Van Gieson stain 40X). (C) Higher power of area of biopsy with "classic" LP features (hematoxylin and eosin 40X) .folds have been reported 2,[5][6][7][8][9][10]. Our patient had a curious distribution in the flexural areas with lesions linearly oriented along skin cleavage lines, a pattern that may represent an isomorphic response to her previous diagnosis of pityriasis rosea.…”

Annular atrophic lichen planus: a review of the literature

“…Among these, several cases have not been substantiated with histological demonstration of reduced elastin fibers in the dermis. 6,11,17,18,25 Epidemiology Annular atrophic lichen planus has been described only in adults, with a male preponderance. The ages of the patients in published literature range from 21 to 77.…”

“…There is also a report of histologically unconfirmed AALP precipitated by psychosocial stress, in whom the lesions resolved after subsidence of the stress. 11 The association between lichen planus and hepatitis C has been widely reported, and there has been one case of AALP with a past history of chronic hepatitis C and current positive antibodies to hepatitis C virus. 12 Neibel et al in 2020 published a case where a patient with longstanding psoriasis and arthritis developed skin lesions suggestive of AALP.…”

“…The third case was reported in 1994 in a 65‐year‐old woman who had hyperpigmented pruritic lesions over the right elbow and left knee for 20 years, which had persisted despite application of multiple steroid preparations 4 . Since then, cases of annular atrophic lichen planus have been reported from various parts of the world 1–25 . Among these, several cases have not been substantiated with histological demonstration of reduced elastin fibers in the dermis 6,11,17,18,25 …”