Colocalization of Lichen Planus and Vitiligo Associated With Selective IgA Deficiency

Abstract

A 28-year-old man with a diagnosis of vitiligo universalis for 6 years presented with reddish polygonal papules that had developed on his left hand first and then on his right hand. On dermatologic examination, porcelain-white hypopigmented appearance was observed all over his body, and there were violaceous, flat-topped papules changing from 2 to 5 mm in diameter localized on the hypopigmented areas of the dorsum of both hands and flexor sites (Figure 1). The physical examination and laboratory investigations including hemogram, erythrocyte sedimentation rate, serum biochemistry, and urinanalysis were normal. Antibodies to thyroid tissue, hepatitis viruses, human immunodeficiency virus, nuclear, and streptolysine were negative. Repeated IgA levels in serum were found to be decreased; however, the other immunoglobulins (IgG, IgM) and C3, C4 and cryoglobulins were in normal ranges. Histopathologic examination of the polygonal papules revealed hyperkeratosis, focal thickening of the granular layer, and irregular acanthosis in triangular saw-tooth pattern. The basal layer was invaded by the lymphocytic inflammatory infiltrate and had numerous necrotic keratinocytes. The infiltrate in the upper dermis was band-like and sharply demarcated at its lower border. There were also a few melanophages in the upper dermis. Melanocytes were decreased in number, and in some areas they were absent at the basal layer of epidermis. Clinical and histopathologic diagnosis were consistent with lichen planus and vitiligo (Figure 2).

Frontal Fibrosing Alopecia and Vitiligo: Coexistence or True Association

“…Lichen planus (LP) has been previously associated with vitiligo [23,24,25,26,27,28,29,30,31]. Furthermore, some authorities consider FFA as a variant of LPP [19,20].…”

Appearances in dermatopathology: The diagnostic and the deceptive

“…Histology of lichen planus shows irregular hyperplasia of the malpighian (spinous) layer (irregular acanthosis) in a triangular pattern giving a saw-tooth appearance [53] [ Figure 20]. Similar saw tooth appearance may be seen in some cases of lichenoid drug eruptions and in lichen planus-like keratoses.…”

Strict Anatomical Colocalization of Vitiligo and Elastolytic Granulomas

“…Multiple conditions have been described colocalized in vitiligo patches, like psoriasis or lichen planus [2,3,4,5]. However, actinic granuloma has not been described in association with vitiligo lesions so far.…”