Dermoscopic approach to hyperpigmented lesions in skin of color

Atypical distribution of lichen planus pigmentosus: Pigmentation of the nose and ears

“…Dermoscopy in LPP demonstrates pigmented globules, whose color ranges from dark brown to bluish-gray, arranged in diffuse, dotted, annular, hem-like, arcuate, speckled, and perifollicular patterns. Wickham striae and vascular features are absent, unlike in classical lichen planus [3,4]. Histopathology reveals a vacuolar interface dermatitis with band-like lichenoid or perivascular lymphocytic infiltrates in the papillary dermis, as well as superficial pigmentary incontinence and melanophages [3,5].…”

“…Wickham striae and vascular features are absent, unlike in classical lichen planus [3,4]. Histopathology reveals a vacuolar interface dermatitis with band-like lichenoid or perivascular lymphocytic infiltrates in the papillary dermis, as well as superficial pigmentary incontinence and melanophages [3,5]. The differential diagnoses are melasma, ashy dermatoses, often present on the trunk and limbs, ochronosis, and post-inflammatory hyperpigmentation.…”