Dermoscopic patterns in active and regressive lichen planus and lichen planus variants: a morphological study

Abstract

Background: Lichen planus (LP) is an acute or chronic inflammatory skin disorder characterized by discrete, violaceous, polygonal papules.
 Objective: In this study, we aimed to categorize the dermoscopic images of LP and LP variants before and after treatment.
 Methods: We analyzed and categorized the dermoscopic images of 255 LP lesions from 60 patients who had been clinically diagnosed with LP or LP variants and confirmed by histopathological examination. We reanalyzed and categorized the dermoscopic images of 50 lesions from fifteen patients after treatment.
 Results: We observed different Wickham striae (WS), pigment, and vascular patterns according to the LP variant, lesion localization and disease duration. Reticular, circular, linear, globular, radial streaming, perpendicular, and veil-like (structureless) WS patterns were detected on dermoscopic examination. Peripheral/diffuse dot globules, peripheral/diffuse peppering, perifollicular/annular, linear, reticular, circular, cobblestone, and homogeneous cloud-like pigment patterns were especially prevalent in LP pigmentosus and regressive LP lesions. As for vascular patterns, there were red dots/globules, radial linear, and peripheral homogeneous patterns described upon dermoscopic evaluation.
 Conclusion: Dermoscopic evaluation can be useful both in the diagnosis and follow up of LP.

Actinic Lichen Nitidus with Dermoscopic Features, and Response to Hydroxychloroquine

“…14,15 However, larger studies have not noted "fern leaf " pattern in WS of LP. 16,17 Structures resembling this pattern have been described as arboriform or starburst patterns in lichenoid eruptions. 18 Hence, we conclude that "fern-leaf "pattern may be seen in LP as well as lichen nitidus, and more importantly hints towards lichenoid eruptions in general.…”

A novel dermoscopic finding—lichen planus pemphigoides

“…We postulate that the Wickham striae (WS) visualized on dermoscopy corresponds to the beaded hypergranulosis seen on histopathology, which is visible as the cleft is subepidermal in nature. WS is considered the hallmark of LP and is pathognomic of the disease 5 . The central dimple, that is, structured white globule, might correspond to the infundibulum of hair.…”

Dermoscopy of acquired pigmentary disorders: a comprehensive review

“…23 A case report by Imbern on-Moya et al describes homogenous whiteblue macules with blue-grey and brown-grey dots and globules and red lines at the periphery. 24 White striae, a common dermoscopic feature of lichen planus, is rarely seen in patients with LPPI; however, Imbern on-Moya et al highlight the possibility of occasional overlap between lichen planus and its variants. 24 In one observational study, no Wickham striae or vascularity was noted, only various pigmented patterns.…”

“…24 White striae, a common dermoscopic feature of lichen planus, is rarely seen in patients with LPPI; however, Imbern on-Moya et al highlight the possibility of occasional overlap between lichen planus and its variants. 24 In one observational study, no Wickham striae or vascularity was noted, only various pigmented patterns. 25 Pigment patterns included perifollicular, linear, and cobblestone pigmentation, as well as diffuse dots/globules, diffuse peppering, or a mix of these patterns.…”