Lichen Planus Pemphigoides: A Case Report

Abstract

Lichen planus pemphigoides describe a rare subset of patients who usually have typical lichen planus then develop blistering on their lichen planus lesions and in normal skin. Less commonly the blistering antedates the lichen planus. They clinically appear to be a combination of lichen planus and bullous pemphigoid. Oral disease may occur and resemble either lichen planus or bullous pemphigoid. Lichen planus pemphigoides has been triggered by medication & PUVA. Pruritus may be severe and lesions may evolve to resemble pemphigoid nodularis. Histopathologically lichen planus lesions show lichen planus and bullous lesion shows the features of bullous pemphigoid. DIF is positive in a linear pattern with IgG and C3 along the basement membrane zone, at the roof of saline split skin. The antigen targeted by the autoantibody in Lichen planus pemphigoides is located in the same region as the bullous pemphigoid antigen (at the basal hemidesmosomes). Lichen planus pemphigoides tends to follow a benign and chronic course, even when compared to bullous pemphigoid. We diagnosed a case of Lichen planus pemphigoides on the basis of history, clinical examination, histopathology & DIF. The patient was treated with systemic & topical steroid, Dapsone. After 2 month of treatment steroid was withdrawn, but Dapsone continue with no relapse.To our knowledge this is the first diagnosed and treated case in this hospital.