Segmental lichen planus pigmentosus: An unusual presentation

Abstract

Lichen planus pigmentosus (LPP) is a distinct clinical entity commonly encountered in the Indian population. It is considered a variant of lichen planus (LP). A 40-year-old male presented with asymptomatic hyperpigmented macules in a segmental distribution since 10 years that were clinically and histopathologically suggestive of LPP. We propose the terminology “segmental lichen planus pigmentosus” and report this unusual presentation.

Lichen planus pigmentosus and its variants: review and update

“…It may be unilateral or bilateral, distributed along one or many Blaschko′s lines . Only one case of segmental LPP in dermatome D11‐12 in the abdomen has been reported in a patient from India . It has been reported predominantly in men aged 5‐61 years, mostly in Asia .…”

“…27 Only one case of segmental LPP in dermatome D11-12 in the abdomen has been reported in a patient from India. 28 It has been reported predominantly in men aged 5-61 years, mostly in Asia. 26,27,[29][30][31] Susceptibility to developing a variant of LPP may be explained during embryogenesis through mosaicisms, which determine cell populations with different immunological and antigenic properties.…”

“…hydroquinone, Kojic acid, modified Kligman's formula (tretinoin 0.025% to 0.05%, hydroquinone 4%, 0.1% dexamethasone) 28,29,34 Inhibition of melanogenesis Increased epidermal turnover 28 At bedtime or twice daily 28 Adjuvant treatment when used in conjunction with an anti-inflammatory treatment. 28,29,34 Q-switched laser (1064 nm Nd-YAG) 32 Melanin selective photothermolysis 32 Every 3 weeks up to 4 months. 32 Low-moderate efficacy, expensive; has been used with tacrolimus in active cases.…”

Líquen Plano Pigmentoso com Apresentação Atípica Simulando uma Máscara de Dormir

“…No entanto não observamos lesões em outras áreas fotoexpostas, como tronco e membros. Embora normalmente descrita como assintomática, a lesão pode apresentar prurido leve e sensação de queimação em até 30% dos casos, 2,7,8 o que não ocorreu no presente caso. Em alguns aspectos, porém, o caso relatado destaca-se por algumas particularidades.…”

“…Não encontramos relatos de uma disposição semelhante, embora tenham sido descritas formas lineares ao longo das linhas de Blaschko, bem como lesões zosteriformes. 4,8,9 Embora não exista tratamento padrão para o LPP, 10 há relatos de uso de corticóide oral e tópico, tacrolimus tópico de forma isolada ou associado à dapsona, e também de Q--switched (QS) laser. 5,7 O uso de lasers QS são promissores, mas com resultados variados.…”