Two Japanese cases of lichen planus pigmentosus‐inversus

Abstract

Case 1 was a 51-year-old Japanese woman. She presented with an asymptomatic brown macule located on the right axilla of 2 months' duration. The smooth macule was 2 cm in diameter with a sharp demarcation (Fig. 1A). Case 2 was a 62-year-old Japanese man. He presented with asymptomatic, symmetric, gray-brown macules located on the groin, axillae, and popliteal region of 6 months' duration. The smooth macules were several millimeters to centimeters in diameter and sharply demarcated (Fig. 1B). Oral or nail lesions, previous inflammatory processes in affected areas, and internal malignancies were absent. A causal relationship with drugs, recent sun exposure, or trauma could not be identified. Findings for work-up, including blood cell count, fasting blood sugar levels, liver function, serum electrolyte levels, serum electrophoresis, urinalysis, antinuclear antibodies, and serological examinations for human hepatitis viruses and syphilis, were within normal limits or negative. The lesions gradually disappeared without medication within 6 months. Biopsy specimens showed a lymphocytic infiltrate with basal vacuolar changes and prominent melanin incontinence in the upper dermis (Fig. 2A). The band-like lymphocytic infiltrate was moderate in Case 1 and mild in Case 2. Immunohistochemistry showed infiltrative CD8(+) T lymphocytes with keratinocytic damage, indicating cytotoxic injury of the keratinocytes (Fig. 2B). Both the epidermis and the upper dermis contained CD1a(+) cells (Fig. 2C). The keratinocytes focally and weakly expressed HLA-DR (Fig. 2D). These findings were identical in samples from both patients.

Lichen planus pigmentosus inversus

“…[1] However, Kashima et al, have described two Japanese patients with the disease. [3] We found only one report of lichen planus pigmentosus inversus in a phototype IV woman [4] and did not find previous reports of the disease in North African dark-skinned persons like our patients. Clinically, the condition is characterized by well-circumscribed violaceous-brown macules confined to intertriginous areas [1] It affects mainly the axillae and groin.…”

“…[1][2][3][4][5] In our series, all patients were women. The mean duration of symptoms before the diagnosis ranges from 2 months to 15 years.…”

A Case of Lichen Planus Pigmentosus-inversus in a Korean Patient

“…The treatment of LPP-inversus is unknown. Some authors reported that the lesions gradually disappeared without medication within several months 3 . The paraneoplastic nature of LPP was described previously 12 .…”

“…We now report a rare case of LPP-inversus in a 31-year-old woman. As far as we know, 17 cases have been reported in the world literature [1][2][3][4][5][6] .…”

Oral, Esophageal and Cutaneous Lichen Ruber Planus Controlled with Alitretinoin: Case Report and Review of the Literature

“…Zosteriform LP follows dermatomal lines and is thought to be an isotopic response to herpes zoster or at least showing antigens against varicella zoster virus in lesional skin [16,17,18]. Lichen planus pigmentosus-inversus is suggested to be a rare variant of LP limited to intertriginous regions and seems to have a short inflammatory phase with fast transformation into a long noninflammatory regressive phase with brown, nonpruritic, small inflammatory macules; scaling is limited [19,20,21,22,23,24,25]. Only one case of coexistence of classic LP and lichen planus pigmentosus-inversus has been described [26].…”