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| DERMOSCOPY IMAGE |
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| Year : 2017 | Volume
: 4
| Issue : 1 | Page : 48-49 |
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Lichen planus pigmentosus
Shekhar Neema Assistant Professor 1, Abhijeet Jha2
1 Department of Dermatology, Command Hospital, Kolkata, West Bengal, India
2 Specialist Medical Officer, Patna Medical College, Patna, Bihar, India
| Date of Web Publication | 19-Jun-2017 |
Correspondence Address:
Shekhar Neema
Department of Dermatology, Command Hospital, Kolkata 700027, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2349-5847.208354
How to cite this article:
Neema S, Jha A. Lichen planus pigmentosus. Pigment Int 2017;4:48-9 |
A 24-year-old female presented with complaints of asymptomatic dark discolouration of face and flexures of 1-month duration. There was no history of drug use or cosmetic application. Examination revealed hyperpigmented macules involving face, trunk and flexures [Figure 1]. Clinical diagnosis of lichen planus pigmentosus (LPP) was made, which was confirmed on histopathology. Dermoscopy (polarised light, 10×, Heine Delta 20) shows diffuse brown background, hem-like pattern of pigment, grey coloured dots and globules and perifollicular pigment deposition [Figure 2]. | Figure 1: Clinical image of lichen planus pigmentosus, showing hyperpigmented macules on face
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 | Figure 2: Dermoscopy (Heine Delta 20, polarised light, 10× attached with Nikon D5200 DSLR) shows diffuse brown background, hem-like pattern of pigment (blue arrow), grey coloured dots and globules (black circle) and perifollicular pigment deposition (yellow star)
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LPP is a variant of lichen planus characterised by hyperpigmented macules in sun-exposed areas and flexures, and such a condition is seen most commonly in Indian patients.[1] Dermoscopy of lichen planus is characterised by presence of white crossing line on dull red background, corresponding to Wickham striae and presence of peripheral dotted vessels.[2] Dermoscopic examination of LPP shows absence of Wickham striae and vascular features. It is characterised by the presence of pigment pattern like slate grey-to-blue dots and globules, perifollicular and peri-eccrine pigment deposition. Hem-like pigment pattern has also been described, and background colour on dermoscopy is brown.[3],[4],[5] Dermoscopy can be used to differentiate LPP from other facial melanoses like melasma and pigmented contact dermatitis. Pigmented contact dermatitis on dermoscopy shows regular distribution of brown-to-grey coloured dots and globules [Figure 3]. It can be used as an adjunct to histopathology, when the patient is not willing to undergo biopsy. With an increase in available literature and the widespread use of dermoscopy, it will be possible to differentiate various facial melanoses on the basis of dermoscopic features confidently. | Figure 3: Dermoscopy (Heine Delta 20, polarised light, 10× attached with Nikon D5200 DSLR) shows regular distribution of brown-to-grey coloured dots and globules (black circle)
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Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Kanwar AJ, Dogra S, Handa S, Parsad D, Radotra BD. A study of 124 Indian patients with lichen planus pigmentosus. Clin Exp Dermatol 2003;28:481-5.  |
| 2. | Vázquez-López F, Manjón-Haces JA, Maldonado-Seral C, Raya-Aguado C, Pérez-Oliva N, Marghoob AA. Dermoscopic features of plaque psoriasis and lichen planus: New observations. Dermatology 2003;207:151-6. |
| 3. | Güngör Ş, Topal IO, Göncü EK. Dermoscopic patterns in active and regressive lichen planus and lichen planus variants: A morphological study. Dermatol Pract Concept 2015;5:45. |
| 4. | Güngör Ş, Topal İO, Erdogan Ş, Özcan D. Classical lichen planus and lichen planus pigmentosus inversus overlap with dermoscopic features. Our Dermatol Online/Nasza Dermatol Online 2014;5. |
| 5. | Murzaku EC, Bronsnick T, Rao BK. Axillary lichen planus pigmentosus-inversus: Dermoscopic clues of a rare entity. J Am Acad Dermatol 2014;71:e119-20. |
[Figure 1], [Figure 2], [Figure 3]
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