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AlNodali N, Aleissa AI. A Case of Unilateral Blaschko-Linear Lichen Planus Pigmentosus in a Seven-Year-Old Female: A Rare Presentation. Cureus 2023; 15:e41354. [PMID: 37546110 PMCID: PMC10399280 DOI: 10.7759/cureus.41354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Lichen planus pigmentosus (LPP) is a rare form of lichen planus that typically affects middle-aged people with darker-pigmented skin. LPP is associated with a longer clinical course than classical lichen planus, which distinguishes it clinically. Its occurrence in children is uncommon, with few reported cases in this population in the literature. We report a rare presentation of unilateral blaschkoid LPP in a seven-year-old Saudi Arabian female patient.
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Almudimeegh A, Habib M, Alsuhaibani O, Alkhudhayri N. Unilateral Lichen Planus Pigmentosus with Blaschko's Line Distribution: A Case Report. Case Rep Dermatol 2023; 15:66-70. [PMID: 37124708 PMCID: PMC10134050 DOI: 10.1159/000529632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/31/2023] [Indexed: 05/02/2023] Open
Abstract
Lichen planus pigmentosus (LPP) is a distinctive variant of lichen planus described for the first time in 1974. A wide range of presentations and distribution patterns have been reported, mainly presenting as dark brown hyperpigmented macules and patches, typically involving sun-exposed areas such as the face, neck, and flexural folds. It is more common in dark-skinned patients with a female predominance. Infrequently, LPP may present as a Blaschkoid distribution, with only a few cases reported in the medical literature. We report an unusual case of LPP that developed with a unilateral Blaschkoid distribution on the left side of the trunk in a 32-year-old female following weight reduction surgery.
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Affiliation(s)
| | - Mohammed Habib
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Merio L, Tounkara TM, Battesti G, Cordoliani F, Arsouze A, Bagot M, Battistella M, Petit A. Blaschko-linear lichen planus of the face: A retrospective study of 6 cases and a literature review. Ann Dermatol Venereol 2021; 149:112-118. [PMID: 34538651 DOI: 10.1016/j.annder.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/07/2021] [Accepted: 08/02/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND METHODS Different clinical and histological variants of lichen planus (LP) exist, such as lichen planopilaris, pigmentosus, linear, or atrophic LP. Recently, some cases came to our attention of hyperpigmented and atrophic linear lesions of the face with lichenoid histology, suggesting a combination of these different variants. We carried out a single-center, retrospective descriptive study of 6 similar cases selected from our database and compared them with a literature review. RESULTS There were 4 males and 2 females of mean age 42 years. Each had linear lesions located on one side of the face. All lesions were initially itchy; they appeared hyperpigmented in all patients and atrophic in 5 cases. Biopsies indicated lichen planopilaris in 5 patients, with deep peri-eccrine involvement in 4 of them. Only 2 of the 6 patients had extra-facial lesions. DISCUSSION AND LITERATURE REVIEW We found 24 cases in the literature having similar clinical and histological aspects. Men aged around 37 years seemed particularly affected. An atrophic course was noticed in 10 patients. Such a clinicopathological picture may suggest differential diagnoses like lichen striatus, lupus erythematosus, lichen sclerosus atrophicus, or Moulin's linear atrophoderma. Early histopathological examination could be of precious assistance in allowing the initiation of effective treatment immediately as of the initial inflammatory phase, thereby limiting the risk of cosmetic sequelae such as atrophy or residual pigmentation. CONCLUSION We describe a form of facial lichen planus that is highly particular in terms of its follicular tropism, its blaschkoid distribution, its pigmented character, and its atrophic progression.
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Affiliation(s)
- L Merio
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - T-M Tounkara
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France; Gamal-Abdel-Nasser University of Conakry, Conakry, Guinea
| | - G Battesti
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - F Cordoliani
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - A Arsouze
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - M Bagot
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - M Battistella
- Department of Pathology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - A Petit
- Department of Dermatology, Saint-Louis Hospital, University of Paris, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
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Daroach M, Guliani A, Keshavmurthy V, Vishwajeet V, Saikia UN, Kumaran MS. Follicular lichen planus pigmentosus in blaschkoid pattern: Superimposed segmental mosaicism. Indian J Dermatol Venereol Leprol 2020; 86:305-307. [PMID: 32242870 DOI: 10.4103/ijdvl.ijdvl_680_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Manju Daroach
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankur Guliani
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinay Keshavmurthy
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikarn Vishwajeet
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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5
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Arpa MG, Flores-Terry MÁ, González-Ruiz L, Villasanti-Rivas N. Linear facial lichen planus pigmentosus. An Bras Dermatol 2019; 94:378-379. [PMID: 31365680 PMCID: PMC6668947 DOI: 10.1590/abd1806-4841.20198537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/17/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Mónica García Arpa
- Department of Dermatology, Hospital General Universitario de Ciudad
Real, Ciudad Real, Spain
| | | | - Lucía González-Ruiz
- Department of Dermatology, Hospital General Universitario de Ciudad
Real, Ciudad Real, Spain
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6
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Vinay K, Kumar S, Bishnoi A, Aggarwal D, Radotra BD, Parsad D, Sendhil Kumaran M. A clinico‐demographic study of 344 patients with lichen planus pigmentosus seen in a tertiary care center in India over an 8‐year period. Int J Dermatol 2019; 59:245-252. [DOI: 10.1111/ijd.14540] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Divya Aggarwal
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Bishan Dass Radotra
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
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7
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Hardy C, Glass J. Linear Lichen Planus in the Setting of Annual Vaccination. Mil Med 2019; 184:e467-e469. [PMID: 30215756 DOI: 10.1093/milmed/usy234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/15/2018] [Indexed: 11/13/2022] Open
Abstract
Vaccines have a well-demonstrated therapeutic benefit. However, the spectrum of potential dermatologic vaccine side effects ranges from localized skin irritation to acute and delayed response. Currently, there are limited published data correlating dermatoses with alterations in the immune system following vaccination. The mechanism by which group A beta-hemolytic streptococci may precede the manifestation of guttate psoriasis is included as a mechanism foundation as we further describe the immunopathogenesis of immune-mediated linear dermatoses. We present a rare case of linear lichen planus following intramuscular influenza vaccination, not associated with an injection site reaction. Immune-related dermatoses may be underreported, and a vaccine history should be considered in all patients with a skin condition that is otherwise attributed as idiopathic.
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Affiliation(s)
- Curtis Hardy
- Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA
| | - Jonathan Glass
- Dartmouth-Hitchcock, One Medical Center Drive, Lebanon, NH
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8
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Bishnoi A, Parsad D, Saikia UN, Kumaran MS. Coexistence of Linear and Inversus Variants of Lichen Planus Pigmentosus: A Rare Occurrence. Indian J Dermatol 2019; 64:152-154. [PMID: 30983614 PMCID: PMC6440191 DOI: 10.4103/ijd.ijd_599_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lichen planus pigmentosus (LPP) is a rare disorder affecting primarily the people with ethnic skin. It results in hyperpigmentation of sun-exposed sites along with the involvement of flexures. In accordance with clinical patterns, different variants such as diffuse, blotchy, reticulate, and perifollicular have been described. Rare variants such as flexural (inversus), mucosal, linear, and zosteriform have been reported scarcely. Inversus LPP refers to the involvement of major flexures such as inframammary area, axillae, and groins in the absence of involvement of photo-exposed sites. We present an unusual case presenting with coexisting linear and inversus variants of LPP.
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Affiliation(s)
- Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Daroach M, Manjunath S, Kumaran SM. A Rare Concomitance of Two Blaschkoid Pigmentary Disorders: A Juggle of Pigmentary Mosaicism. Indian Dermatol Online J 2019; 10:75-76. [PMID: 30775307 PMCID: PMC6362744 DOI: 10.4103/idoj.idoj_218_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Manju Daroach
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Seema Manjunath
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sendhil Muthu Kumaran
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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10
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Gutierrez D, Gaulding J, Motta Beltran A, Lim H, Pritchett E. Photodermatoses in skin of colour. J Eur Acad Dermatol Venereol 2018; 32:1879-1886. [DOI: 10.1111/jdv.15115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 05/30/2018] [Indexed: 02/06/2023]
Affiliation(s)
- D. Gutierrez
- The Ronald O. Perelman Department of Dermatology New York University New York NY USA
| | - J.V. Gaulding
- Department of Dermatology Henry Ford Hospital Detroit MI USA
| | | | - H.W. Lim
- Department of Dermatology Henry Ford Hospital Detroit MI USA
| | - E.N. Pritchett
- Department of Dermatology Henry Ford Hospital Detroit MI USA
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11
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Polat M, Tuman B, Özyalvaçlı G. A case of unilateral blaschkoid lichen planus pigmentosus. An Bras Dermatol 2017; 92:442-443. [PMID: 29186276 PMCID: PMC5514604 DOI: 10.1590/abd1806-4841.20175664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 10/27/2016] [Indexed: 11/22/2022] Open
Affiliation(s)
- Mualla Polat
- Faculty of Medicine, Department of Dermatology, Abant Izzet Baysal University - Bolu, Turkey
| | - Bengü Tuman
- Faculty of Medicine, Department of Dermatology, Abant Izzet Baysal University - Bolu, Turkey
| | - Gülzade Özyalvaçlı
- Faculty of Medicine, Department of Pathology, Abant Izzet Baysal University - Bolu, Turkey
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12
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Robles-Méndez JC, Rizo-Frías P, Herz-Ruelas ME, Pandya AG, Ocampo Candiani J. Lichen planus pigmentosus and its variants: review and update. Int J Dermatol 2017; 57:505-514. [DOI: 10.1111/ijd.13806] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 07/19/2017] [Accepted: 09/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Juan Carlos Robles-Méndez
- Department of Dermatology; Hospital Universitario “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Nuevo León México
| | - Paulina Rizo-Frías
- Department of Dermatology; Hospital Universitario “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Nuevo León México
| | - Maira Elizabeth Herz-Ruelas
- Department of Dermatology; Hospital Universitario “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Nuevo León México
| | - Amit G. Pandya
- Department of Dermatology; University of Texas Southwestern Medical Center; Dallas TX USA
| | - Jorge Ocampo Candiani
- Department of Dermatology; Hospital Universitario “Dr. José Eleuterio González”; Universidad Autónoma de Nuevo León; Nuevo León México
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13
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Weston G, Payette M. Update on lichen planus and its clinical variants. Int J Womens Dermatol 2015; 1:140-149. [PMID: 28491978 PMCID: PMC5418875 DOI: 10.1016/j.ijwd.2015.04.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 04/02/2015] [Accepted: 04/06/2015] [Indexed: 12/24/2022] Open
Abstract
Lichen planus (LP) is an inflammatory skin condition with characteristic clinical and histopathological findings. Classic LP typically presents as pruritic, polygonal, violaceous flat-topped papules and plaques; many variants in morphology and location also exist, including oral, nail, linear, annular, atrophic, hypertrophic, inverse, eruptive, bullous, ulcerative, lichen planus pigmentosus, lichen planopilaris, vulvovaginal, actinic, lichen planus-lupus erythematosus overlap syndrome, and lichen planus pemphigoides. Clinical presentation of the rarer variant lesions may be largely dissimilar to classic LP and therefore difficult to diagnose based solely on clinical examination. However, histopathological examination of LP and LP-variant lesions reveal similar features, aiding in the proper diagnosis of the disease. Management of LP and LP variants aims to control symptoms and to decrease time from onset to resolution; it often involves topical corticosteroids, but varies depending on the severity and location of the lesion. The literature contains an array of reports on the variations in presentation and successful management of LP and its variants. A familiarity with LP and its variants is important in achieving timely recognition and management of the disease.
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Affiliation(s)
- Gillian Weston
- University of Connecticut School of Medicine, Farmington, CT
| | - Michael Payette
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT
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Torrelo A, Azorín D, Noguera L, Hernández-Martín A, Happle R, Requena L. Segmental prurigo pigmentosa. Pediatr Dermatol 2014; 31:523-5. [PMID: 24846714 DOI: 10.1111/pde.12349] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Prurigo pigmentosa (PP) is an inflammatory skin disease of unknown origin. The skin lesions in PP are symmetrically distributed on the back, chest, and neck. Pruritus is a prominent feature in many cases. We report on a 13-year-old girl with lesions typical of PP in a segmental arrangement on her left chest. A segmental distribution of PP has not been previously reported.
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Affiliation(s)
- Antonio Torrelo
- Department of Dermatology, Hospital del Niño Jesús, Madrid, Spain
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15
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Han XD, Goh CL. A case of lichen planus pigmentosus that was recalcitrant to topical treatment responding to pigment laser treatment. Dermatol Ther 2014; 27:264-7. [DOI: 10.1111/dth.12134] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Xiuhui Debra Han
- Department of Dermatology; National Skin Centre; Singapore Singapore
| | - Chee Leok Goh
- Department of Dermatology; National Skin Centre; Singapore Singapore
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16
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Bogun Y, Scolyer RA, Guitera P. Asymptomatic linear pigmentation of the skin. Linear lichen planus pigmentus (LPP). Int J Dermatol 2013; 52:935-7. [PMID: 23869926 DOI: 10.1111/ijd.12015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yvonne Bogun
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.
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Kumar S, Okade R, Rahman YA. Unilateral Blaschkoid lichen planus in successive pregnancies. Dermatol Reports 2011; 3:e35. [PMID: 25386287 PMCID: PMC4211518 DOI: 10.4081/dr.2011.e35] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 09/06/2011] [Indexed: 11/30/2022] Open
Abstract
A number of genetic, congenital and acquired dermatoses have been known to follow Blaschko's lines. A common disorder like lichen planus can very rarely present with pruritic lesions in atypical patterns such as unilateral distribution, painful eruptions and along Blaschko's lines. Various triggering factors varying from viral infections and vaccinations to trauma have been implicated in lichen planus. We describe a female patient in the second trimester of her second pregnancy who developed unilateral lichen planus along Blaschko's lines during both pregnancies. No case of lichen planus along Blaschko's lines recurring during pregnancy is reported so far. Could pregnancy itself be a contributory factor towards onset of lichen planus in this case?
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Affiliation(s)
- Shiva Kumar
- Department of Dermatology, Venereology and Leprosy, Sri DevarajUrs, Medical College, Tamaka, Kolar, India
| | - Rajendra Okade
- Department of Dermatology, Venereology and Leprosy, Sri DevarajUrs, Medical College, Tamaka, Kolar, India
| | - Yasmin Abdul Rahman
- Department of Dermatology, Venereology and Leprosy, Sri DevarajUrs, Medical College, Tamaka, Kolar, India
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