Lichen aureus L81.92

Rarer, therapy-refractory variant of Purpura pigmentosa progressiva with often segmentally arranged lichenoid papules, probably caused by a chronic recurrent vasculopathy.

Unexplained, possibly drug-induced, infections, traumas, also occurring on the floor of a CVI. Relationships to the Lichen palnus or to a Mycosis fungoides are denied by many authors. To what extent a lichen aureus can appear as a clinical precursor of a linear morphea is reserved for further observations(Johnston M et al. 2019)

Mostly young men, rarely children

legs, arms, more rarely: hands, trunk

Often segmental, usually unilaterally arranged, small blue-reddish to reddish-brownish, lichenoid, occasionally itchy papules or plaques with surrounding fine, reddish or yellowish margins. Further described are areal, brownish red, mostly blurred spots or atrophic plaques, the colour nuances of which can also slide into yellowish-brownish tones depending on the acute state.

With normal surface epithelium, a band-like lymphohistiocytic infiltrate is found in the upper dermis. Furthermore, perivascular, periadnexal and perineural lymphohistiocytic infiltrates in the middle dermis with erythrocyte extravasations to varying degrees. Hemosiderin in the tissue and in macrophages.

Drug exanthema; Dermatite lichénoide purpurique et pigmentée; Lichen striatus;

Chronic course, resistance to therapy, (spontaneous) regression after months to years.

1. Aoki M et al (2002) Lichen aureus. Cutis 69: 145-148
2. Böhler-Sommeregger K et al (1987) Lichen aureus. Act Dermatol 13: 273-277
3. Brown-Falco O et al (1989) Lichen aureus zosteriformis. dermatologist 40: 370-372
4. Johnston M et al (2019) Linear morphea overlying site of previous lichen aureus in a pediatric patient. Pediatric Dermatol 36:e91-e92.
5. Li Q et al (2003) Chronic vulvar purpura: persistent pigmented purpuric dermatitis (lichen aureus) of the vulva or plasma cell (Zoon's) vulvitis? J Cutan catholic 30: 572-576
6. Martin RH (1958) Case for diagnosis. Trans St John's Hosp Dermatol Soc 40: 98
7. Zhao Yu-Kun et al (2014) Segmental lichen aureus in a young woman with spontaneous improvement. JDDG 12: 260-262