Lichen planus actinicus L43.3

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

actinic lichen planus; actinic lichen ruber planus; lichenoid melanodermitis; lichen planus subtropicus; lichen planus tropicalis; lichen tropicalis

Definition
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Chronic lichen planus in light-exposed skin zones, in dark-skinned children and young adults living in tropical or subtropical zones.

Occurrence/Epidemiology
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Worldwide occurrence, preferably in countries of the Middle East, furthermore in India and in African countries (e.g. Ethiopia). Isolated cases in Japan and in Central Europe.

Etiopathogenesis
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Unexplained; photodermatosis?

Manifestation
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  • Dark skinned people (skin type IV). Children are often affected. Rarely adults. Patients between 7 and 47 years of age (average age 17 years) were found in larger collectives.
  • w:m=2.5:1
  • Preferred occurrence in spring and summer.

Localization
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Light-exposed areas (91%), especially in the area of the forehead, back of the hand, also on the red of the lips of the lower lip.

Clinical features
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  • Itchy exanthema consisting of red-brown, flat papules which can confluent to form up to 5.0 cm large, mostly anular, marginal, only slightly itchy plaques.
  • The anular lichen planus actinicus is the most common with >80%.
  • In the melasma form there are non-anular, flat, brown-black spots or patches (also dyschrome form).

Histology
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Picture of the classical Lichen planus (see there).

General therapy
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Textile and physical light protection.

External therapy
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Glucocorticoids such as 0.25% prednicarbate (e.g. Dermatop ointment) or 0.1% mometasone (e.g. Ecural fat cream) can be helpful.

Internal therapy
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According to the Lichen planus. A successful therapy with antimalarial drugs has been reported several times.

Literature
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  1. Aloi F et al (1997) Actinic lichen planus simulating melasma. Dermatology 195: 69-70
  2. Bouassida S et al (1998) Actinic lichen planus: 32 cases. Ann Dermatol Venereol 125: 408-413
  3. Collgros H et al (2014) Childhood actinic lichen planus: four cases report in Caucasian Spanish children and review of the literature. J Eur Acad Dermatol Venereol doi: 10.1111/jdv.12917
  4. Dammak A et AL: (2007) Childhood actinic lichen planus (6 cases)]. Arch Pediatrist 15:111-114
  5. Dekio I et al (2010) Actinic lichen planus in a Japanese man: first case in the East Asian population. Photodermatol Photoimmunol Photomed 26:333-335
  6. Peretz E et al (1999) Annular plaque on the face. Actinic lichen planus ALP). Arch Dermatol 135: 1543-1546
  7. Ramírez P et al (2012) Childhood actinic lichen planus: successful treatment with antimalarials. Australas J Dermatol53:e10-13
  8. Skowron F et al (2002) Erythematosus actinic lichen planus: a new clinical form associated with oral erosive lichen planus and chronic active hepatitis B. Br J Dermatol 147: 1032-1034

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020