Lichen planus actinicus L43.3

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

The incidence of actinic lichen planus has been estimated at 1 case per million population per year (Bouassida S et al. 1998).

Worldwide occurrence, preferentially in Middle Eastern countries, further in India and in African countries (e.g. Ethiopia).

Isolated cases in Japan and in Central Europe.

Unresolved.

Genetic factor: Etiopathonetically, reports of familial occurrence of lichen ruber actinicus are noteworthy (Gökşin Ş et al. 2022).

Immunologic factor (associated occurrence with immune disease): co-occurrence with vitiligo has been reported (Baghestani S e al. 2013).

Dark-skinned people (skin type IV) preferred.

Children are frequently affected. Rarely adults. In larger collectives, patients were found between 7 and 47 years of age (average 17 years).

w:m=2.5:1

Preferential occurrence in spring and summer.

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.

Itchy exanthema consisting of red-brown, flat papules that may confluence to form mostly anular, marginal, only mildly pruritic plaques up to 5.0 cm in size.

Anular lichen planus actinicus is the most common, accounting for >80%.

In the melasma form, non-anular, two-dimensional, brown-black spots or patches are found (also dyschromic form).

Picture of the classical Lichen planus (see there).

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

Chronic course is the rule. Worsening after sun exposure. When healed, the foci resemble melasma.

1. Aloi F et al (1997) Actinic lichen planus simulating melasma. Dermatology 195: 69-70
2. Baghestani S e al. (2013) Familial colocalization of lichen planus and vitiligo on sun exposed areas. Ann Dermatol 25:223-225.
3. Bouassida S et al (1998) Actinic lichen planus: 32 cases. Ann Dermatol Venereol 125: 408-413.
4. 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
5. Dammak A et AL: (2007) Childhood actinic lichen planus (6 cases)]. Arch Pediatr 15:111-114
6. 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.
7. Gökşin Ş et al (2022) Familial actinic lichen planus: three cases from the Same Family. Ann Dermatol 34: 370-373.
8. Peretz E et al (1999) Annular plaque on the face. Actinic lichen planus ALP). Arch Dermatol 135: 1543-1546.
9. Ramírez P et al (2012) Childhood actinic lichen planus: successful treatment with antimalarials. Australas J Dermatol53:e10-13
10. Skowron F et al (2002) Erythematosus actinic lichen planus: a new clinical form associated with orally erosive lichen planus and chronic active hepatitis B. Br J Dermatol 147: 1032-1034.