Lichen planus pigmentosus (inversus) L43.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 13.02.2023

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Synonym(s)

Inverse lichen planus pigmentosus; Pigmented inverse lichen planus; Pigmented lichen planus inversus; Pigmented lichen ruber planus inversus

History
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Pock, 2001

Definition
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Rare brownish coloured variant of the classic Lichen planus, often located in the large articular flexures, in which the characteristic red-violet colour of the Lichen planus is supplemented or completely replaced by a brown colour component.

Occurrence/Epidemiology
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Has been described preferentially in Caucasians and Asians.

Worldwide, about 50 cases have been described so far (note: such numbers, however, say little about the actual prevalence of lichen planus pigmentosus inversus).

Manifestation
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Affected are adults between 40 and 60 years of age. In children this clinical picture has not been described. w>m=2:1

Localization
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Lichen planus pigmentosus occurs mainly in the intertriginous areas, such as axillary, popliteal, submammary, inguinal, vulvar and penile areas.

Clinical features
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Well-demarcated, disseminated, 0.2-0.5 cm, only slightly pruritic, purplish-brown or homogeneous brown patches are found. These may confluence to form extensive, irregularly configured, patches (see Fig.). The lesions tend to be chronic, lasting months or years.

Histology
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The histology of this lichen planus variant shows the characteristic phenomena of lichen planus, with lichenoidal infiltrates in band form, mostly only minor orthohyperkeratosis (intertrigines) and a conspicuous pigment incontinence.

Differential diagnosis
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Literature
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  1. Chen S et al (2015) Lichen planus pigmentosus-inversus: report of three Chinese cases and review of the published work. J Dermatol 42: 77-80
  2. Ghorbel HH et al (2014) Lichen planus pigmentosus inversus. Indian J Dermatol Venereol Leprol 80:580
  3. Murzaku EC et al (2014) Axillary lichen planus pigmentosus-inversus: dermoscopic clues of a rare entity. Diagnosis: lichen planus pigmentosus (LPP). J Am Acad Dermatol 71:e119-20
  4. Pock L et al (2001) Lichen planus pigmentosus inversus. J Eur Acad Dermatol Venereol 15: 452-454
  5. Schmid C et al (2018) Slate grey patches in both armpits. Dermatologist 69: 177-179
  6. Sindhura KB (2015) Lichen planus pigmentosus: a retrospective clinico-epidemiological study with emphasis on the rare follicular variant. J Eur Acad Dermatol Venereol doi: 10.1111/jdv.1345

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Erythema dyschromicum perstans;

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Last updated on: 13.02.2023