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An interesting case of colocalization of segmental lichen planus and vitiligo in a 14‐year‐old boy
Author(s) -
Sardana Kabir,
Sharma Ravi C.,
Koranne R. V.,
Mahajan Supriya
Publication year - 2002
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1046/j.1365-4362.2002.01552_2.x
Subject(s) - acanthosis , medicine , hyperkeratosis , dermatology , vitiligo , histopathology , foreskin , pathology , papillary dermis , discoid lupus erythematosus , clobetasol propionate , lupus erythematosus , psoriasis , dermis , antibody , biology , immunology , genetics , cell culture
A 14‐year‐old boy had segmental vitiligo (L 3−4 ) on the right thigh and leg for 4 years, and was advised to apply topical clobetasol propionate, 0.05%, in the night, with daily sun exposure for 10 min, as he refused to comply with topical psoralens. As there was no response to therapy even after 3 months, the patient stopped the steroid cream but continued with the sun exposure. Subsequently, the patient noticed gradual‐onset, itchy, violaceous, pigmented, raised lesions superimposed on the vitiligo macules. Cutaneous examination revealed violaceous, polygonal papules, 0.5 × 0.5 cm in size, some of which coalesced to form discrete violaceous plaques, confined to areas of vitiligo, with a clear‐cut demarcation from normal skin ( Fig. 1). The scalp, palms, soles, nails, and mucosa were normal. Histopathology of the polygonal papules revealed hyperkeratosis, wedge‐shaped hypergranulosis, irregular acanthosis with saw toothing of the rete ridges, basal cell liquefaction, and a band‐like lymphocytic infiltrate ( Fig. 2), consistent with lichen planus. The patient was subsequently prescribed fluticasone propionate (0.05%) ointment once daily for the lesions of lichen planus. There was a marked improvement in the lesions of lichen planus after 1 month. 1Violaceous papules of lichen planus colocalized on vitiligo macules with associated leukotrichia seen on the right leg2Histopathology reveals hyperkeratosis, wedge‐shaped hypergranulosis, irregular acanthosis with saw toothing of the rete ridges, basal cell liquefaction, and a band‐like lymphocytic infiltrate (hematoxylin and eosin, × 40)