A study of 124 Indian patients with lichen planus pigmentosus

Abstract

Lichen planus pigmentosus is a fairly common disorder of pigmentation in Indians, but reports comprising a sizeable number of patients are lacking in the literature. We now describe the clinical and epidemiological features and histopathological findings for 124 lichen planus pigmentosus patients. A retrospective analysis of medical records of patients attending our centre during the past 12 years was undertaken. Of the 124 patients (56 male, 68 female), the majority (48.4%) had the disease for 6 months to 3 years. The face and neck were the commonest sites affected with pigmentation varying from slate grey to brownish-black. The pattern of pigmentation was mostly diffuse (77.4%), followed by reticular (9.7%), blotchy (7.3%) and perifollicular (5.6%). Lichen planus was noted in 19 patients with typical histopathological changes of the disorder. Lichen planus pigmentosus, a distinct clinical entity commonly encountered in the Indian population, should be considered in the spectrum of lichenoid disorders as a variant of lichen planus.

Childhood lichen planus pigmentosus

“…Kanwar et al suggested that mustard oil, amla oil, henna and hair dye could be the precipitating factors in predisposed individuals [2]. These factors could not be identified in any of our patients.…”

“…Palms, soles and nails are not affected. Although lesions are generally asymptomatic, mild pruritus and burning sensations are present in about one-third of patients [2]. In our pediatric series, the trunck was the most common site of lesions, itching was present in only one patient.…”

“…LPP is a rare variant of lichen planus, first described by Bhutani et al [1]. It generally starts in the third or fourth decade of life and there is a slight female predilection [2]. The prevalence of LPP among children with lichen planus is low ranging from 2.8 to 4% [3,4].…”

“…The disease is insidious in onset and has a chronic course [2]. The treatment is based on corticosteroids and topical tacrolimus.…”

Clinical variants of lichen planus

“…Besides extensive, perifollicular, linear or zosteriform distribution, lichen planus pigmentosus may follow the lines of Blaschko (Figure 10) or the course of the saphenous varicose veins on the legs [48,49]. Sites of predilection include intertriginous regions or the fl exures of the limbs [49,50].…”