An interesting case of colocalization of segmental lichen planus and vitiligo in a 14‐year‐old boy

Abstract

A 14‐year‐old boy had segmental vitiligo (L3−4) 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. 1 Violaceous papules of lichen planus colocalized on vitiligo macules with associated leukotrichia seen on the right leg 2 Histopathology 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)

Frontal Fibrosing Alopecia and Vitiligo: Coexistence or True Association

“…Lichen planus (LP) has been previously associated with vitiligo [23,24,25,26,27,28,29,30,31]. Furthermore, some authorities consider FFA as a variant of LPP [19,20].…”

“…Additionally, there are several reports describing lesions of LP that developed mainly over sun-exposed vitiliginous skin [25,26,29,30,31]. Extrapolating this to FFA, actinic damage in vitiliginous skin may trigger initiation of FFA on vitiligo-affected skin.…”

Colocalization of Vitiligo and Lichen Planus on Scrotal Skin: A Finding Contrary to the Actinic Damage Theory

“…A case of vitiligo developing around the lesions of LP is an example of this hypothesis [3] . Other evidence that suggests a possible common pathogenetic mechanism for the association of vitiligo and LP is colocalization of these disorders [6][7][8] .…”

“…The last example of colocalized vitiligo and LP was a 14-yearold boy who developed LP lesions on the previous vitiligo lesions present for 4 years, which were located on both his legs [8] .…”

Pleomorphic cutaneous sarcoidosis confined to lesions of vitiligo vulgaris in a patient with type 1 diabetes mellitus

“…Strict anatomical co-localization of psoriasis and lichen planus on lesions of VV have been reported in literature with hypothesis suggested by the authors. [6][7][8][9][10] Anstey et al and Sardana et al suggested that photodamage within the vitiliginous skin may alter the expression of antigens identified by infiltrating T cells in lichen planus. [9,10] Julian et al proposed that some cellular injury in vitiliginous skin might lead to immune mechanisms causing Koebner's phenomenon.…”