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Lichen planus pigmentosus
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Lichen planus pigmentosus

Contributors: Alex Derstenfeld, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Lichen planus pigmentosus (LPP, not to be confused with lichen planopilaris) is a rare variant of lichen planus (LP). Classically, it presents as patchy brown or gray pigmentation in sun-exposed areas. Rare variant presentations include lichen planus pigmentosus inversus (LPP-inversus) and LPP along Blaschko lines. Although LPP most often exists in isolation, it occurs with other forms of LP in around 20% of cases, including lichen planopilaris, oral LP, and classic LP.

LPP is most common in people with intermediate and darker skin colors, is rare in people of Northern European descent, and has a slightly higher prevalence in women than men. The condition most commonly occurs between the third and fifth decades of life. The time course of LPP is unpredictable. The condition is most often described as chronic and progressive with periods of remission and exacerbation.

In LPP, CD8+ autoreactive T cells attack epidermal keratinocytes, leading to an inflammatory lichenoid response. The initial inflammatory infiltrate resolves relatively quickly and leaves behind marked dermal pigmentary incontinence.

LPP has been shown to be more prevalent in patients with hepatitis C virus, diabetes, thyroid disease, and dyslipidemia. Furthermore, two Indian studies have linked LPP to the use of mustard oil, amla oil, henna, hair dye, and nickel.

Codes

ICD10CM:
L43.8 – Other lichen planus

SNOMEDCT:
717061002 – Lichen planus pigmentosus

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Last Reviewed:11/04/2019
Last Updated:01/25/2021
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Lichen planus pigmentosus
Lichen planus pigmentosus (Classic) : Face, Neck, Oval configuration, Photodistributed, Hyperpigmented macules, Hyperpigmented patches, Arms
Copyright © 2021 VisualDx®. All rights reserved.