Annular lichen planus: clinical and dermoscopic features
1Department of Dermatology, Hassan II University Hospital Center, Fes, Morocco; 2Department of Urology, Hassan II University Hospital Center, Fes, Morocco
Corresponding author: Dr. Aicha Nassiri, E-mail: firstname.lastname@example.org
Submission: 19.01.2019; Acceptance: 10.04.2019
Cite this article: Nassiri A, Aqil N, Elloudi S, Baybay H, Mernissi FZ, Amrani O, Ahsaini M, Nabil A, Tazi MF, El Hassan Farih M. Annular lichen planus: clinical and dermoscopic features. Our Dermatol Online. 2019;10(4):402-403.
© Our Dermatology Online 2019. No commercial re-use. See rights and permissions. Published by Our Dermatology Online.
Annular lichen planus (ALP) is a long-recognized clinical variant of lichen planus, but is often considered uncommon in occurrence. The typical distribution and presentation of this variant have not been well described.
We sought to better define the sites affected and clinical characteristics of the annular variant of lichen planus, along with the age and race of patients affected with this disorder.
A 34-year-old man visited our department for evaluation of a three-month, mildly pruritic eruption on the genital area. Clinical examination violaceous plaques of annular morphology with central atrophyon scrotum (Fig. 1). Application of dermoscopy revealed white annular lines (the so-called Wickham striae) were dermoscopically evident, along with dotted and short linear vessels and yellow scales (Fig. 2). Since the dermoscopic presence of Wickham striae is considered highly specific of LP, the dermoscopic findings prompted us to perform a biopsy for histopathologic assessment. Histopathology, revealed hyperkeratosis, dense hypergranulosis, vacuolar degeneration of basal cell keratinocytes, band-like lymphocytic infiltration in the upper dermis, as well as presence of colloid bodies, justifying the diagnosis of LP.
|Figure 1: Violaceous plaques of annular morphology with central atrophyon scrotum.
|Figure 2: Annular Wickham striae.
Wickham striae is commonly seen on dermoscopic examination in CLP lesions and it corresponds to hypergranulosis histologically [3–6]. WS disappears after treatment, suggesting that we can use it as an activation marker in LP lesions.
In the current case, circular and radial streaming Wickham striae patterns were detected similar to the Tan et al. study. We believe that dermoscopic evaluation can be useful both in the diagnosis and follow up of LP.
ALP commonly involves the male genitalia but also has a predilection for intertriginous areas such as the axilla and groin folds. Eruptions typically consist of a few lesions localized to one or a few sites. Distal aspects of the extremities, and less commonly the trunk, may also be involved. ALP is a subtype of lichen planus that may be more common than is reflected in the literature.
The examination of the patient was conducted according to the Declaration of Helsinki principles.
1. Lallas A, Kyrgidis A, Tzellos TG, Apalla Z, Karakyriou E, Karatolias A, et al. Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea. Br J Dermatol 2012;166:1198-205.
Source of Support: Nil
Conflict of Interest: None declared.
If you wish to reuse any or all of this article please use the e-mail (email@example.com) to contact with publisher.
|Search Authors in