Description
A 55-year-old woman presented with a 3-month history of violaceous, itchy, flat-topped papules located on her forearms (figure 1), trunk and legs. There was no history of drug intake.
Figure 1
Clinical presentation of active lichen planus. Purplish-violaceous, polygonal-shaped, flat-topped small papules located on the forearms. The surface is slightly shiny showing a network of fine white lines ('Wickham's striae'). Coalescence into linear plaques is related to Koebner phenomenon. Excoriations are also present.
The forearm lesions were studied with a hand-held dermoscope ( 10; Heine Optotechnik, Germany) revealing yellow dots and Wickham striae (WS), surrounded by radial linear and dotted capillaries (figure 2). Mature lesions also revealed peripheral pigmented dots and diffuse scale distribution (figure 3). The diagnosis of lichen planus (LP) was considered after clinical and dermoscopic correlation, and confirmed histologically. Screening for hepatitis B...
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