Dermoscopic patterns in active and regressive lichen planus and lichen planus variants: a morphological study

Abstract

Background: Lichen planus (LP) is an acute or chronic inflammatory skin disorder characterized by discrete, violaceous, polygonal papules. Objective: In this study, we aimed to categorize the dermoscopic images of LP and LP variants before and after treatment. Methods: We analyzed and categorized the dermoscopic images of 255 LP lesions from 60 patients who had been clinically diagnosed with LP or LP variants and confirmed by histopathological examination. We reanalyzed and categorized the dermoscopic images of 50 lesions from fifteen patients after treatment. Results: We observed different Wickham striae (WS), pigment, and vascular patterns according to the LP variant, lesion localization and disease duration. Reticular, circular, linear, globular, radial streaming, perpendicular, and veil-like (structureless) WS patterns were detected on dermoscopic examination. Peripheral/diffuse dot globules, peripheral/diffuse peppering, perifollicular/annular, linear, reticular, circular, cobblestone, and homogeneous cloud-like pigment patterns were especially prevalent in LP pigmentosus and regressive LP lesions. As for vascular patterns, there were red dots/globules, radial linear, and peripheral homogeneous patterns described upon dermoscopic evaluation. Conclusion: Dermoscopic evaluation can be useful both in the diagnosis and follow up of LP.

Keywords

• dermoscopy
• lichen planus
• annular lichen planus
• Wickham striae
• pigment pattern