Beso Adahra P, Chhangte Mary Z, Dey Biswajit, Verma Shikha
Pathology, State Cancer Institute, Gauhati Medical College and Hospital (GMCH), Guwahati, IND.
Dermatology, All India Institute of Medical Sciences, Guwahati, Guwahati, IND.
Cureus. 2024 Nov 27;16(11):e74627. doi: 10.7759/cureus.74627. eCollection 2024 Nov.
Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus, characterized by the insidious onset of dark brown to gray pigmented macules, mainly in sun-exposed areas and flexural folds. It is mainly reported in Indian, Latino, American, and Middle Eastern patients. This paper aims to document the clinicopathological characteristics of LPP.
A five-year retrospective study from January 2017 to December 2021 analyzed 42 patients diagnosed with LPP who presented with idiopathic, itchy/asymptomatic, hyperpigmented/violaceous macules at the Dermatology outpatient department. The study excluded those with melasma, post-inflammatory pigmentation, or cases where a skin biopsy was unavailable. Demographic, clinical, and histopathological data, including age, sex, residence, site of involvement, pigmentation pattern, and biopsy results, were reviewed. Routine hematoxylin-eosin staining was performed on all biopsies, with special stains such as Masson's trichrome and Congo red used in selected cases to assess fibrosis and to rule out amyloid.
The study involved 42 patients, with a higher prevalence in female patients, 29 (69.0%) compared to 13 (30.9%) male patients, and an average age of 34.2 years. The majority of patients were from urban areas (28, 66.7%), with the most common sites of involvement being the head and neck (14, 33.3%), upper limbs (nine, 21.4%), and back (eight, 19%). Pigmentation patterns were predominantly diffuse (29, 69%), with less common patterns including reticular (seven, 16.7%) and blotchy (four, 9.5%). Histopathological findings included orthokeratosis, epidermal thinning, and melanin incontinence, with Masson's trichrome staining indicating fibrosis in nine (21.4%) cases. Civatte bodies were present in 33 (78.3%) cases. Direct immunofluorescence showed IgM positivity in one of six cases.
LPP is a common pigmentary disorder characterized by persistent, asymptomatic, slaty-gray pigmentation, mainly in sun-exposed areas. Histopathologically, it features orthokeratosis, hypergranulosis, dense dermal lymphocytic infiltrate, melanin incontinence, and frequent Civatte bodies.
色素性扁平苔藓（LPP）是扁平苔藓的一种罕见变体，其特征为隐匿性出现深棕色至灰色色素沉着斑，主要见于暴露于阳光的部位和屈侧皮肤褶皱处。主要在印度、拉丁裔、美国和中东患者中报道。本文旨在记录色素性扁平苔藓的临床病理特征。
一项为期五年的回顾性研究，时间跨度为2017年1月至2021年12月，分析了42例在皮肤科门诊诊断为色素性扁平苔藓的患者，这些患者表现为特发性、瘙痒/无症状、色素沉着/紫红色斑。该研究排除了患有黄褐斑、炎症后色素沉着或无法进行皮肤活检的病例。回顾了人口统计学、临床和组织病理学数据，包括年龄、性别、居住地、受累部位、色素沉着模式和活检结果。对所有活检标本进行常规苏木精-伊红染色，在部分病例中使用特殊染色如Masson三色染色和刚果红染色来评估纤维化并排除淀粉样变。
该研究纳入42例患者，女性患者患病率较高，有29例（69.0%），男性患者13例（30.9%），平均年龄34.2岁。大多数患者来自城市地区（28例，66.7%），最常见的受累部位是头颈部（14例，33.3%）、上肢（9例，21.4%）和背部（8例，19%）。色素沉着模式主要为弥漫性（29例，69%），较少见的模式包括网状（7例，16.7%）和斑片状（4例，9.5%）。组织病理学表现包括正角化、表皮变薄和色素失禁，Masson三色染色显示9例（21.4%）有纤维化。33例（78.3%）出现基底细胞液化变性小体。直接免疫荧光显示6例中有1例IgM阳性。
色素性扁平苔藓是一种常见的色素沉着性疾病，特征为持续、无症状的石板灰色色素沉着，主要见于暴露于阳光的部位。组织病理学上，其特征为正角化、颗粒层增厚、密集的真皮淋巴细胞浸润、色素失禁和频繁出现基底细胞液化变性小体。
