A Case Report of Isolated Pigmentosus Atrophic Lichen Planus on the Supramaxillary Area: A New Variant ？

Abstract Background: Lichen planus pigmentosus (LPP) and atrophic lichen planus (ALP) are two rare subtypes of Lichen Planus（LP）, the former is characterized by epidermal atrophy and the latter by over pigmentation. LP with both of the above manifestations has few reports and there is a lack of treatment experience. Case presentation: We herein reported a 22-year old girl with a complaint of a sharply edged brown plaque on the supramaxillary area with pain and itchy for 6 months. The skin biopsy sample from the forehead revealed thinning of epidermal ridges, liquefaction degeneration of basal cells, loss of cuticular process, lichenoid lymphocytic infiltration and incontinence of pigment as well as numerous melanophages. It was diagnosed as atrophic Lichen planus pigmentosus (ALPP), and the plaque was completely cleared after 10 months of Alternating topical corticosteroids or calcineurin inhibitors. Discussion and Conclusions: ALPP might be an independent variant of LP or LPP that causes significant epidermal atrophy in the degenerative phase. This case revealed the special type of LP and provided a clinical reference for the treatment.