INTRODUCTION
Linear lichen planus pigmentosus (LPP) of the face is a rare acquired variant of lichen planus, with only a few cases published in the literature.1 It is an inflammatory condition with unknown etiology, characterized by blue-gray hyperpigmented macules, and tends to affect sun-exposed areas of the head and neck.1-4 The pathophysiology of linear LPP is poorly understood, though it is postulated to be caused by T-lymphocyte autoimmunity against keratinocytes.5-7 Linear LPP more frequently affects middle aged women and skin phototypes III to VI.1,3 It has also been proposed to be associated with hepatitis C infection, ultraviolet (UV) radiation, and contact allergens.1,3,8 Treatment for linear LPP is difficult and there is no established first-line therapy; however, tacrolimus ointment, topical corticosteroids, and various systemic agents are effective in improving the appearance.3,8,9
Linear LPP tends to show a unilateral distribution and can present along the lines of Blashko and in areas of koebnerization. Prior reports have characterized linear LPP that follows the lines of Blashko as more commonly affecting the trunk. Only 3 cases of linear LPP of the face have been reported in the literature.1
We present 3 cases of linear lichen planus pigmentosus of the forehead along the lines of Blashko, a unique presentation of linear LPP of the face. One of our cases also provides supporting evidence for tacrolimus as a preferred therapy. To our knowledge, this case series is the largest case series of linear LPP of the forehead to be reported. We review the literature, clinical presentation, and management options available for this entity.
Linear LPP tends to show a unilateral distribution and can present along the lines of Blashko and in areas of koebnerization. Prior reports have characterized linear LPP that follows the lines of Blashko as more commonly affecting the trunk. Only 3 cases of linear LPP of the face have been reported in the literature.1
We present 3 cases of linear lichen planus pigmentosus of the forehead along the lines of Blashko, a unique presentation of linear LPP of the face. One of our cases also provides supporting evidence for tacrolimus as a preferred therapy. To our knowledge, this case series is the largest case series of linear LPP of the forehead to be reported. We review the literature, clinical presentation, and management options available for this entity.
CASE REPORTS
Case 1
A 48-year-old man presented to the Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine with a chief concern of 5 months of forehead discoloration (Figure 1). He denied itch, pain, and preceding trauma to the forehead. He had been using
Jamaican black
A 48-year-old man presented to the Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine with a chief concern of 5 months of forehead discoloration (Figure 1). He denied itch, pain, and preceding trauma to the forehead. He had been using
Jamaican black
