INTRODUCTION
Lichen planus pigmentosus (LPP) is a rare variant of lichen planus (LP) characterized by persistent dark brown, black, or slate gray coalescing macules primarily affecting sun-exposed areas, including the face, neck, and upper extremities.1,2 This condition was first recognized and reported in India.3 However, since its discovery, it has been reported in various other ethnicities with diverse skin types, including patients of Southeast Asian, Hispanic, and African descent.4 The exact etiology of LPP remains unclear; however, it has been associated with ultraviolet radiation, hepatitis C infection, environmental pollution, and the topical application of mustard oil, henna, and hair dyes, particularly in India.5
LPP patients often experience significant psychosocial distress due to the cosmetic impact of the condition, further compounded by its refractory response to most treatment modalities.6 Existing studies on treatment for LPP primarily focus on non-procedural therapies such as topical corticosteroids, calcineurin inhibitors, and systemic treatments. While these treatment strategies may potentially be effective in stabilizing the disease and preventing further progression, the residual pigmentation caused by pigment incontinence in the dermis is often resistant to conventional treatments.7,8
Cosmetic procedures are increasingly being used for pigmentary disorders, offering a promising alternative for LPP management.9-11 Techniques such as laser therapy, chemical peels, and platelet-rich plasma have been used for the reduction of excess pigmentation in LPP patients.4,8 However, existing literature on their application in LPP remains limited. This review aims to evaluate current procedural options for LPP treatment, focusing on their efficacy, safety, and practical considerations. By providing a comprehensive analysis of these treatment modalities, this paper seeks to guide dermatologists in optimizing care for patients with LPP and highlight areas for future research.
LPP patients often experience significant psychosocial distress due to the cosmetic impact of the condition, further compounded by its refractory response to most treatment modalities.6 Existing studies on treatment for LPP primarily focus on non-procedural therapies such as topical corticosteroids, calcineurin inhibitors, and systemic treatments. While these treatment strategies may potentially be effective in stabilizing the disease and preventing further progression, the residual pigmentation caused by pigment incontinence in the dermis is often resistant to conventional treatments.7,8
Cosmetic procedures are increasingly being used for pigmentary disorders, offering a promising alternative for LPP management.9-11 Techniques such as laser therapy, chemical peels, and platelet-rich plasma have been used for the reduction of excess pigmentation in LPP patients.4,8 However, existing literature on their application in LPP remains limited. This review aims to evaluate current procedural options for LPP treatment, focusing on their efficacy, safety, and practical considerations. By providing a comprehensive analysis of these treatment modalities, this paper seeks to guide dermatologists in optimizing care for patients with LPP and highlight areas for future research.
