Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2022; 10(24): 8679-8685
Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8679
Unilateral lichen planus with Blaschko line distribution: A case report
Shuai Dong, Wen-Jing Zhu, Meng Xu, Xue-Qi Zhao, Yan Mou
Shuai Dong, Wen-Jing Zhu, Meng Xu, Xue-Qi Zhao, Yan Mou, Department of Dermatology, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Author contributions: Dong S collected the data, performed the literature search and contributed to the manuscript drafting; Zhu WJ, Xu M, Zhao XQ did the follow up and contributed to the manuscript drafting; Mou Y was involved in treatment of the patient, and revised and reviewed the manuscript; all authors issued final approval for the version to be submitted.
Supported by National Natural Science Foundation of China, No. 81803160.
Informed consent statement: Informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Mou, MD, PhD, Associate Professor, Senior Consultant Dermatologist, Department of Dermatology, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, Jilin Province, China. muyan_20031017@jlu.edu.cn
Received: February 14, 2022
Peer-review started: February 14, 2022
First decision: March 24, 2022
Revised: April 3, 2022
Accepted: July 25, 2022
Article in press: July 25, 2022
Published online: August 26, 2022
Abstract
BACKGROUND

Lichen planus (LP) with distribution of lesions along Blaschko’s lines is a rare entity, accounting for 0.24%-0.62% of all patients. Unilateral distribution of lesions in arm, leg, trunk, and waist is even less common. Approximately 10% of patients with LP manifest nail lesions.

CASE SUMMARY

A 20-year-old woman presented to our department with polygonal, purpuric, flat-topped papules over the right arm, right leg, and right side of trunk and waist for the last 5 mo. The patient initially developed nail deformation in the left middle finger with no obvious cause, followed by development of blue-purple and red maculopapular rash with pruritus. During the disease course, the skin lesions aggravated and spread to several segments due to scratching. The lesions showed unilateral distribution along the Blaschko’s lines. The diagnosis of LP along Blaschko’s lines was established based on dermoscopy and skin biopsy. Her cutaneous lesions considerably improved after 4-wk treatment with intramuscular glucocorticoid, oral acitretin, topical glucocorticoid, and retinoids.

CONCLUSION

Cases of LP involving multiple segments of the body along the Blaschko’s lines with nail damage are rare.

Keywords: Lichen planus, Blaschko’ lines, Lichen planus involving nails, Case report

Core Tip: Lichen planus (LP) with lesion distribution along the Blaschko’s lines can be differentiated from other skin lesions with linear distribution by dermoscopy and pathological biopsy. The isotopic response can occur in patients with LP, which may be an important cause for rapid spread of lesions and involvement of multiple segments. Therefore, early diagnosis and treatment are of great significance. Treatment strategy should be individualized based on the lesion characteristics and patient acceptance. Our patient showed considerable improvement of cutaneous lesions after 4-wk treatment with intramuscular glucocorticoid, oral acitretin, topical glucocorticoid and retinoids.