Eruptive lichen planus

Eruptive Lichen Planus Associated With Chronic Hepatitis C Infection Presenting as a Diffuse, Pruritic Rash

Lichen planus has been associated with several precipitating factors, such as drugs, immunizations, and viral infections, including hepatitis C virus (HCV). Eruptive or disseminated lichen planus is a rare variation that most often presents as an acute, widespread exanthem that progresses rapidly and usually lasts for a shorter duration. This variation has not been well studied, and little is known about the etiologies and treatments of this rare form. Thus far, only a few cases of eruptive lichen planus have been reported to be associated with HCV infection. We report a case a 62-year-old woman who presented with a rapidly progressive, diffuse, pruritic rash of the trunk, upper extremities, and thighs that was determined to be eruptive lichen planus secondary to chronic HCV infection. The patient was treated with topical steroids and oral antihistamines, and her rash spontaneously resolved approximately six months after the initial presentation.

Update on lichen planus and its clinical variants

Lichen planus (LP) is an inflammatory skin condition with characteristic clinical and histopathological findings. Classic LP typically presents as pruritic, polygonal, violaceous flat-topped papules and plaques; many variants in morphology and location also exist, including oral, nail, linear, annular, atrophic, hypertrophic, inverse, eruptive, bullous, ulcerative, lichen planus pigmentosus, lichen planopilaris, vulvovaginal, actinic, lichen planus-lupus erythematosus overlap syndrome, and lichen planus pemphigoides. Clinical presentation of the rarer variant lesions may be largely dissimilar to classic LP and therefore difficult to diagnose based solely on clinical examination. However, histopathological examination of LP and LP-variant lesions reveal similar features, aiding in the proper diagnosis of the disease. Management of LP and LP variants aims to control symptoms and to decrease time from onset to resolution; it often involves topical corticosteroids, but varies depending on the severity and location of the lesion. The literature contains an array of reports on the variations in presentation and successful management of LP and its variants. A familiarity with LP and its variants is important in achieving timely recognition and management of the disease.