Lichen Planus Pigmentosus: A Clinico-Pathological Study in a Caucasian Population from North Africa

This study investigates lichen planus pigmentosus (LPP) in a Caucasian population from southeastern Tunisia, involving 41 patients over a 6-year period. The study found that LPP predominantly affects middle-aged women with darker skin phototypes, presenting as brown-gray to purplish-gray macules, primarily on the face and neck. The most common pigmentation pattern was blotchy, and pruritus was present in 53% of cases. Dermoscopic analysis revealed brown to gray-blue perifollicular hyperpigmentation as a common feature. LPP was associated with other lichen planus variants and conditions like dysthyroidism and hepatitis B. The study highlights that LPP, though rare in Caucasians, is underreported and has a significant social impact due to its aesthetic effects. Treatment is challenging, with pigmentation often resistant to therapy, emphasizing the importance of avoiding trigger factors and identifying comorbidities.