PMC5758953_01
Discrete and coalescing polygonal-shaped, violaceous, flat-topped papules located on the trunk and extremities: (a) and (b) some lesions have a network of fine white lines, "Wickham striae."
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On physical exam, he had violaceous, flat-topped, 3- to 6-mm discrete and coalescing papules on his dorsal hands, back, chest, abdomen, buttocks, and lower extremities (Figure 1(a) and (b)).
(a) H&E, original magnification 4x. (b) H&E, original magnification 10x. (a) and (b) Histologic images highlighting classic features of lichen planus including a lichenoid lymphocytic infiltrate, epidermal hyperkeratosis, hypergranulosis, basal vacuolar alteration, and Max Joseph spaces with colloid bodies and dermal melanophages.
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Histopathology revealed a dense lichenoid infiltrate of lymphocytes with colloid bodies along the dermal-epidermal junction (Figure 2(a)). There was epidermal hyperplasia with orthokeratosis, focal hypergranulosis, and a saw-toothed rete-ridge pattern with Max Joseph spaces (Figure 2(b)).