PMC9891236_01
LPP in the right cheek extending to the lateral border of the lip. (A) Over the right cheek, near the nasolabial fold, there are multiple, lichenoid, brown-gray macules coalescing into a patch extending to the lateral lip in a linear pattern. (B) At the three-month follow-up, over the right cheek and near the nasolabial fold, there is an improvement over the periphery showing a non-hemogenous brown-gray linear patch (arrow).
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FIG1
The dermatological assessment showed multiple, coalescing, brown-to-grayish macules and papules forming a patch over the right cheek (Figure 1A); there was no erythema or scales. At the three-month follow-up examination, the hyperpigmentation improved (Figure 1B), and the patient will continue oral isotretinoin 20 mg OD along with topical adapalene gel and 4% hydroquinone cream.
Histopathology. (A) Hematoxylin and eosin (H&E) histopathology showing orthokeratosis, mild acanthosis (H&E x10). (B) Histopathology showing periadnexal inflammatory cell infiltrate (H&E x20). (C) Histopathology showing a Civatte body (arrowhead), melanin incontinence (arrow), and mild inflammatory infiltrate, suggestive of lichen planus pigmentosus (LPP) (H&E x40).
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FIG2
Histopathology showed acanthosis and mild hyperkeratosis with melanophages along with peri- and intrafollicular inflammatory cell infiltrate in the dermis (Figure 2).