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eISSN: 2084-9893
ISSN: 0033-2526
Dermatology Review/Przegląd Dermatologiczny
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SCImago Journal & Country Rank
5/2021
vol. 108
 
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abstract:
Case report

Atypical coexistence of polymorphic light eruption and eruptive lichen planus in a patient with necrobiosis lipoidica

Weronika Buczyńska
1
,
Agnieszka Popow
1
,
Julia Nowowiejska
2
,
Anna Baran
2
,
Iwona Flisiak
2

  1. Student Research Club at the Department of Dermatology and Venereology, Medical University of Bialystok, Bialystok, Poland
  2. Department of Dermatology and Venereology, Medical University of Bialystok, Bialystok, Poland Country
Dermatol Rev/Przegl Dermatol 2021, 108, 407–413
Online publish date: 2022/02/07
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Introduction
Polymorphic light eruption is a photodermatosis characterised by an erythematous, papular and vesicular rash developing in areas exposed to UV radiation. Lichen planus in the eruptive variant presents with diffuse polygon-shaped papules accompanied by pruritus. Necrobiosis lipoidica manifests as yellow-brown atrophic plaques with central telangiectasias, typically located on the lower legs.

Objective
Presentation of a case of atypical coexistence of polymorphous light eruption, eruptive lichen planus, and necrobiosis lipoidica.

Case report
A 59-year-old woman with a history of necrobiosis lipoidica involving the skin of both lower extremities was admitted to the Department of Dermatology for the diagnosis work-up of skin lesions that appeared 2 weeks earlier. Confluent erythematous and papular lesions were observed on the skin of the neck, chest, shoulders, and back. Additionally, diffuse pruritic papules were noted within the upper and lower extremities and in the sacral region. The histopathological features of a skin sample taken from the back and forearm were consistent with polymorphous light eruption and lichen planus, respectively. Clobetasol and antihistamines were used, leading to an improvement in skin condition.

Conclusions
Simultaneous occurrence of the three dermatoses mentioned above is an uncommon phenomenon, and may be diagnostically challenging. Consequently, effective diagnostic management should incorporate histopathological examination in correlation with the clinical presentation and comprehensive anamnesis.

keywords:

polymorphous light eruption, eruptive lichen planus, necrobiosis lipoidica, Koebner phenomenon



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