Case presentation:
A 75-year-old man, with a skin phototype IV, presented with itchy
lesions on the face and the neck, evolving for 1 month. Dermatological
examination revealed multiple purplish-brown annular lesions on
forearms, neck, scalp and face (Figure 1) with involvement of
the lower lip (Figure 2) . Histological examination of biopsy
specimen from the forearm and the lower lip showed the same aspect
characterized by interface dermatitis with band lymphocytic infiltrate
and dermal elastosis (Figure 3) . The clinical presentation, the
predilection of the lesions to the photo-exposed zones and the
histopathological findings were compatible with the diagnosis of actinic
LP.
Actinic LP is a rare variant of LP occurring on photo exposed areas in
dark phototype patients. It mainly affects children and young
adults.1 Several forms have been described: the
annular form as in our case, the dyschromic and the melasma-like form.
Unlike LP, mucosal involvement during actinic LP is usually absent and
lip involvement is exceptionally reported.1,2
The involvement of the lower lip in our case is explained by an
increased exposure to ultraviolet which is considered an important
factor in the etiopathogenesis of actinic LP.
The treatment of actinic LP is based on photoprotection and topical
corticosteroids. Other treatments have been proposed with variable
results: hydroxycloroquine, acitretin, general corticosteroids and
cyclosporine.2
Authorship: All authors had access to the data and a role in
writing this manuscript.