A cross-sectional observational study of clinicodermatoscopic features in cutaneous lichen planus in Indian skin

Background: Lichen planus (LP) is a papulosquamous skin disorder characterized by violaceous polygonal papules and plaques associated with itching. Dermoscopy in LP shows variable forms of whitish structures that correlate with Wickham striae (WS), vascular structures, and pigmentary changes that aid in its diagnosis. Aim: To study the correlation between clinical and dermatoscopic features in cutaneous variants of LP in Indian skin. Method: Patients with LP presenting over a period of 1 year were included. Dermoscopy of the lesions in polarized mode was done using video dermatoscope − Dino-Lite Premier AM4113ZT model. Both clinical and dermoscopy findings were photographed, recorded, and studied. Result: Fifty-six percent patients (39/70) had classical LP (CLP), 14% patients (10/70) had hypertrophic LP which were the most common clinical variants. Reticulate pattern of WS was the most common pattern observed in 40% (28/70) cases and a new rosette pattern of WS was observed in 13% (9/70) cases. Nonvascular findings such as WS, comedo-like openings, and grey blue dots showed statistically significant association with CLP. Among the pigmentary findings, pepper-like pigmentation was seen in 64% (25/39) CLP and reticulate pattern of pigmentation in 85% (6/7) cases of LP pigmentosus. Perifollicular pigmentation showed statistical significance in 100% cases of lichen planopilaris. Conclusion: In view of consistent dermoscopic features observed in LP, it aids as a valuable noninvasive diagnostic tool, many a times obviating the need for skin biopsy. Limitations: Small sample size and the exclusion of lesions of LP over the nails, genitals, and oral mucosa.