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Year : 1992  |  Volume : 58  |  Issue : 2  |  Page : 128-130

Coexistent vitiligo and actinic lichen planus

Correspondence Address:
Khalil Ahmad

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A case of vitiligo who subsequently developed the lesions of lichen planus is described. Both types of lesions occurred on sun exposed areas, aggravated on photochemotherapy and showed improvement on para aminobenzoic acid cream application with avoidance of sun exposure. The possibility of common aetiological background is discussed.

Keywords: Vitiligo, Lichen planus, Auto-immunity, Actinic radiation

How to cite this article:
Ahmad K, Kachhawa D, Khullar R, Khar. Coexistent vitiligo and actinic lichen planus. Indian J Dermatol Venereol Leprol 1992;58:128-30

How to cite this URL:
Ahmad K, Kachhawa D, Khullar R, Khar. Coexistent vitiligo and actinic lichen planus. Indian J Dermatol Venereol Leprol [serial online] 1992 [cited 2020 Oct 20];58:128-30. Available from:

  Introduction Top

The occurrence of 2 or more diseases in the same patient sometimes provides the clue regarding the common aetiological background. The association of vitiligo with a number of autoimmune disorders has been reported from time to time.[1],[2],[3],[4] Similarly lichen planus has also been found to be associated with various autoimmune disorders. [5] We are here in reporting a case of vitiligo who later developed lichen planus. Besides association, the distribution, response to photochemotherapy and avoidance of sun exposure suggested a common background for the 2 entities.

  Case Report Top

A 25-year-old housewife attended our department with gradually progressive, asymptomatic, whitish and non scaly macules of 8 years duration on forehead, nose and dorsa of hands. For last 6 months she had a gradually progressive linear, itchy, hyperpigmented and scaly plaque on right side of face, and violaceous papular lesions on lower lip and extensor aspect of forearms [Figure - 1]. Examination of scalp, nails and oral mucosa showed no abnormality. There was no history of any other illness or drug intake.

Investigations revealed normal haemogram, urinalysis and blood sugar level. Skin biopsy taken from both types of lesions for histo-pathological examination showed the features consistent with vitiligo and lichen planus from the respective lesions.

Photochemotherapy using psoralens and sun exposure aggravated both types of lesions. In view of this response and presence of both types of lesions on sun exposed areas, the patient was advised to apply para-aminobenzoic acid cream (PABA) on involved areas with avoidance of sun exposure. With this treatment the patient showed improvement in all lesions within 2 weeks. Patient could be followed up for next 3 months during which she showed progressive and satisfactory improvement.

  Comments Top

The exact aetiology of vitiligo is not known but possible hypotheses are on genetic transmission, autoimmunity, neurohumoral factors, autotoxicity and exogenous chemical exposure. The incidence of vitiligo in patient with autoimmune disease is 10 to 15 percent as compared to 1 percent in general population. [6] sub Since lichen planus has also been seen to be associated with various autoimmune disorders, the coexistence of vitiligo and lichen planus in our case may not be merely coincidental and possibility of common autoimmune background is there.

Role of actinic radiations in the pathogenesis of both types of lesions, in our case, is strongly suspected because of following features : (a) The presence of each type of lesion only on sun exposed areas of body (b) Aggravation of each type of lesion with photochemotherapy (c) improvement of each type of lesion on application of PABA and avoidance of sun exposure. It is quite interesting to note that in the same area of the same subject depigmented (vitiligo) as well as hyperpigmented (lichen planus) lesions, responding similarly to actinic exposure and withdrawal, have occurred.

  References Top

1.Cunliffe WJ, Newell DJ, Stevenson CJ. Vitiligo, thyroid disease and auto-immunity. Br J Dermatol 1968; 80: 135-9.  Back to cited text no. 1  [PUBMED]  
2.Dawber RPR. Clinical associations of vitiligo. Postgrad Med J 1970; 46: 276-7.  Back to cited text no. 2    
3.Koranne R V, Sehagal VN, Sachdeva K G. Assoication of pemphigus vulgaris with vitiligo. Ind J Dermatol venereol Leprol 1986; 52: 107-8.  Back to cited text no. 3    
4.Sharma S C. Autoimmune and cutaneous association of various types of vitiligo. Ind J Dermatol venereol Leprol 1991; 57: 107-8.  Back to cited text no. 4    
5.Black MM. Lichen Planus and lichenoid eruption. In : Text Book of Dermatology, (Rook A, Wilkinson DS, Ebling FJG, et al, eds), 4th edn. Oxford: Black well scientific publication, 1986: 1676.  Back to cited text no. 5    
6.Lerner AB. Vitiligo. J Invest Dermato! 1955; 32 : 285.  Back to cited text no. 6    


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