History:

Lichen planus actinicus (LPA), or pigmentosus, or subtropicus occurs mainly in Middle Eastern countries, where between 20% and 30% of LP cases are of this type. It tends to be more common in young adults of both sexes. The lesions develop in spring and summer on sun-exposed areas, especially the face. Three different forms have been described: annular (the most common type), pigmented (melasma-like), and dyschromic. The lesions are typically annular plaques with central slate blue to light brown pigmentation and well-defined, slightly raised, hypopigmented borders. Pruritus is minimal or absent and usually there is no oral mucous membrane involvement. The presented woman has melasma-like LPA involving mainly the butterfly area of the face of many months duration.