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Review
. 2017 Mar 31;11(1):1-4.
doi: 10.3315/jdcr.2017.1239.

Bullous lichen planus - a review

Angeliki Liakopoulou  1 , Efstathios Rallis  2
Affiliations
Review

Bullous lichen planus - a review

Angeliki Liakopoulou et al. J Dermatol Case Rep. .

Abstract

Bullous lichen planus is a rare variant of lichen planus. It is characterized by vesicles or bullae, which usually develop in the context of pre-existing LP lesions. It is often misdiagnosed and should be differentiated from other subepidermal bullous diseases especially lichen planus pemphigoides. The diagnosis is based on clinical suspicion and is confirmed by histopathology and immunofluoresence. The clinical features of bullous lichen planus include typical lichen planus lesions, accompanied by the formation of bullae on the affected or perilesional skin. This is evident on histology, with alteration of the dermo-epidermal junction and intrabasal bullae as a consequence of extensive inflammation. The histologic features in conjunction with the negative immunofluoresence indicate that bullous lichen planus is a form of "hyper-reactive lichen planus" rather than a distinct entity. There is no standard treatment of bullous lichen planus. Topical and systemic corticosteroids, dapsone and acitretin have been described as effective choices.

Keywords: bullous lichen planus; lichen planus; lichen planus pemphigoides; review.

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Figures

Figure 1
Figure 1
Bullae located on violaceus papules on the legs.
Figure 2
Figure 2
Histopathology from a lichen planus lesion with hyperkeratosis, hypergranulosis and sawtooth-like acanthosis (H&E, ×40).
See this image and copyright information in PMC

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