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Case Reports
. 2025 May 3;17(5):e83388.
doi: 10.7759/cureus.83388. eCollection 2025 May.

A Linear Affair: Blaschkoid Pattern in Lichen Planus Pigmentosus

Jebisha J B  1 , Arun Vignesh  1 , Murugan Sundaram  1 , Sudha Rangarajan  1 , Adikrishnan Swaminathan  1
Affiliations
Case Reports

A Linear Affair: Blaschkoid Pattern in Lichen Planus Pigmentosus

Jebisha J B et al. Cureus. .

Abstract

Lichen planus pigmentosus (LPP) is an acquired disorder of hyperpigmentation. Atypical presentations, such as linear or blaschkoid distribution, are exceedingly rare and may pose diagnostic challenges. We report a case of a 32-year-old male with pruritic, hyperpigmented, slate-gray to brown macules and patches distributed linearly along Blaschko's lines on the right upper back and upper limb. The diagnosis of LPP was corroborated by clinical appearance, dermoscopic examination, and histopathological analysis. Recognition of such unusual patterns is essential for accurate diagnosis and to differentiate from other linear pigmentary disorders.

Keywords: blaschko lines; dermoscopy findings; lichen planus pigmentosus; linear variant; pigmentary disorders.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Hyperpigmented slate-gray to brown macules arranged in a curvilinear pattern along Blaschko’s lines over the right upper back and shoulder
Figure 2
Figure 2. Lesions extending linearly across the flexor aspect of the right upper limb
Figure 3
Figure 3. Dermoscopic examination (10x magnification)
Brown to bluish gray dots and globules arranged in a reticular pattern (black arrows).
Figure 4
Figure 4. Dermoscopic examination (10x magnification)
Brown dots and globules arranged in a hem-like pattern (black arrows).
Figure 5
Figure 5. Histopathological examination (H&E stain, 400x)
Atrophic epidermis, basal vacuolar degeneration (red arrow), superficial and perivascular lymphocytic infiltrates (blue arrows), melanin incontinence (black arrow), and pigment-laden macrophages (green arrow) in the upper dermis.
See this image and copyright information in PMC

References

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