Lichen planus pigmentosus
Also called lpp
Slate-grey patches of pigmentation, mostly on sun-exposed skin of the face and neck, common in darker skin.
Under clinical reviewThe clinic is checking this page against its current practice. Please ask at your consultation before you rely on a detail.
What you can do
- Sun avoidance and photoprotection are a must.
- Avoid the trigger agents listed above wherever you can.
Read the full page on lichen planus pigmentosus
What it is
Lichen planus pigmentosus, or LPP, is a condition marked by slate-grey pigmentation, mostly on the face and neck. The pigmentation is classically over sun-exposed areas, spread evenly and symmetrically, and it is common in dark-skinned people. On the face it favours the temples — the sides of the forehead — and the area in front of the ears; on the neck it affects all sides. Arms, legs and trunk can also be involved.
The patches are dark brown to grey or grey-blue, round or oval, with irregular and poorly defined borders that gradually enlarge and join up. LPP is usually symptomless, although it can occasionally cause mild itching, which is a marker of activity and progression; the itch is present in the early, active phase and disappears quickly afterwards. Rarely there is a burning sensation. It is usually seen in the third to fifth decade of life, in both sexes and slightly more often in women, and is commonly seen in India, the Middle East and South America.
What causes it
The cause is not exactly known, but a number of agents have been reported as predisposing factors, with sunlight the principal trigger. Other agents thought to make the skin more sensitive to light include mustard oil, which contains allyl thiocyanate, amla oil, fragrances and hair dyes.
How we treat it
LPP may run a long clinical course. Treatment involves avoiding the triggers and using applied and oral medicines to settle the inflammatory reaction and reduce the pigmentation. How far the pigmentation fades varies from person to person.
Topical agents include hydroquinone, commonly used in combination with retinoic acid, azelaic acid, kojic acid, glycolic acid and tacrolimus. Medicines taken by mouth include corticosteroids and vitamin A, and other options are tranexamic acid and low-dose isotretinoin. Because the lesions seldom clear completely, lasers or chemical peels may be used alongside the topical agents in selected cases.
What you can do
Sun avoidance and photoprotection are a must. Avoid the trigger agents listed above wherever you can.
Written from the clinic's own patient leaflet, by Dr. D. A. Satish.
Reviewed by Dr. D. A. Satish · Under clinical review
Please note
The information on this website is for general education only. It is not a substitute for a consultation, a diagnosis or a prescription. Always see a qualified doctor about your own condition.