Lichen planus pigmentosus (LPP) is a prevalent variant in India. Which feature distinguishes LPP from classical lichen planus?
- A Presence of Wickham's striae on the lesions
- B Hyperpigmented macules without erythema or Wickham's striae, primarily on face and flexures, with incontinence of pigment histologically ✓
- C Involvement of nails in >60% of cases
- D Strong association with hepatitis C virus infection
Correct answer: B. Hyperpigmented macules without erythema or Wickham's striae, primarily on face and flexures, with incontinence of pigment histologically
Explanation
LPP presents as brownish-grey/dark hyperpigmented macules and patches predominantly on the face (forehead, temples) and flexures, without the violaceous papules, Wickham's striae, or prominent Koebner's phenomenon of classical LP. Histologically, the dominant finding is pigment incontinence (melanin-laden macrophages in the upper dermis) with mild vacuolar change and minimal epidermal hyperplasia. Hepatitis C is classically associated with LP (classical form), not specifically LPP.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.