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Michael Bigby, MD

Arch Dermatol. 1996;132(6):697-698.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

I SAW A PATIENT along with a dermatology resident. The patient was a black woman with several papules and a plaque on her thigh. The plaque was slightly larger than 1 cm in diameter, hyperpigmented, and had a thin raised border. The papules were 3 to 5 mm, flat topped, and similarly hyperpigmented. None of the lesions was erythematous. The patient had no oral lesions and had normal nails. Despite the lack of Wickham's striae and an atypical location and appearance, we agreed that lichen planus was the most likely diagnosis. The papules had the characteristic flat-topped morphology. Pigment incontinence is a prominent feature of lichen planus.^1,2 Erythema is often difficult to discern in dark skin.³ Sarcoidosis and granuloma annulare were considered in the differential diagnosis but were considered much less likely. A 4-mm punch biopsy specimen was obtained to confirm the diagnosis.

Several days later I received . . . [Full Text PDF of this Article]

Author Affiliations
Massachusetts General Hospital-East 149 13th St Charlestown, MA 02129

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