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Induction of dramatic hyperpigmentation in a patient with generalized lichen planus treated with re-PUVA
Christopher S Carlin1, Scott R Florell, Gerald G Krueger
1Department of Dermatology, University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
Background:
Retinoids plus PUVA (re-PUVA) may be used in the treatment of lichen planus in cases that do not respond to monotherapy. Hyperpigmentation is a potential side effect of re-PUVA therapy.
Objective:
A case of remarkably intense transient hyperpigmentation secondary to re-PUVA therapy is presented.
Methods And Results:
An 18-year-old male with lichen planus who had been taking isotretinoin 80 mg per day for seven days developed an exaggerated hyperpigmentation following the third dose of PUVA.
Conclusion:
As the hyperpigmentary reaction did not occur until the third PUVA dose, which was near the steady state of isotretinoin, this case may illustrate a case of photosensitization secondary to isotretinoin alone or isotretinoin in combination.