Colocalization of lichen planus and vitiligo associated with selective IgA deficiency

Area of Science:

• Dermatology
• Immunology

Background:

• Vitiligo universalis is a chronic autoimmune condition causing widespread skin depigmentation.
• Lichen planus is an inflammatory condition affecting skin and mucous membranes.

Observation:

• A 28-year-old man with vitiligo universalis developed reddish, violaceous, flat-topped papules on his hands.
• Dermatologic examination revealed porcelain-white hypopigmented skin with these papules on hands and flexor sites.
• Histopathology showed hyperkeratosis, saw-tooth acanthosis, and a lymphocytic infiltrate with necrotic keratinocytes.

Findings:

• Laboratory investigations were largely normal, with decreased IgA levels noted.
• Clinical and histopathological findings were consistent with a dual diagnosis of lichen planus and vitiligo.
• Histopathology confirmed epidermal changes and a band-like lymphocytic infiltrate in the dermis, with reduced melanocytes.

Implications:

• This case underscores the possibility of co-occurrence of lichen planus and vitiligo.
• Understanding this association may aid in diagnosing and managing complex dermatological presentations.
• Further research into shared etiological factors or pathomechanisms is warranted.