Eruptive lichen planus in a child

Lichen planus is a chronic inflammatory disease of the skin and mucous membranes. Typically, skin lesions include violaceous, polygonal, flat papules and plaques. However, the clinical presentation of lichen planus can be heterogeneous and show divergent degrees of cutaneous and mucous manifestation. The disease usually affects adults and is only rarely encountered in children. Here, we present a 7-year-old boy who rapidly developed itching skin lesions on the extremities and trunk. He had no history of concomitant drug intake, infection or vaccination. Clinical examination of the skin found multiple white-grayish papules and plaques whereas the scalp, mucous membranes and nails were not affected. Histologic examination showed typical findings of lichen planus. We initiated topical corticosteroid therapy, which resulted in healing of the skin lesions within 4 weeks. To our knowledge this is the first instance of exanthematous lichen planus in childhood successfully treated with topical corticosteroid ointment alone. Thus, even generalized lichen planus lesions can be effectively cleared without systemic therapies, which can be potentially associated with serious side effects, especially in children.