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[Zosteriform lichen aureus. Pediatric clinical case].

Álvaro Rivera-Rodríguez1, Sergio Hernández Ostiz2, Ana L Morales-Moya2

  • 1Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. alvaroriverarodriguez@gmail.com.

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This study reports a rare case of lichen aureus in a pediatric patient, presenting with numerous zosteriform lesions. Treatment with topical mometasone furoate showed partial improvement, highlighting the need for further research.

Keywords:
pediatricspigmented purpuric eruption

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Area of Science:

  • Dermatology
  • Pathology

Background:

  • Lichen aureus is a rare pigmented purpuric dermatosis.
  • Pigmented purpuric dermatoses encompass a group of rare skin conditions characterized by purpura and hyperpigmentation.

Observation:

  • A 10-year-old boy presented with numerous, asymptomatic, brownish macules (<1 cm) with sharp edges and lichenified surfaces on his left inner leg in a zosteriform distribution.
  • Histopathology revealed a superficial dermal band-like inflammatory infiltrate containing lymphocytes, histiocytes, erythrocytes, and hemosiderin.

Findings:

  • The patient was diagnosed with zosteriform lichen aureus and treated with topical mometasone furoate for 3 weeks, resulting in partial lightening of the macules.
  • Lesions persisted for 2 years, with new lesions appearing on the ipsilateral ankle, indicating a chronic or relapsing course.

Implications:

  • This case highlights the importance of considering lichen aureus in pediatric patients with atypical presentations, including zosteriform distribution.
  • Differential diagnosis should include other pigmented purpuric dermatoses and pigmented purpuric mycosis fungoides.
  • While spontaneous resolution and various therapeutic options exist, further studies are necessary to establish optimal treatment strategies and understand the long-term prognosis of zosteriform lichen aureus.