Lichenoid pseudovesicular papular eruption of the nose (LIPEN): clinicodermoscopic and histopathological correlation

Lichenoid pseudovesicular papular eruption of the nose (LIPEN) is an uncommon and often overlooked facial dermatosis characterised by monomorphic papules with a pseudovesicular appearance, predominantly affecting the nasal dorsum and adjacent centrofacial areas. Owing to its clinical resemblance to several inflammatory and granulomatous dermatoses, it is frequently misdiagnosed, leading to delayed recognition and inappropriate management for a long term. We report a patient presenting with chronic, asymptomatic centrofacial papules unresponsive to conventional therapies. Dermoscopic examination revealed characteristic brown-grey dots and globules with a pseudoreticular pattern. Histopathological evaluation demonstrated features of lichenoid interface dermatitis, confirming the diagnosis of LIPEN. Patient responded to topical calcineurin inhibitors. Recognition of its distinctive clinicodermoscopic and histopathological features is essential to differentiate LIPEN from common mimics and guide appropriate management.