Lichen planus in tropical Africa

The pattern of Lichen Planus seen among 95 Nigerians seen over a 3 year period is described. They constituted 5% of all skin cases, with females slightly more affected than males. A younger age group is predominantly affected. In most patients (68%), the lesions are widespread all over the body. Large papules, scaly patches and hypertrophic verrucous lesions in the legs are frequent findings. Patients having lesions in the mouth are few. Seasonal variations of the disease do occur, the peak being during the rainy season, April-September (65%). Pruritus is a constant feature. Lesions do heal with marked residual hyperpigmentation. There is no report so far of the "subtropical" (actinic) Lichen Planus in West Africa. It is suggested that drugs, weather and the hard native sponge may play a role in the causation of the disease in tropical Africa.