Periorbital linear lichen planus pigmentosus—report of 2 cases and literature review

Linear lichen planus pigmentosus (LPP) represents an extremely rare variant of lichen planus (LP). This idiopathic and inflammatory skin condition commonly affects dark-skinned individuals along sun-exposed areas (face: along the facial lines of Blaschko, neck, limbs) and flexural folds (axilla, inguinal, submammary).1, 2, 3, 4, 5, 6, 7, 8, 9 Periorbital linear LPP is an even rarer clinical entity with only a few recently published reports of this benign dermatosis affecting the periorbital region.10, 11 There has also been a published case report of bilateral periorbital lichen nitidus; this is, however, a separate clinical entity from periorbital linear LPP.12 Importantly, periorbital linear LPP may clinically mimic other conditions such as linear and/or pigmented basal cell carcinoma, malignant melanoma, and lentigo maligna and must be distinguished from these more sinister pathologies. The authors report 2 rare cases of rapidly progressive periorbital linear LPP presenting to the Oculoplastics Department at Bristol Eye Hospital, U.K. from January to April 2017. The clinical notes, photographs, and histological findings for the 2 patients included in this study were retrospectively reviewed. Informed consent for photography and educational use were obtained from both patients and are kept in their respective medical records.