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Therapeutic Approach

Lichen planus pigmentosus (LPP), a rare variant of lichen planus, is an acquired pigmentary disorder characterized by the appearance of gray-brown macules and patches on sun-exposed or unexposed areas of skin. LPP is usually categorized based on clinical presentation; diffuse, reticular, blotchy, perifollicular, segmental, inversus (flexural), and linear (along Blaschko lines). Initial management should focus on avoiding triggers, such as oral medications, mustard oil application, sun exposure, friction, or tight clothing. Treatment is usually difficult and refractory and should be based on the variant of LPP and severity. See Table 68-1.

Table 68-1Lichen Planus Pigmentosus Treatment Table

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