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 JCDSA  Vol.5 No.3 , September 2015
Melasma, Melasma-Like Lichen Planus Actinicus, and Butterfly Lichen Planus Actinicus Build up One Spectrum (Clinico-Histopathological Study)
Abstract: Background: Facial melanosis is a major pigmentery problem seen in the daily clinical practice. Melasma and lichen planus actinicus are among these common causes. Still some facial melanosis that had features of melasma and butterfly lichen planus actinicus but could not be classified to either of them. Objective: To evaluate melasma, lichen planus actinicus and cases that could not be classified into one or either of them using clinical picture, Wood’s lump examination, and histopathological assessment. Patients and Methods: This is a case descriptive, comparative, clinical and histopathologicasl study carried out in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during the period from December 2012-May 2014. Forty patients with facial hyperpigmentation were included in this study. Twelve (30%) were males and 28 (70%) were females with female to male ratio: 2.3:1. Mean age ± SD of studied patients was 37.07 ± 9.63 years. History, physical examination, Wood’s lump examination and photographic pictures were done for all patients. Punch biopsy was taken from each patient, and processed and stained with Hematoxylin-Eosin (HE) and Fontana-Masson (FM) for histological evaluations. Results: These diseases were classified into: melasma with 11 patients, female to male ratio: 4.5:1 with mean age ± SD was 33.64 ± 6.516 years, melasma-like lichen planus actinicus with 21 patients, female to male ratio: 2.5:1,mean age ± SD: 39 ± 8.349 years, butterfly lichen planus actinicus with 8 patients, female to male ratio: 1:1, mean age ± SD: 36.75 ± 15.088 years. This classification depends on the following findings: some of these results could be more frequent and intense in one than others; they were the diseases of young age group, that had more tendency to affect females than males, sun light exposure and outdoor activities were the main etiological factors, but these factors were more triggering in lichen planus actinicus followed by melasma-like lichen planus actinicus and to lesser extent in melasma. The skin types were mostly III, the location and distribution of pigmentation were almost similar, Wood’s lamp findings were similar although was not conclusive. The histopathological findings especially the level of melanin deposition and inflammatory infiltrate were comparable but the melanin deposition was more intense in butterfly lichen planus and melasma-like lichen planus actinicus and to lesser extent in melasma. Conclusion: From the epidemiological, clinical and histopathological findings of the present work, we can suggest a conclusion that melasma, butterfly lichen planus actinicus, and melasma-like lichen planus actinicus were inflammatory skin diseases that build up one spectrum where melasma at one pole and lichen planus actinicus at the other pole and melasma-like lichen planus actinicus at the middle. The young age group, during their active reproductive life, will have these diseases in relation to sun light exposure with seasonal variations.
Cite this paper: Sharquie, K. , Noaimi, A. , Al-Shukri, M. (2015) Melasma, Melasma-Like Lichen Planus Actinicus, and Butterfly Lichen Planus Actinicus Build up One Spectrum (Clinico-Histopathological Study). Journal of Cosmetics, Dermatological Sciences and Applications, 5, 212-222. doi: 10.4236/jcdsa.2015.53026.
References

[1]   Anstey, A.V. (2010) Disorders of Skin Colour. Rook’s Textbook of Dermatology. 8th Edition, Wiley-Blackwell Publishing Company, Singapore, 2923-2982.

[2]   Chang, M.W. (2012) Disorders of Hyperpigmentation. Dermatology Jean L Bolognia, 3rd Edition, Elsever Saundres, 1052-1053.

[3]   Pandya, A.G. and Guevara, I.L. (2000) Disorders of Hyperpigmentation. Dermatologic Clinics, 18, 91-98.
http://dx.doi.org/10.1016/S0733-8635(05)70150-9

[4]   Sharquie, K.E. and Noaimi, A.A. (2014) Gazelle Eye Like Facial Melanosis (Clinico-Histopathological Study). Journal of Pigmentary Disorders, 2, 111.

[5]   Sharquie, K.E., Noaimi, A.A. and Al-Ogaily, S.M. (2015) Acanthosis Nigricans as a Cause of Facial Melanosis (Clinical and Histopathological Study). IOSR Journal of Dental and Medical Science, in Press.

[6]   Mohammad, K.I. (1989) Melasma in Iraq. Clinical and Epidemiological Study. A Diploma Dissertation in Dermatology and Venereology, College of Medicine, University of Baghdad, Baghdad.

[7]   Sharquie, K.E. and Dhahir, S.A. (2000) Melasma in Iraqi Women, a Clinical, Histopathological and Histochemical Study. Journal of Pan-Arab League of Dermatologists, 3, 111-117.

[8]   Tetsuo, S. and Yoko, K. (2012) Lichen Planus and Lichenoid Dermatoses. In: Bolognia, J.L., Jorizzo, J.L. and Schaffer, J.V., Eds., Dermatology Jean L Bolognia, 3rd Edition, Elsever Saundres, 183-195.

[9]   Al-Waiz, M.M. (1999) Lichen Planus among IRAQI Patients a Clinico-Epidemiological Study. Iraqi Journal Community Medicine, 12, 63-66.

[10]   Al-Waiz, M.M. (1999) Treatment of Lichen Planus Actinicus by PUVA Therapy. Iraqi Journal Community Medicine, 12, 55-57.

[11]   Lattif, E.A. (1991) Lichen Planus Actinicus among Iraqi Patients. A Diploma Dissertation in Dermatology & Venereology, College of Medicine, University of Baghdad, Baghdad.

[12]   Kang, W.H., Yoon, K.H., Lee, E.S., Kim, J., Lee, K.B., Yim, H., Sohn, S. and Im, S. (2002) Melasma: Histopathological Characteristics in 56 Korean Patients. British Journal of Dermatology, 146, 228-237.
http://dx.doi.org/10.1046/j.0007-0963.2001.04556.x

[13]   Salman, M.S., Kibbi, A.G. and Shukrallah, Z. (1989) Actinic Lichen Planus. Aclinicopathologic Study of 16 Patients. Journal of American Academy Dermatology, 20, 226-231.
http://dx.doi.org/10.1016/S0190-9622(89)70026-8

[14]   Parihar, A., Sharma, S., Bhattacharya, S.N. and Singh, U.R. (2014) A Clinicopathological Study of Cutaneous Lichen Planus. Journal of the Saudi Society of Dermatology & Dermatologic Surgery, 12, 1.

 
 
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