PA32 Severe lichen planus with co-localization of vitiligo: a rare and unusual case

Abstract A 13-year-old boy was seen in the urology clinic for hypo­pigmented patches on glans penis. He underwent circumcision presumed balanitis xerotica obliterans, but histological examination of skin showed lichen planus (LP). This prompted a full check by team, which similar scrotum, anus and ears. referral made to dermatology further assessment. Closer history revealed 1-year inflamed behind ears that spread periorbital penile regions. Concurrent patchy hair loss noted over this time period; otherwise, he asymptomatic, with no relevant past medical or family history. Full extensive areas well-circumscribed erythema penis, peri-orbitally within conchal bowl both Areas scarring alopecia were present complete eyelashes. The severity his condition warranted immediate commencement high-dose oral steroid therapy trial protopic 0.1% ointment. review 6 months later clearly defined depigmentation where there previously active LP, particularly across nose periorbitally, consistent vitiligo. Ongoing follow-up at 1 year stable appearance these areas, despite ongoing use topical calcineurin inhibitor. Co-localization vitiligo context LP is rare entity, only 10 case reports literature. fact are common, each said affect 1–2% general population, may mean their association merely coincidence. However, number publications suggest causal link must be as immunological mechanisms shared two conditions. aetiology known. Various theories exist, including autoimmune hypothesis, conditions immunologically mediated. Another assumes inflammatory mediator release from ultraviolet damage, photosensitive depigmented skin. third supposes photodamage induces Koebner phenomenon vitiligo-affected skin, resulting areas. No theory has been proven definitively. In most cases, described precursor disease; rarely, diseases occur concomitantly progress together. We preceding Our not demonstrates importance diagnosing lesions, provides evidence more than coincidental. More studies into needed understand its entirety.