[Pigmentosus hypertrophic lichen planus with Blaschkoian distribution, 3 clinical subtypes in a single patient].

A 48-year old female, with no relevant history of morbidity, consulted for symptoms of 3-month evolution of pruritic lesions located on the left side of the body that had been growing progressively. A physical examination found evidence of hyper-pigmented and hyperkeratotic papules that had coalesced into plaques on the abdomen, hip and upper part of the left thigh. The lesions did not go above the middle line of the body; on the upper part of the thigh they presented a blaschkoid distribution. (fig. 1). Dermatoscopy revealed pigmentation and Wickham striae (fig. 2). The skin biopsy confirmed the presence of pigmented hypertrophic lichen planus. Treatment was initiated with topical clobetasol. One month later, during follow-up, scarce response was observed so the treatment was changed to systemic therapy with oral isotretinoin.