Lichen planopilaris with drug-induced lichen planus: A Case Report

Rabia  Alam; Harsh  Tyagi; Shitij  Goel

doi:10.51168/sjhrafrica.v6i12.2334

Authors

Rabia Alam Junior Resident, Department of Dermatology, Venereology & Leprosy, School of Medical Sciences and Research Sharda University Greater Noida
Harsh Tyagi Junior Resident, Department of Dermatology, Venereology & Leprosy, School of Medical Sciences and Research Sharda University Greater Noida
Shitij Goel Professor & HOD, Department - Dermatology, Venereology and Leprosy, School of Medical Sciences and Research Sharda University Greater Noida

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2334

Keywords:

Lichenoid drug eruption, lichen planus, lichen planopilaris, anti-tubercular therapy, scarring alopecia, drug-induced skin reaction, cutaneous adverse effect, tuberculosis treatment

Abstract

Background:

Lichenoid drug eruption is a known adverse reaction to several medications, including anti-tubercular therapy, and may clinically resemble idiopathic lichen planus. Lichen planopilaris is a scarring inflammatory disorder of hair follicles that can result in permanent alopecia. The coexistence of these two conditions is rare and presents diagnostic and management challenges.

Case presentation:

A 25-year-old female receiving first-line anti-tubercular therapy for pulmonary tuberculosis developed progressive scarring alopecia of the scalp along with pruritic violaceous papules over the neck, trunk, and axillae. Dermoscopy and histopathological examination confirmed a lichenoid drug eruption with coexisting lichen planopilaris. Given the near completion of tuberculosis treatment, anti-tubercular drugs were continued, and the patient was managed with topical corticosteroids, emollients, and oral antihistamines, with planned initiation of hydroxychloroquine after therapy completion.

Conclusions:

Early identification of drug-induced lichenoid reactions is crucial to prevent irreversible scarring. A conservative, multidisciplinary approach can allow continuation of essential anti-tubercular therapy while effectively managing cutaneous manifestations.

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