3 years hx Now spreading towards chest and back Diag plz

Taking in consideration the age, site (very important), duration, the dark violaceous to purplish rash, the case goes with LP.

Is it LP actinicus or Ordinary LP?

  1. Although three years duration, still you can recognize wickham’s striae ie still the rash is active rather than postinflammatory hyperpigmentation. This feature is in favor of ordinary LP vs. LP actinicus!

  2. Spreading of the rash towards the hidden parts of the trunk like the chest and especially the back is also in favor of ordinary LP!

  3. Lacking the characteristic morphological shapes of LP actinicus like annularity, mask type or melasma like is also in favor of ordinary LP!

  4. Itching wasn’t mentioned per history! Itching with such a rash will be in favor of ordinary LP vs. LP actinicus!

LP vs. Psoriasis

Symptomatology, color of rash, shiny surface and reticular scaling are in favor of LP. However, still psoriasis is a differential. Treat with topical corticosteroids plus a calcineurin inhibitor

A/c: itching , severe burning irritation for 2 months.

Drug hx : topical anti fungal cream. But no improvment.

No pus/blood or watery discharge.

O/e: thighs