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PUVA-Induced Lichen Planus
Soni Nanda, Chander Grover and Belum Siva Nagi Reddy
Department of Dermatology, Venereology and Leprology, Maulana Azad Medical College and Associated Hospitals, New Delhi, India.
A 28-year-old male with histologically proven psoriasis vulgaris was administered oral 8-methoxypsoralen UVA therapy (PUVA). The plaques of psoriasis gradually responded to treatment, however numerous pruritic, violaceous papules over the right forearm and left thigh developed 5 months after starting PUVA (45 sittings with a cumulative dose of 156 J/cm2). Histopathologic examination of these lesions was compatible with the diagnosis of lichen planus (LP). On stopping PUVA therapy, the lesions subsided in one month. This case emphasizes the hypothesis that cell injury caused by PUVA therapy could expose some sequestered antigens to autoreactive lymphocytes and induce lichen planus.
key words: psoralen ultraviolet A therapy; lichen planus; epitope spreading
Received September 2, 2002; Accepted for publication November 19, 2002
Reprint requests to: Dr. Soni Nanda, C-85, East End Apartments, Mayur Vihar, Phase-I Extension, New Delhi, India.
J Dermatol 30 (2): 151-153, 2003
Japanese Dermatological Association
http://www.dermatol.or.jp
