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INTRODUCTION: Zosteriform Lichen Planus represents a relatively uncommon variant of LP. It is characterized by a distinctive distribution following Blaschko's line and involving multiple dermatomes, setting it apart as a unique manifestation. There have been several cases of cutaneous LP reported, but relatively few of them presented as zosteriform LP. To our knowledge, this is the first documented case of zosteriform LP as an adverse drug reaction. PRESENTATION OF CASE: A 62-year-old female presented to the dermatology clinic with asymptomatic hyperpigmented patches that exhibited gradual spreading. The patient had a history of breast cancer and underwent a mastectomy procedure, chemotherapy, adjuvant therapy, and radiation treatment. A dermatological examination revealed the presence of multiple hyperpigmented, ill-defined macules arranged linearly on the left flank and inner thigh. DISCUSSION: A biopsy confirmed the diagnosis as Lichen Planus. The patient's condition significantly improved following a nine-week topical steroid with dose tapering. CONCLUSION: Zosteriform LP is a rare adverse skin reaction associated with chemotherapeutic drugs. The immunosuppression induced by chemotherapy may trigger T-cell activation, leading to a lichenoid tissue reaction. A thorough patient history assessment is essential for the management of such adverse reactions.
RESUMO
Context: Many therapeutic modalities have been reported for the treatment of warts: a common bothersome condition; however, no single treatment is completely effective. Aims: This study aimed to evaluate the efficacy and safety of intralesional injection of measles, mumps and rubella (MMR) vaccine and to compare its efficacy with 85% formic acid puncture for common warts. Settings and Design: This was a prospective comparative study. Methods and Material: A total of 60 patients, divided into two groups, were included in the study. Group A received an intralesional MMR vaccine of 0.3 ml per lesion, and group B received 85% formic acid puncture into each lesion with a maximum of 10 warts treated in each case. Five sessions were conducted every 2 weeks in each case with a follow-up period of 3 months to check for recurrence. Statistical Analysis Used: The Chi-square test, Fisher's test and t-test were used for statistical analysis. A P-value <0.05 was considered statistically significant. Results: In group A, the complete response was observed in 62.5%, partial response in 8% and no response in 4.1% of patients. In group B, the complete response was observed in 31.8%, partial response in 63.6% and no response in 4.5% of patients. The difference in cure rates was found to be statistically significant with a P value of 0.031. No recurrence was observed in both groups in the follow-up period. Conclusions: Immunotherapy by intralesional MMR vaccine is a simple, well-tolerated, effective and cost-benefit modality for the treatment of warts and showed a statistically significant cure rate than formic acid therapy.
