Triamcinolone
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First report of lichen planus?: case report A 21-year-old man developed linear lichen planus during treatment with triamcinolone acetonide for alopecia areata. The man was receiving IM triamcinolone 40mg once a month for alopecia areata. After 10 injections, he noticed the development of numerous eruptions on his left thigh. He presented with a 2-month history of these pruritic linear eruptions. The eruptions consisted of multiple pigmented brownish papules, predominantly distributed on the posterior region of the left thigh with a disseminated but, at some portions, clear linear distribution. Dermoscopy showed Wickham’s striae. Skin biopsy revealed basal cell hydropic degeneration and Civatte body formation associated with hypergranulosis, rete ridges that were saw-tooth like in appearance and a band-like mononuclear cell infiltrate in the upper dermis. Findings were consistent with a diagnosis of lichen planus. However, a dense infiltration of mononuclear cells around eccrine glands, which is characteristic of lichen striatus, was also observed. The man received topical difluprednate for over 1 year without remarkable improvement. Author comment: "Although glucocorticoid has not been reported as an inducer for [lichen planus], in our case, we can not exclude the possibility that the injections might have influenced the immune system." Numata Y, et al. Linear lichen planus distributed in the lines of Blaschko developing during intramuscular triamcinolone acetonide therapy for alopecia areata multiplex. Journal of the European Academy of Dermatology and 801124615 Venereology 22: 1370-1372, No. 11, Nov 2008 - Japan
» Editorial comment: A search of AdisBase, Medline, and Embase did not reveal any previous case reports of lichen planus associated with triamcinolone. The WHO Adverse Drug Reactions database contained no reports of lichen planus and two reports of lichenoid dermatitis associated with triamcinolone.
0114-9954/10/1228-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 15 Nov 2008 No. 1228
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