Zosteriform pattern in LP, without evidence of herpes zoster, is an extremely rare occurrence and such presentation of the disease over head and neck region, to the best of our knowledge, was not reported in literature before. We present a patient who had grouped lichenoid lesions on one side of the neck with no previous or concomitant history of herpes zoster on the involved site or elsewhere on the body.
Case Report: A 56 years old male patient, who was otherwise healthy, presented with moderately itchy hyperpigmented papular skin lesions, which were arranged in groups as well as discretely on the right side of the upper neck, pre-auricular and lower mandibular area. There was sharp demarcation in the midline. The lesions appeared suddenly and persisted without any significant change except that some of the contiguous papules transformed into plaques. There was no history of drug intake such as antimalarials, antihypertensive, antibiotics, and heavy metals prior to eruption. He did not have previous or concomitant history of herpes zoster at the site of these lichenoid lesions or elsewhere on the body. He was neither hypertensive nor diabetic. Routine laboratory investigations were within normal limits and he was negative for hepatitis B and hepatitis C serology. Histology of a papular skin lesion revealed hyperkeratosis, hypergranulosis, basal cell degeneration, civatte bodies, pigmentary incontinence and upper dermal dense mononuclear infiltrate. The patient was treated with potent topical steroid (clobetasol) to which he responded satisfactorily.
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