Lichen Planus Pemphigoides With Extensive Melanosis

Abstract

Lichen planus pemphigoides occurred in a patient with malignant lymphoma. A square of lichenified brown skin appeared shortly after the last roentgen irradiation treatment, being strictly defined to the irradiated field. A few weeks later a bullous eruption with clinical and histological features suggestive of pemphigus vulgaris occurred which was also localized on the peripheric sides of the lichenificated square. Several months later a papular lichen planus rash, with severe itching and a typical histological picture, appeared. In a later stage of the disease, there appeared a dark, almost black, pigmentation of the skin which gradually spread over the whole body. The patient died 11 months after onset of the skin disturbances. Postmortem examination failed to reveal any signs of the lymphosarcoma. The possibility of a connection between the lichen planus pemphigoides and the malignant disease is discussed.