Post-inflammatory hyperpigmentation

QUESTION 46

A 66-year-old African American woman presents to the dermatology clinic for follow-up of lichen planus. She has had lichen planus for several years with flares of her disease every 2–3 months. She is currently improved with the use of topical triamcinolone 0.1% ointment. She is concerned about darkly pigmented areas on her arms and back, particularly in areas of the body where lichen planus have resolved. The areas are asymptomatic and have been present for at least 3 months. On examination, there are hyperpigmented macules and patches in a linear arrangement on the left shoulder and upper arm with a well-demarcated border and many scattered hyperpigmented macules on the back, all at sites of prior lichen planus lesions (46a, b).