Dermatology: Practical and Conceptual Image Letter | Dermatol Pract Concept. 2024;14(1):e2024085 1 Dermoscopy of Actinic Lichen Planus Muazzez Cigdem Oba1, Meryem Yuvruk2 1 Department of Dermatology, Health Sciences University, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, Turkey 2 Department of Pathology, Health Sciences University, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, Turkey Citation: Oba MC, Yuvruk M. Dermoscopy of Actinic Lichen Planus. Dermatol Pract Concept. 2024;14(1):e2024085. DOI: https://doi .org/10.5826/dpc.1401a85 Accepted: September 2, 2023; Published: January 2024 Copyright: ©2024 Oba et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: Both the authors have contributed significantly to this publication. Corresponding Author: Muazzez Cigdem Oba, Department of Dermatology, Health Sciences University, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, Turkey. Email: muazzez.oba@istanbul.edu.tr Case Presentation An otherwise healthy 37-year-old woman presented to our clinic complaining of a rash on her lower eyelids that had been persistent for approximately one year. She de- nied use of any cosmetic products on her face. On der- matologic examination, the patient had well-circumscribed erythematous, scaly, slightly hyperpigmented thin plaques on lateral sides of both lower eyelids (Figure 1, A and B). Lesions were asymptomatic and had increased in size during summer. Dermatoscopic examination revealed the presence of scales and perifollicular pigmentation on an erythematous base (Figure 1C). Histopathology revealed parakeratosis, basal vacuolar degeneration, necrotic kera- tinocytes, dermal lichenoid infiltration and melanophages (Figure 1, D and E). The patient was diagnosed with actinic lichen planus. Teaching Point Actinic lichen planus, also known as lichen planus subtropicus, is a rare photosensitive variant of lichen planus that typically af- fects young adults with dark complexion. Differing from classic lichen planus, Koebner phenomenon, pruritus, mucosal or nail involvement are commonly absent in actinic lichen planus [1]. Data on dermoscopic findings of actinic lichen planus is scarce. A dermoscopic study on lichen planus variants re- ported presence of diffuse peppering on brown background in all 10 lesions of 2 actinic lichen planus cases with the absence of Wickham striae and vascular patterns [2]. Similarly, diffuse peppering along with some hair follicles with central black dots was reported in dermoscopy of a case actinic lichen planus [1]. We presented this case of actinic lichen planus, which is a less-known subtype of lichen planus with its different der- moscopic findings. 2 Image Letter | Dermatol Pract Concept. 2024;14(1):e2024085 References 1. Venturini M, Manganoni AM, Zanca A, et al. Pigmented actinic lichen planus (PALP) mimicking lentigo maligna melanoma: Usefulness of in  vivo reflectance confocal microscopy in di- agnosis and follow-up. JAAD Case Rep. 2018;4(6):568-572. DOI: 10.1016/j.jdcr.2018.02.008. PMID: 29998176. PMCID: PMC6038262. 2. Güngör Ş, Topal IO, Göncü EK. Dermoscopic patterns in ac- tive and regressive lichen planus and lichen planus variants: a morphological study. Dermatol Pract Concept. 2015;5(2): 45-53. DOI: 10.5826/dpc.0502a06. PMID: 26114051. PMCID: PMC4462898. Figure 1. (A,B) Scaly plaques on both lower eyelids. (C) Dermoscopic image showing scales and perifollicular hyperpigmentation on ery- thematous base. (D) Basal vacuolar degeneration, dermal lichenoid lymphocytic infiltration, dermal melanophages, necrotic keratinocyte on hair follicle epithelium. (H&E x200). (E) Parakeratosis and dermal lichenoid lymphocytic infiltration (H&Ex100).