Induction of dramatic hyperpigmentation in a patient with generalized lichen planus treated with re-PUVA.
BACKGROUND
Retinoids plus PUVA (re-PUVA) may be used in the treatment of lichen planus in cases that do not respond to monotherapy. Hyperpigmentation is a potential side effect of re-PUVA therapy.


OBJECTIVE
A case of remarkably intense transient hyperpigmentation secondary to re-PUVA therapy is presented.


RESULTS
An 18-year-old male with lichen planus who had been taking isotretinoin 80 mg per day for seven days developed an exaggerated hyperpigmentation following the third dose of PUVA.


CONCLUSIONS
As the hyperpigmentary reaction did not occur until the third PUVA dose, which was near the steady state of isotretinoin, this case may illustrate a case of photosensitization secondary to isotretinoin alone or isotretinoin in combination.
Carlin
Christopher S
CS
Department of Dermatology, University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
Florell
Scott R
SR
Krueger
Gerald G
GG
D000293:Adolescent; D003879:Dermatologic Agents / Q000009:adverse effects*; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced*; D015474:Isotretinoin / Q000009:adverse effects*; D008010:Lichen Planus / Q000188:drug therapy*; D008297:Male; D011701:PUVA Therapy / Q000009:adverse effects*
D003879:Dermatologic Agents; D015474:Isotretinoin