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Lichen Planus Pigmentosus Inversus (LPPI) is a rare variant of lichen planus characterized by well-demarcated, often slight pruritic, dark-gray plaques in intertriginous zones, hence the attribute of “inversus”, originally described by Pock et al. in 2001. Less than 100 cases have been reported to date, and here we present a case in a 52-year-old male who presented with two months duration of grey-brownish plaques in bilateral axillary, submammary, antecubital, and inguinal folds. No triggering agent was present, and the biopsy showed an interface/lichenoid dermatitis with plenty of pigment incontinence. Topical tacrolimus 0.1% ointment was administered with moderate improvement at five weeks. A review of the literature showed no significant differences in involved sites and age distribution among genders, with a slightly longer duration of manifestations in females. The most administered therapeutic agents were topical corticosteroids, alone or in combination with other agents, and tacrolimus.

A 35-year-old man was referred to our hospital with a 3 months history of itchy cutaneous eruption on the trunk and asymptomatic cutaneous eruption on both groins. Physical examination revealed several, purplish-brown, scaly papules on the trunk and well-circumscribed, brown patchs in a linear distribution, on the bilateral inguinal regions. Dermoscopic examination of papules on the trunk revealed white crossing lines surrounded by brown dots; dermoscopic examination of patchs on groins revealed gray-brown dots and globules. According to histological, dermoscopical and clinical changes, the diagnoses of classical lichen planus (LP) for the lesions on the trunk; and lichen planus pigmentosus inversus (LPPI) for the lesions on the inguinal regions were made. Inhere we have described a rare case of LPPI and classical LP with dermoscopic features; and we suggest that LPPI is a variant of classical LP.