Various drugs have been known to cause a rash with lichenoid features. These include antimalarials, arsenicals, beta blockers, captopril, furosemide, gold salts, methyl dopa, penicillamine, quinidine, sulfonylurea, salsalate and thiazides. One patient's LP was caused by gold-containing cinnamon schnapps. Another developed LP-like contact dermatitis due to contact with methacrylic acid esters (used in the car industry) [BJD 1996;134;358]. Vaccination against hepatitis B has triggered several cases of LP--the majority reported out of Italy and France [JAAD 2001;45;614]. See also lichen planus.
Some have said that lichenoid drug eruptions differ from classic LP in that classic LP prefers the flexor extremities whereas LDE has a more symmetric involvement of the trunk and extremities. Atypical forms are more likely. A photodistribution is also more common in LDE. Some have said that the histology may help in differentiating.
Removal of the offending agent is of course indicated. Steroids--topical or in severe cases systemic--may be given as a short course.
JAAD July 2009 Volume 61, Issue 1, Pages 104–111
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