The patient is an otherwise healthy 30 yo man in good general health. For two months he has had a slightly pruritic dermatitis on his forehead.
Clinically, we considered En Coup de Sabre (Linear scleroderma)
Dermatoscopic Image: (Courtesy of Makayla Powers PA-C)
Punch biopsy showed:
Lichenoid interface and perifollicular dermatitis with postinflammatory pigment alteration. No features of localized scleroderma. These findings are suggestive of discoid L.E. or linear L.P.
Photomics courtesy of David Jones, MD, Berkshire Medical Center, Pittsfield, Massachusetts.
Treatment was initiated with clobetasol ointment. Will switch to tacrolimus ointment if response is good.
References
1.
Rodriguez E et. Al. Acute Onset Linear Lichen Planus Pigmentosus of the
Forehead: A Case Series J Drugs Ddermatol 2023 Jan 1;22(1):94-97. Free Full Text
2. Khelifa E. Linear sclerodermic lupus erythematosus, a distinct variant of linear morphea and chronic cutaneous lupus erythematous. Int J Dermatol 2011 Dec;50(12):1491-5. PMID 22097995
3. Reference suggested by Dr. Sontheimer. Dao DP, Sahni DR, Sontheimer DR. Linear discoid lupus erythematous simulating en coup de sabre morphea in a female chronic granulomatous disease carrier. Dermal Online J. 2023 Dec 15;29(6). Free Full Text.
4. Das A et al. Linear lesions in dermatology: a clinicoaetiopathological study. Clin Exp Dermatol 2021 Dec;46(8):1452-1461. PMID: 34022084
5. Urur YG. Et. Al. Dermoscopic Characteristics of Cutaneous Lupus Erythematosus According to Subtype, Lesion Location, Lesion Duration, and CLASI Score. Dermatol Pract Concep. 2024 Jan 1;14(1):e2024040. Free Full Text.
