A Delphi consensus on the nomenclature and diagnosis of lichen planus pigmentosus and related entities

Rashmi Sarkar, Keshavamurthy Vinay, Anuradha Bishnoi, Shital Poojary, Monisha Gupta, Muthu Sendhil Kumaran, Akshay Jain, Chethana Gurumurthy, Pooja Arora, Rajat Kandhari, Sanjay Rathi, Vijay Zawar, Vishal Gupta, Vignesh Narayan Ravivarma, Michelle Rodrigues, Davinder Parsad

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8 Citations (Scopus)

Abstract

Background: Although well known in clinical practice, research in lichen planus pigmentosus and related dermal pigmentary diseases is restricted due to lack of consensus on nomenclature and disease definition. Aims and Objectives: Delphi exercise to define and categorise acquired dermal pigmentary diseases. Methods: Core areas were identified including disease definition, etiopathogenesis, risk factors, clinical features, diagnostic methods, treatment modalities and outcome measures. The Delphi exercise was conducted in three rounds. Results: Sixteen researchers representing 12 different universities across India and Australia agreed to be part of this Delphi exercise. At the end of three rounds, a consensus of >80% was reached on usage of the umbrella term ‘acquired dermal macular hyperpigmentation’. It was agreed that there were minimal differences, if any, among the disorders previously defined as ashy dermatosis, erythema dyschromicum perstans, Riehl’s melanosis and pigmented contact dermatitis. It was also agreed that lichen planus pigmentosus, erythema dyschromicum perstans and ashy dermatosis did not differ significantly apart from the sites of involvement, as historically described in the literature. Exposure to hair colours, sunlight and cosmetics was associated with these disorders in a significant proportion of patients. Participants agreed that both histopathology and dermatoscopy could diagnose dermal pigmentation characteristic of acquired dermal macular hyperpigmentation but could not differentiate the individual entities of ashy dermatosis, erythema dyschromicum perstans, Riehl’s melanosis, lichen planus pigmentosus and pigmented contact dermatitis. Limitations: A wider consensus involving representatives from East Asian, European and Latin American countries is required. Conclusion: Acquired dermal macular hyperpigmentation could be an appropriate conglomerate terminology for acquired dermatoses characterised by idiopathic or multifactorial non-inflammatory macular dermal hyperpigmentation.
Original languageEnglish
Pages (from-to)41-46
Number of pages6
JournalIndian Journal of Dermatology , Venereology and Leprology
Volume89
Issue number1
DOIs
Publication statusPublished - Jan 2023

Open Access - Access Right Statement

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License (https://creativecommons.org/licenses/by-nc-sa/4.0/), which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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