Hyperpigmented Upper Eyelid: A Clue to the Diagnosis of Facial Lichen Planus Pigmentosus in a Patient with Frontal Fibrosing Alopecia

Facial lichen planus pigmentosus (LPPig) was identified as a rare variant of classic lichen planus in patients with frontal fibrosing alopecia (FFA). Diagnosing facial LPPig can be challenging due to its similarity to melasma or postinflammatory hyperpigmentation. The document described a case of a postmenopausal black woman with FFA who exhibited brown-grayish pigmentation on her face and upper eyelids, confirmed by dermoscopy. The study suggested that hyperpigmentation of the upper eyelid, identified through specific dermoscopy features (upper eyelid sign), could serve as a diagnostic clue for LPPig, potentially avoiding the need for a scar-causing face biopsy.