The rare occurrence of cutaneous and mucosal lichen planus in HIV infection

Description

A 36-year-old man, a rickshaw driver by profession, who was diagnosed with HIV infection 3 years back, was on regular antiretroviral therapy consisting of zidovudine, lamivudine and nevirapine. He presented with complaints of a pruritic rash on both his legs since 7 months, which started as a single lesion and gradually spread to the current state over the next 6 weeks. Barring his antiretroviral therapy, he did not have any other drug history. He did not consume alcohol, did not chew tobacco and did not smoke. His CD4-positive cell count at the time of presentation was 336/mm³, serology for hepatitis C virus and hepatitis B virus was negative and other laboratory parameters such as complete blood count, liver and renal function tests were normal.

On examination, he had polygonal, planar, purple papules over the anterior aspect of legs (figure 1), and also white lacy lines (with a reticular pattern) in the left buccal mucosa (figure 2), which were suggestive of Wickham striae.

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