Abstract:- 

Lichen Planus pigmentosus of the face will cause diffuse pigmentation over the face, following sun exposure and trivial injuries. Common sites of Lichen planus Pigmentosus are face arms and other sun exposed areas and if Koebner Phenomenon is present, the Hyper pigmentation will recur periodically with mildest and trivial injuries like even shaving the face. So for no shorter treatment is available for this type of Koebner inducible Hyper pigmentation, usually the pigmentation will settle only after two years, in spite of vigorous treatment with all modalities of treatments.

One young man of age 40 years came with diffuse pigmentation of face in the sun exposed area (sides of face) of six months duration.  He has been treated with high potent steroids and the following drugs at various consultations, Tretinoic acid cream, kojjc acid cream and vitamin c, Tacrolimus, pimecrolimus and Topical metronidazole gel. Patient became anxious and depressed. I had put him on Topical mild potent steroid Hydrocortisone cream mixed with    kojjc acid and vitamin c cream and applied over the lesion at night and a sunscreen in the daytime. Patient was advised to visit my clinic once in a week for mesotherapy with water. It has been done as follows, patient was asked to apply the mixture of kojjc and Hydrocortisune over the pigmented area followed by the water mesotherapy. Water is a harmless agent even when applied in a Jet form. This is continued at an interval of once in a weak for 20 weeks. This mesotherapy was done in a slow speed, over the cream applied pigmented area. After 20 weeks there was a marked improvement in the pigmentation. 75 percentage of clearance of lesion and color change was noted. Serial photos were taken and compared the efficacy. This procedure was carried out with the consent of the patient. Mesotherapy with water will enhance the absorption of drugs applied over the skin.

Conclusion:-

Since koebner phenomenon positive pigment Lichen planus is a difficult problem for early healing and clearance; we are in a position to go for a novel innovative treatment for early improvement. The above method seems to be a safe and effective technic for early clearance of pigmentation; and for the psychologically affected patients with recurrent pigmentation.

The following advices are given to the patient.

1.      Avoid Sun exposure.

2.      Use adequate sunscreen lotions.

3.      Avoid trivial injuries.

4.      Avoid shaving, instead trimming best.