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Linear rays of depigmentation along lymphatics after intralesional corticosteroid therapy

Department of Dermatology, Venereology and Leprosy, Mahatma Gandhi Institute of Medical Sciences, Maharashtra, India A 53‐year‐old female, diagnosed as hypertrophic lichen planus presented to us with white colored patches over her ankles with linear white lines radiating to her legs. She received intralesional injections of triamcinolone acetonide in the skin lesions on multiple occasions in the past for hypertrophic lichen planus. Her general and systemic examinations were normal. Cutaneous examination showed bilaterally symmetrical depigmented patches over both ankles and curvilinear rays of depigmented lines arising from the superior margin of depigmented patch [Figure 1]. The lines extended up to the middle third of both legs [Figure 2]. However, she had no signs suggestive of exogenous Cushing’s syndrome. We diagnosed post‐intralesional steroid induced depigmentation along the dermal lymphatics and reassured her about the benign nature of the condition and treated her with repigmenting therapy (topical psoralen ultraviolet A therapy and topical calcineurin inhibitor).