Lichen planus (LP) is a chronic inflammatory dermatosis with a prevalence of 0.1%-4%, typically affecting individuals aged 30-60 years. Isolated lip involvement is uncommon, seen in 0.51%-8.9% of cases, predominantly in middle-aged men. We report a 58-year-old male with well-controlled diabetes who developed isolated lower lip LP, initially misdiagnosed as herpes simplex virus infection and unresponsive to oral acyclovir. Dermoscopy and histopathology confirmed the diagnosis. The patient was managed with a novel regimen: Tacrolimus 0.1% ointment (morning) and tretinoin 0.025% cream (night), alongside sunscreen and petroleum jelly. After 4 weeks, marked improvement was observed with flattened lesions and reduced pruritus. This case underscores the potential efficacy of combining a calcineurin inhibitor and a retinoid as a corticosteroid-sparing alternative for localized LP. Clinically, this approach offers a valuable treatment option for patients with lip LP showing suboptimal response to initial corticosteroid therapy, minimizing steroid-related adverse effects and improving therapeutic outcomes.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Complementary Therapies ; Lichen Planus ; Tacrolimus ; Tretinoin

Background: Skin metastases are rare yet crucial indicators of advanced disease. They can mimic various skin conditions, making them challenging to diagnose. Aims and Objectives: To investigate the incidence rate of biopsy-confirmed cutaneous metastasis and explore the clinical presentation, workup, and diagnostic techniques for skin metastases Materials and Methods: Local study involving comprehensive laboratory tests, pathological examination, and immunohistochemistry to identify primary tumors and confirm diagnoses. Results: Nodules were the most common manifestation of skin metastases, particularly in breast carcinoma. The chest wall and abdomen were frequent sites of involvement. Pathological examination and immunohistochemistry played a critical role in confirming diagnoses, revealing various histopathologic patterns. Immunohistochemical markers assisted in determining tumor origin but required careful interpretation. Monitoring tumor behavior over time provided insights into nature and origins. Conclusion Comprehensive workups including laboratory testing, pathology, and immunohistochemistry are essential for accurate diagnosis and management of skin metastases. Careful monitoring of tumor behavior can provide valuable information about its nature and origins.
Diagnosis