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March 2011

Eruptive Lichen Planus Triggered by Acupuncture

Author Affiliations

Author Affiliations: Departments of Dermatology (Drs Fleming and Higgins) and Histopathology (Dr Diaz-Cano), King's College Hospital, London, England.

Arch Dermatol. 2011;147(3):361-362. doi:10.1001/archdermatol.2011.29

We report the case of a 41-year-old, previously fit and healthy woman who developed a widespread eruption following acupuncture treatment for musculoskeletal back pain. Four days after the treatment, she noticed a pruritic papular eruption on her lower back, where the acupuncture needles had punctured her skin. The eruption then spread to her feet, wrists, and chest. She took no regular medications apart from levothyroxine for hypothyroidism and was penicillin allergic.

On examination, we found that she had a florid, widespread eruption on her trunk and limbs, coalescing at skin fold sites on her back. On closer inspection, we noted dense crops of flat-topped, polygonal, red-brown and violaceous papules and plaques at sites of acupuncture needle placement on her lower back (Figure 1). The eruption also involved her trunk, back, and limbs, with dense foci on her wrists and ankles (Figure 2). Her face, palms, and soles were spared. She had a florid white lacy pattern consistent with Wickham striae on her buccal mucosa, but her genital mucosa was spared.

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