Volume 23 Number 5, Part I November 1990
Lichen planus pigmentosus To the Editor: I read with interest the letter by Kanwar
and Kaur (J AM ACAD DERMATOL 1989;21:815). The authors state that lichen planus pigmentosus was first reported by Bhutani et al.' in 1974. To set the record straight, lichen planus pigmentosus was first described in Indian literature by Sharat C. Desai in 19562: ... the senior author (S. C. D.) has been observing an unusual variant of the disease since 8 years, the diagnosis of which presented difficulties before, but it now seems that it is an atypical variant of lichen planus. He has named it Lichen Planus Pigmentosus sine Lichen, as the descriptive term for this type. This is characterized by generalized mottled pigmentation of bluish black or slatey colour, and usually unaccompanied by typical Lichen Planus lesions.
As pointed out by pinkuS,3 the disease seems to have been well known in France even earlier, where it was known as lichen plan pigmente4 or lichen invisible pigmentogene, whereas it seems to have been described independently in Japanese5 and Italian6 literature in the late 1950s as lichen pigmentosus and lichen invisible pigmentogeno, respectively.
Joseph A. Sundharam, MD Department ofDermatology and Venereology Maulana Azad Medical College New Delhi, India REFERENCES 1. Bhutani LK, Bedi TR, Pandhi RK, et aL Lichen planus pigmentosus. Dermatologica 1974;149:43-50. 2. Desai SC, Marquis L. Lichen planus: clinical study of 67 cases with results of penicillin therapy. Indian J Dermatol VenereoI1956;22:31-48. 3. Pinkus H. Lichenoid tissue reactions. Arch Dermatol1973; 107:840-6. 4. Gougerot H. Lichens atypiques ou invisibles pigmentogenes reveles par des pigmentations. Bull Soc Fr Dermatol Syph 1935;42:792-4. 5. Shima T. Supplementativestudy on lichen pigmentosus. Jpn J DermatoI1956;66:346-53 [English abstract]. 6. Allegra F. Un caso di melanosi della facia: lichen invisible pigmentogeno? Ital Dermatol 1959;100:271-87.
Reply To the Editor: While thanking Dr. Sundharam for his interest and acknowledging the observations ofDesai and Marquis, we reiterate that Bhutani et al. were the first to delineate this entity through clinical and histopathologic studies. For several years before, similar dermatoses have been reported in French, Italians, and even Japanese, but with a descriptive overlap suggesting facial melanoses or pigmented cosmetic dermatosis.' The relevant Indian manuscript quoted in Dr. Sundharam's letter deals mainly with penicillin therapy of lichen planus and makes a cursory mention of a clinical descriptive entity. On the other hand, Bhutani et al. de-
Correspondence 955 fined thenomenclature, clinicalcharacteristics, and pathologic features of this variant as recognized and accepted today.. An example would perhaps illustrate this scientific convention. Although psoralens and UV light were used by several workers before Fitzpatrick coined the term "PUVA" and popularized its use in 1974, PUVA today is irrevocably associated with the name of Fitzpatrick. To quote Carrington et al. 2 with reference to scleredema adultorum of Buschke (first described by Curzio in 1752, more than a century before Buschke), "so, as is often the case, the name of the disease is based on the first person to give a classic description, not necessarily the person who described it." This convention is being frequently discussed as the "Matthew effect" in science,3 and Dr. Sundharam may find solace in it. Thus in our opinion the academic credit for adequately delineating and characterizing lichen planus pigmentosus should deservedly go to Bhutani et al. for having culled out a distinct entity from the existing chaos of conflicting terminology and description. Apparently we are not alone in this reiteration; Herman Pinkus in his Guide to Dermatohistopathology and Martin Black in his chapter on lichen planus and lichenoid eruptions in the Textbook of Dermatology, edited by Rook et al., are in consonance with our views.
Amrinder J. Kanwar, MD, and Surrinder Kaur, MD, FAMS Department ofDermatology, Postgraduate Institute ofMedical Education and Research Chandigarh, India REFERENCES 1. Pinkus H. Lichenoid tissue reactions. Arch Dermatol1973; 107:840-6. 2. Carrington PR, Sanusi ID, Winder PR, et al. Scleredema adultorum. Int J DermatoI1984;23:514-22. 3. Jackson R. The Matthew effect in science. Int J Dermatol 1988;27:16.
Occurrence of a melanoma in a young man being treated for psoriasis To the Editor: Barnhill and Wiles describe the development of a melanoma in a patient with psoriasis who had received hydroxyurea, methotrexate, UV light, topical corticosteroids, tar, and anthralin therapy (J AM ACAD DERMATOL 1989;21:148-50). The occurrence of melanomas in patients with psoriasis is surprisingly uncommon. We report the concurrence of a superficial spreading melanoma in a young man with psoriasis. Case report. A 22-year-old man was first seen in January 1988 with a guttate flare of his psoriasis. He had a 7-year history of psoriasis. Previous treatments included various tar prep-
Lichen planus pigmentosus To the Editor: I read with interest the letter by Kanwar
and Kaur (J AM ACAD DERMATOL 1989;21:815). The authors state that lichen planus pigmentosus was first reported by Bhutani et al.' in 1974. To set the record straight, lichen planus pigmentosus was first described in Indian literature by Sharat C. Desai in 19562: ... the senior author (S. C. D.) has been observing an unusual variant of the disease since 8 years, the diagnosis of which presented difficulties before, but it now seems that it is an atypical variant of lichen planus. He has named it Lichen Planus Pigmentosus sine Lichen, as the descriptive term for this type. This is characterized by generalized mottled pigmentation of bluish black or slatey colour, and usually unaccompanied by typical Lichen Planus lesions.
As pointed out by pinkuS,3 the disease seems to have been well known in France even earlier, where it was known as lichen plan pigmente4 or lichen invisible pigmentogene, whereas it seems to have been described independently in Japanese5 and Italian6 literature in the late 1950s as lichen pigmentosus and lichen invisible pigmentogeno, respectively.
Joseph A. Sundharam, MD Department ofDermatology and Venereology Maulana Azad Medical College New Delhi, India REFERENCES 1. Bhutani LK, Bedi TR, Pandhi RK, et aL Lichen planus pigmentosus. Dermatologica 1974;149:43-50. 2. Desai SC, Marquis L. Lichen planus: clinical study of 67 cases with results of penicillin therapy. Indian J Dermatol VenereoI1956;22:31-48. 3. Pinkus H. Lichenoid tissue reactions. Arch Dermatol1973; 107:840-6. 4. Gougerot H. Lichens atypiques ou invisibles pigmentogenes reveles par des pigmentations. Bull Soc Fr Dermatol Syph 1935;42:792-4. 5. Shima T. Supplementativestudy on lichen pigmentosus. Jpn J DermatoI1956;66:346-53 [English abstract]. 6. Allegra F. Un caso di melanosi della facia: lichen invisible pigmentogeno? Ital Dermatol 1959;100:271-87.
Reply To the Editor: While thanking Dr. Sundharam for his interest and acknowledging the observations ofDesai and Marquis, we reiterate that Bhutani et al. were the first to delineate this entity through clinical and histopathologic studies. For several years before, similar dermatoses have been reported in French, Italians, and even Japanese, but with a descriptive overlap suggesting facial melanoses or pigmented cosmetic dermatosis.' The relevant Indian manuscript quoted in Dr. Sundharam's letter deals mainly with penicillin therapy of lichen planus and makes a cursory mention of a clinical descriptive entity. On the other hand, Bhutani et al. de-
Correspondence 955 fined thenomenclature, clinicalcharacteristics, and pathologic features of this variant as recognized and accepted today.. An example would perhaps illustrate this scientific convention. Although psoralens and UV light were used by several workers before Fitzpatrick coined the term "PUVA" and popularized its use in 1974, PUVA today is irrevocably associated with the name of Fitzpatrick. To quote Carrington et al. 2 with reference to scleredema adultorum of Buschke (first described by Curzio in 1752, more than a century before Buschke), "so, as is often the case, the name of the disease is based on the first person to give a classic description, not necessarily the person who described it." This convention is being frequently discussed as the "Matthew effect" in science,3 and Dr. Sundharam may find solace in it. Thus in our opinion the academic credit for adequately delineating and characterizing lichen planus pigmentosus should deservedly go to Bhutani et al. for having culled out a distinct entity from the existing chaos of conflicting terminology and description. Apparently we are not alone in this reiteration; Herman Pinkus in his Guide to Dermatohistopathology and Martin Black in his chapter on lichen planus and lichenoid eruptions in the Textbook of Dermatology, edited by Rook et al., are in consonance with our views.
Amrinder J. Kanwar, MD, and Surrinder Kaur, MD, FAMS Department ofDermatology, Postgraduate Institute ofMedical Education and Research Chandigarh, India REFERENCES 1. Pinkus H. Lichenoid tissue reactions. Arch Dermatol1973; 107:840-6. 2. Carrington PR, Sanusi ID, Winder PR, et al. Scleredema adultorum. Int J DermatoI1984;23:514-22. 3. Jackson R. The Matthew effect in science. Int J Dermatol 1988;27:16.
Occurrence of a melanoma in a young man being treated for psoriasis To the Editor: Barnhill and Wiles describe the development of a melanoma in a patient with psoriasis who had received hydroxyurea, methotrexate, UV light, topical corticosteroids, tar, and anthralin therapy (J AM ACAD DERMATOL 1989;21:148-50). The occurrence of melanomas in patients with psoriasis is surprisingly uncommon. We report the concurrence of a superficial spreading melanoma in a young man with psoriasis. Case report. A 22-year-old man was first seen in January 1988 with a guttate flare of his psoriasis. He had a 7-year history of psoriasis. Previous treatments included various tar prep-
