Cutaneous Lupus Erythematosus/Lichen Planus Overlap Syndrome With Vitiligo-Like Depigmentation: A Case Report

Cutaneous lupus erythematosus/lichen planus (CLE/LP) overlap syndrome is an uncommon interface dermatosis with features of both disorders.We describe a 60-year-old woman who initially developed pruritic, erythematous, scaly lesions on the dorsal hands, and facial erythema.The initial eruption resolved spontaneously within two months, without treatment, followed by persistent depigmented and erythematous patches at the previously affected sites.Wood's lamp examination accentuated the depigmentation.Histopathology of a depigmented dorsal-hand patch showed interface dermatitis with basal vacuolar alteration and a bandlike lymphocytic infiltrate.Melan-A staining on the same specimen demonstrated melanocyte loss.Direct immunofluorescence of perilesional skin showed immunoglobulin deposition at the dermoepidermal junction and shaggy fibrinogen staining.The findings supported CLE/LP overlap syndrome with subsequent vitiligo-like depigmentation.Hydroxychloroquine 200 mg twice daily and once-daily topical ruxolitinib were initiated; mild repigmentation at the oral commissure was documented clinically and with Wood's lamp examination at one month.Distinguishing coexisting vitiligo from postinflammatory melanocyte loss remains challenging, and the temporal association does not establish causality.