Dear XXXXXXX

Thanks for the query.

You have told that your diagnosis is LPP. LPP can be many things but as you have said you have got hyperpigmented spots over neck. The description fits as lichen planus pigmentosus but needs inspection to confirm.

Lichen planus pigmentosus is pigmentary disorder of unknown etiology. In which slate grey to black brown pigmentation develops over neck, upper chest, upper limbs. Do your spots look so?

If yes, unfortunately it has no definite treatment. Oral and Topical steroids, Topical hydroquinone(2-4 %), Tretinoin 0.025%, Adapalene 0.1%, Glycolic acid 6-12%, Kojic acid, Azelaic acid , Glycolic acid peeling can be used to treat this hyperpigmenatation. You need prescription from a Doctor as most of them can cause local irritant reaction.

Medicines prescribed to you i.e. colchicine(zycolchine), steroids (zempred ),isotretinoin( Isotroin ) are advisable you may continue with them but melanocyl contains psoralen it should not be used by you as it may lead to further darkening of skin.

In addition you may apply Aloevera lotion during day and also a mild steroid at night time .
Don't use melanocyl. Topical hydroquinone 4% can be used at night time.

Hope I answered your query, I am available for follow up.

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Dear XXXXXXX

Thanks for getting back to me.

LPP has a chronic course it may take 6 months of treatment to show response.
Keep good nutritious diet, take lot of vit c containing foods like lemon water, citrous fruits.
Avoid sun exposure.

You will need prescription for those drugs as they cause local irritation talk to your doctor about the use and application process.

Hope I answered your query, I am available for follow up.

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