The main clinical patterns of lichen planus actinicus include:
1. Classical annular pattern
2. Melasma or mask like pattern
3. Lichen nitidus like pattern
4. Classical LP like pattern (confined to sun exposed areas)
The current case presented with two morphologies:
1. Annular hyperpigmented form (the upper large plaque) and
2. Ordinary LP-like form (the lower smaller papules).
The back and sides of the neck are frequently involved sites by LPA especially in persons who wear shirts with low level or without collars. The patient was advised to practice sun protection measures, hHe wasprescribed a potent topical corticosteroids with a calcineurin inhibitors (the latter alone are ineffective despite the claims of success). For widespread cases systemic Hydroxychloroquine can be prescribed for widespread cases.