History:

 A 23-year-old male presented with a symptomatic rash involving the face including the lips of five months duration.

LPA Vs DLE?

The characteristic violaceous to hyperpigmented color, minimal scaling except on the lips, annular shapes and absent atrophic scarring are all in favor of LPA. However, the lip involvement caused the main confusion as it is commonly involved in DLE, but also frequently involved in LPA which usually favors the lower lip. How to relieve this confusion? 

Answer: Skin biopsy was consistent with LPA.

Regarding treatment, with such cases of limited extent and usually asymptomatic (only of cosmetic concern), Topical corticosteroids plus Tacrolimus ointment and sunscreen gave very satisfactory results for both the patient and treating doctor. In refractory cases, systemic therapy can be justified.