Lichen Planus in Silicosis Patient with Unusually High Antinuclear Antibody Titer

On cutaneous examination, multiple well defined hyperpigmented scaly papules and plaques were present in bilateral symmetric fashion on scalp, forehead, malar areas, nose, ears, retroauricular area, back, dorsum of hands, and extensor aspect of limbs [Figure 1] and [Figure 2]. Differential diagnosis of Lichenoid eruption was excluded based on history (onset of lesions before starting ATT) and histopathology (absence of parakeratosis, focal agranulosis, deep perivascular infiltrates of eosinophils and plasma cells) and subacute lupus eythematosus (LE) was excluded based on clinical morphology of lesions and histopathology (absent epidermal atrophy, dermal oedema and mucin). [1]{Figure 4}{Figure 5}{Figure 6} Various case reports have suggested a link between silicosis and various autoimmune disorders like systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, vasculitis, Sjogren syndrome, pemphigus vulgaris and bullous pemphigoid.