Esomeprazole-induced lichen planus

Introduction: Lichenoid drug eruption (LDE) is an uncommon cutaneous drug reaction (CDR) that has classically been associated with anti-hypertensive drugs, gold, and penicillamine. Case presentation: We present the case of a 63-year-old woman who developed a pruriginous disseminated dermatosis composed of violaceous polygonal flat-topped papules affecting the flexural aspects of the upper and lower limbs, abdominal flanks, and the lumbar and sacral regions. The lesions started 2 weeks after initiating esomeprazole intake. A histopathological exam of one of the lesions was compatible with LDE. The patient discontinued esomeprazole and was treated with medium potency topical corticosteroids and emollient with full resolution of symptoms. Conclusion: Even though CDRs associated with proton-pump inhibitors (PPI) are relatively common, there are only three reported cases of LDE. We report this case to highlight the importance of considering PPIs as the culprit drug in similar clinical situations.