We present the case of a 29-year-old black female with an initial clinical and histopathologic diagnosis of actinic lichen nitidus. Three years later, she presented with scattered hyperpigmented macules with oval pink/violaceous plaques bilaterally on her forearms and on her neck, clinically consistent with actinic lichen planus. She was treated with topical steroids at each visit, with subsequent resolution of her lesions. In this report, we discuss the spectrum of actinic lichenoid dermatoses and of disease that presents even in the same patient.
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