Lichen aureus with clonal T cells in a child possibly induced by regular consumption of an energy drink.

Lichen aureus is a rare disease of unknown origin that is classified under the group of pigmented purpuric dermatoses. Its most important differential diagnosis is both clinically and histologically mycosis fungoides, into which the disease can proceed in very rare cases. We describe an unusual multilocular lichen aureus possibly induced by the almost daily consumption of an energy drink. An 11-year-old boy presented with a history of asymptomatic ochre patches on his extremities and abdomen occurring after regular consumption of an energy drink. Histologic examination showed a band-like lymphocytic infiltrate, containing hemosiderin deposits and extravasal erythrocytes adjacent to dermal blood vessels, in the iron-stain detection of hemosiderin. Because of these findings, lichen aureus was diagnosed. After a 2-month abstention from the energy drink, no new lesions appeared and the present lesions grew pale and finally disappeared. The case shows a rare multilocular lichen aureus, which disappeared after the consumption of an energy drink was stopped. The ingredients of the energy drink are an example of a possible trigger of the disease.