Giant annular lichenoid drug eruption caused by efavirenz therapy

Lichen planus (LP) is a common inflammatory dermatosis, which involves the skin, mucosa, and nails. The clinical presentation is highly variable with over 20 distinct morphologic forms described.1 Annular LP, which presents with circinate lesions with elevated borders, is a rare form of LP, comprising 7%-10% of LP cases.2 Annular LP has been reported in association with Sneddon syndrome, Crohn disease, and HIV infection.2,3 Drug-induced annular LP has not been described. Here, we report the first case of efavirenz-induced giant annular LP in a patient with HIV.