Epidemiology, clinical features, and associated factors in 78 cases of lichen planus on black skin

Comparative Analysis of Sociodemographic, Clinical Features, Laboratory Findings, and Treatment Protocols in Generalized and Localized Cutaneous Lichen Planus

BACKGROUND

Lichen planus (LP) is a chronic, inflammatory, and mucocutaneous disease that can present in various clinical forms, affecting the skin, mucosa, and appendages of the skin. A more extensive form of cutaneous LP, known as generalized cutaneous LP (GCLP), involves a significant portion of the body surface area. Because of the accompanying intense pruritus and difficulties with its treatment, the diagnosis and treatment of GCLP are gaining importance. In this study, we aimed to compare the characteristics of cutaneous LP with localized involvement and those of GCLP.

METHODS

We retrospectively analyzed patients' sociodemographic characteristics (age, gender), clinical features (localization and duration of lesions), laboratory findings, treatments received, and relapse rates following treatment using electronic medical records obtained from our university's digital registry system.

RESULTS

Among the patients with cutaneous LP, 24.7% (n=46) had localized cutaneous LP (LCLP), and 22.5% (n=42) had GCLP. Involvement of the trunk and flexural regions was higher among the patients with GCLP than LCLP (p<0.001 and p=0.012, respectively). Hypertriglyceridemia and hepatitis B core antibody positivity were also observed more frequently in the patients with generalized than LCLP (p=0.005 and p=0.016, respectively). Narrowband ultraviolet B and acitretin were more effective in treating patients with GCLP (p<0.001 and p=0.001, respectively). When the relapse rates in both LP groups were compared, relapses were more frequent in the patients with GCLP (p=0.022).  Conclusions: The lesion localization, treatment needs, and relapse rates of patients with GCLP differ from those of patients with LCLP.  This article was previously presented as an e-poster at the 32nd National Turkish Dermatology Congress on November 24, 2024.

Lichen Planus

Lichen planus (LP) is a T cell-mediated disease affecting the stratified squamous epithelia of the skin and/or mucus membrane. Histologically, the disease is characterized by a lichenoid inflammatory infiltrate and vacuolar degeneration of the basal layer of the epidermis. LP has three major subtypes: Cutaneous, mucosal and appendageal LP. Rarely, it may affect the nails in the absence of skin and/or mucosal changes. LP may also be induced by several drugs, typically anti-hypertensive medication or be associated with infections, particularly viral hepatitis. The diagnosis is based on the clinical presentation and characteristic histological findings. Although the disease is often self-limiting, the intractable pruritus and painful mucosal erosions result in significant morbidity. The current first-line treatment are topical and/or systemic corticosteroids. In addition, immunosuppressants may be used as corticosteroid-sparing agents. These, however are often not sufficient to control disease. Janus kinase inhibitors and biologics (anti-IL-12/23, anti-IL17) have emerged as novel future treatment options. Thus, one may expect a dramatic change of the treatment landscape of LP in the near future.

No evidence for association between cutaneous lichen planus and hepatitis B and C virus infection in south Poland - a case-control study

BACKGROUND

The incidence of hepatitis C virus (HCV) infection among patients with lichen planus (LP) varies considerably. Currently, there is more evidence for the association between hepatitic C and oral LP (OLP) than cutaneous LP (CLP). There is also lack of data on the Polish population. The study aimed at assessing the prevalence of HCV infection and liver test abnormalities among patients with CLP in south Poland.

METHODS

Eighty-four patients with CLP and 130 patients with other dermatoses (controls) were included in this retrospective case-control study. Medical records were reviewed for the presence of anti-HCV antibodies and hepatitis B surface antigen (HBsAg) and serum levels of liver function tests: aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glumatyltranspeptidase (GGT).

RESULTS

Anti-HCV antibodies were not found in any of the patients in the study or control group. HBsAg was detected in one (1.19%) patient with CLP and none of the controls. Considering the prevalence of abnormal liver function parameters, there were no statistically significant differences in the frequencies of AST (P = 0.87), ALT (P = 0.9), and GGT (P = 0.81) above the upper limit between patients with CLP and patients with other dermatoses.

CONCLUSIONS

Currently, there is no evidence confirming the relationship between HCV infection and CLP in southern Poland. There is also no increased incidence of liver function abnormalities compared to patients with other dermatoses. However, there is a need for further research on larger groups of patients.