Clinicopathological Study of 307 Patients with Lichen Planus Actinicus and Pigmentosus Referred to Razi Skin Hospital from 2016 to 2021
Keywords:
lichen planus actinicus, lichen planus pigmentosus, clinicopathology, vacuolar degenerationAbstract
Introduction: The two less-known subtypes of lichen planus (LP) are lichen planus actinicus (LPA) and lichen planus pigmentosus (LPP), with the highest prevalence in the Middle East. Objectives: We aimed to evaluate the clinicopathological profile of these patients. Methods: 307 cases including 184 LPA and 123 LPP patients were recruited from the registered pathology reports of Razi Skin Hospital of Tehran from April 2016 to March 2021. The clinical features and pathological reports were extracted and analyzed. Results: Among 307 patients, 117 (63.9%) in the LPA group and 88 (71.5%) in the LPP group were women. Duration of disease ranged from 1 month to 20 years and 1 month to 12 years in the LPA and LPP groups, respectively. Face (159 patients), limbs (68), and neck (23) were the most frequent sites of involvement in LPA patients, whereas face (60 patients), limbs (47), and trunk (42) were more commonly involved in the LPP patients. Pruritus and oral mucosal lesions were found with similar frequency in both groups. Pathological evaluation showed vacuolar degeneration of basal layer (100%), lymphocytes infiltration (97.3%), and melanin incontinence (58.2%) as the most frequent findings in LPA and vacuolar degeneration of basal layer (100%), lymphocytes infiltration (100%), and melanin incontinence (52/8%) as the most frequent findings in LPP cases.Conclusion: LPA and LPP were both more prevalent among women. Face was the most common site of involvement in both LPA and LPP. Vacuolar degeneration, lymphocyte infiltration, melanin incontinence, and hyperkeratosis were more common histological findings in this study.
References
Le Cleach L, Chosidow O. Clinical practice. Lichen planus. N Engl J Med. 2012;366(8):723-732. DOI: 10.1056/NEJMcp1103641. PMID: 22356325.
[Usatine RP, Tinitigan M. Diagnosis and treatment of lichen planus. Am Fam Physician. 2011;84(1):53-60. PMID: 21766756.
Parihar A, Sharma S, Bhattacharya SN, Singh UR. A clinicopathological study of cutaneous lichen planus. J Dermatology Dermatologic Surg. 2015;19(1):21–26. DOI: 10.1016/j.jssdds.2013.12.003.
Wagner G, Rose C, Sachse MM. Clinical variants of lichen planus. J Dtsch Dermatol Ges. 2013;11(4):309-319. DOI: 10.1111/ddg.12031. PMID: 23320493.
Kanwar AJ, Dogra S, Handa S, Parsad D, Radotra BD. A study of 124 Indian patients with lichen planus pigmentosus. Clin Exp Dermatol. 2003;28(5):481-485. DOI: 10.1046/j.1365-2230.2003.01367.x. PMID: 12950331.
Bourra H, Leila B. Lichen planus pigmentosus. Pan Afr Med J. 2013;15:55. DOI: 10.11604/pamj.2013.15.55.2976. PMID: 24147181. PMCID: PMC3801232.
Weston G, Payette M. Update on lichen planus and its clinical variants. Int J Womens Dermatol. 2015;1(3):140-149. DOI: 10.1016/j.ijwd.2015.04.001. PMID: 28491978. PMCID: PMC5418875.
Meads SB, Kunishige J, Ramos-Caro FA, Hassanein AM. Lichen planus actinicus. Cutis. 2003;72(5):377-381. PMID: 14655778.
DOSTROVSKY A, SAGHER F. Lichen planus in subtropical countries; study of an annular type with inverse localization (uncovered surfaces of the skin). Arch Derm Syphilol. 1949;59(3):308-328. DOI: 10.1001/archderm.1949.01520280060007. PMID: 18115015.
Bouassida S, Boudaya S, Turki H, Gueriani H, Zahaf A. Lichen plan actinique: 32 cas [Actinic lichen planus: 32 cases]. Ann Dermatol Venereol. 1998;125(6-7):408-413. PMID: 9747296.
Kilaimy M. Lichen planus subtropicus. Arch Dermatol. 1976;112(9):1251-1253. DOI: 10.1001/archderm.112.9.1251. PMID: 999301.
Salman SM, Kibbi AG, Zaynoun S. Actinic lichen planus. A clinicopathologic study of 16 patients. J Am Acad Dermatol. 1989;20(2 Pt 1):226-231. PMID: 2915056.
Kim T, Borok J, Wright KT. Oral prednisone: A unique and effective treatment for actinic lichen planus. JAAD Case Rep. 2018;4(10):976-978. DOI: 10.1016/j.jdcr.2018.07.001. PMID: 30406171. PMCID: PMC6214885.
Durgaraju S, Katakam N. A clinico-histopathological study of lichen planus. Journal of Pharmaceutical Research International. 2020;3(2):165–168. DOI: 10.9734/jpri/2021/v33i731197.
Al-Mutairi N, El-Khalawany M. Clinicopathological characteristics of lichen planus pigmentosus and its response to tacrolimus ointment: an open label, non-randomized, prospective study. J Eur Acad Dermatol Venereol. 2010;24(5):535-540. DOI: 10.1111/j.1468-3083.2009.03460.x. PMID: 19840200.
Boch K, Langan EA, Kridin K, Zillikens D, Ludwig RJ, Bieber K. Lichen Planus. Front Med (Lausanne). 2021;8:737813. DOI: 10.3389/fmed.2021.737813. PMID: 34790675. PMCID: PMC8591129.
Mendiratta V, Sanke S, Chander R. Lichen Planus Pigmentosus: A Clinico-etiological Study. Indian Dermatol Online J. 2019;10(3):288-292. DOI: 10.4103/idoj.IDOJ_253_18. PMID: 31149573. PMCID: PMC6536068.
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