Background: Lichen planus (LP) is an inflammatory skin disease of unknown etiology associated with chronic inflammation, oxidative stress induction, and cardiovascular risk factors. Objectives: To document the prevalence of metabolic syndrome (MetS), dyslipidemia, and associated factors in Nigerian patients with LP. Methods: A cross-sectional design was made to evaluate 90 patients with LP and 90 controls for MetS and dyslipidemia in two Nigerian teaching hospitals. Diagnosis of LP was made with the aid of histology, and MetS and dyslipidemia were diagnosed using the National Cholesterol Education Program Adult Treatment Panel III criteria. Results: The prevalence of MetS was insignificantly higher in LP than in control (18.9% vs. 13.5, P = 0.311), and dyslipidemia was significantly associated with LP (60% vs. 40%, P = 0.007). LP was associated with higher mean of serum triglyceride (1.21 ± 0.34 vs. 1.08 ± 0.32 mmol/L, P = 0.003), low-density lipoprotein cholesterol (3.47 ± 0.89 vs. 3.12 ± 0.77 mmol/L, P = 0.007), and T-cholesterol (5.32 ± 0.88 vs. 4.92 ± 0.86, P = 0.002). LP patients with MetS were older ( P < 0.001) and less likely to have Wickham's striae ( P = 0.028) compared to those without MetS. Female LP patients were older ( P = 0.047), obese ( P = 0.043), and had insignificant increase in MetS prevalence compared to the males. Hypertrophic LP was more frequent in patients with dyslipidemia (63.0% vs. 27.8%, P = 0.002), and the family history of diabetes mellitus (DM) was an independent predictor of MetS in LP patients (odds ratio: 4.4, confidence interval: 1.0–19.1, P = 0.047). Limitation: Availability of fund is a significant factor that limited the sample size to the minimum required as always in a poor-resource setting. Conclusions: LP has an insignificant association with MetS and a significant association with dyslipidemia among Nigerians. The family history of DM is an independent predictor of MetS in LP patients. LP patients should be routinely screened for MetS and its components.
Introduction. Lichen planus is a chronic inflammatory skin disease known to have several clinical variants with attended variable clinical outcomes. Certain complications have been observed in the hypertrophic type, which were not found in association with the classic variant. Objective: To identify the epidemiologic and clinical differences between the classic and hypertrophic lichen planus and clinical correlates. Material and Methods. Of 104 participants with lichen planus included in the study, 49 had classic and 55 hypertrophic lichen planus. Demographic and clinical information was obtained. Diagnosis of lichen planus was made clinically and confirmed with histology. The participants were screened for metabolic syndrome, hepatitis B, and C. Results: Mean age of all patients was 37.20±13.39 years, with no age and gender differences between the participants with classic and hypertrophic lichen planus. Classic lichen planus was more likely to be painful, (8.2% vs 0.0, p=0.046), generalized (95.9% vs 16.4%, p<0.001), involve the oral mucosa (38.8% vs 0.0, p<0.001), the nails (38.8% vs 1.8, p<0.001), present with kobnerisation (55.1% vs 5.5%,<0.001), Wickhiam striae (69.4% vs 16.4%, p<0.001), associated with Hepatitis B vaccination (16.3% vs 3.6%, p<0.028) and anti HCV positivity (16.3% vs 0.0%, p=0.002). Hypertrophic lichen planus was significantly associated with impaired glucose tolerance/diabetes mellitus (16.4% vs 2.0%, p=0.013), dyslipidemia (74.5% vs 40.8%, p=0.001) and saw-tooth histologic appearance compared to classic type. Conclusion: Hypertrophic lichen planus is more likely to be associated with metabolic complications compared to the classic type. Further studies are needed to loink this difference t chronic inflamation.
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