A Clinico-epidemiological study of patients with lichen planus and associated metabolic complications at a tertiary care centre

Abstract

Background: An association between lichen planus and systemic disorders such as diabetes mellitus, dyslipidemia and metabolic syndrome has been reported. Aim: To assess the clinico-epidemiological profile of lichen planus, evaluate prevalence of underlying metabolic complications and compare the clinical profile of patients with and without metabolic syndrome. Material and methods: All the patients with lichen planus attending dermatology out patient department of a tertiary care centre in South Rajasthan over a period of one year were studied. Patients with lichenoid drug eruptions and those receiving systemic treatment for lichen planus were excluded from the study. Statistical analysis was done using the chi – square test. A p value < 0.05 was considered significant. Results: A total of 270 patients of lichen planus were enrolled. Male to female ratio was found to be 0.76: 1. Maximum (64; 23.7%) patients belonged to the age group of 31 – 40 years. Classical morphology was the most common (128; 47.4%) cutaneous pattern. Mucosal and nail involvement was seen in 80 (29.6%) and 87 (32.2%) patients respectively. Koebner phenomenon was present in 57 (21.1%) patients. The investigations were completed by 175 (64.8%) patients. Diabetes mellitus and hypertension were found in 12.6% (22/175) and 14.3% (25/175) patients respectively. The diagnostic criteria for dyslipidemia and metabolic syndrome were fulfilled by 39.4% (69/175) and 27.4% (48/175) patients respectively. Majority (81.2%) of the patients with metabolic syndrome belonged to age group 40 years and above, and oral and nail involvement was found to be more common in them. It is recommended that these patients should be screened for complications like diabetes, hypertension, dyslipidemia and metabolic syndrome. Conclusion: Significant numbers of lichen planus patients were found to have dyslipidemia and metabolic syndrome. Patients aged 40 years and above, with oral and nail involvement have higher propensity to be associated with metabolic syndrome and therefore such patients should be screened for metabolic complications. Timely screening and early intervention may reduce the risk of related morbidity and mortality. Limitations: Lack of control group is the drawback of our study. Age and sex matched comparative studies are required for confirmation of the results.

Metabolic syndrome in patients with lichen planus: A case‐control study

“…Our study showed a significant association of Metabolic Syndrome in patients with LP as reported previously 12,13,15,22 . Among patients with Metabolic Syndrome, the majority were females which is in accordance with a study by Saxena et al 15 .…”

“…21 Our study showed a significant association of Metabolic Syndrome in patients with LP as reported previously. 12,13,15,22 Among patients with Metabolic Syndrome, the majority were females which is in accordance with a study by Saxena et al 15 The gender difference might be due to the predominant female population in our study. Metabolic Syndrome was predominant in the 4 th decade in our study however, Kurian et al, and Rana et al reported metabolic syndrome predominantly in the 5 th and 6 th decade respectively.…”

“…Metabolic Syndrome has been reported in around 3%-59% of patients with LP as reported in the literature and was found to be 32% in our study which is in accordance with studies reported previously. 6,[11][12][13][14][15] The etiopathogenesis of Metabolic Syndrome in LP is elusive however, the theory of autoimmunity has been proposed. 16 Interleukins (IL-1, IL-6, IL-9, IL-23), TNF-α, and IFNγ are reported to be overexpressed in lesions of LP.…”

Lichen planus and its clinical variants: a retrospective study in a tertiary care centre

“…In our study, the youngest affected person was 5 years old, and the oldest was 76 years old, which is similar to the study conducted by Gupta et al 6 Our study's male to female ratio of 0.72:1 is comparable to that of Sharma et al (0.76:1) Parihar et al (0.8:1) which indicates a female preponderance. 4,7 Figure 4: Associations of different types of lichen planus.…”

“…3 Diabetes mellitus (DM), HTN, Hypothyroidism, and dyslipidemia are a few metabolic conditions that have been associated to the disease. 4 LP may serve as an external indicator of underlying immune and metabolic dysfunction. 5 Dermoscopy helps in differentiating from other mimicking dermatoses, often obviating the need for a skin biopsy.…”