Dermatomyositis and lichen planus-an association or manifestation?

Abstract

Summary Two patients with dermatomyositis presented with violaceous lichenoid eruptions on the light exposed areas. Histology and direct immunofluorescence showed the typical features of lichen planus. The rash in dermatomyositis usually consists of a purplish‐red heliotrope erythema on the face, erythematous changes on the hands and backs of the fingers with diffuse redness and shining of the nail folds (Rowell, 1979). A pathognomonic sign in dermatomyositis is the Gottron papule, a violaceous flat‐topped lesion over the dorsal interphalangeal joints and occasionally a diffuse lichenoid eruption occurs which may be mistaken for lichen planus (Braverman, 1983). However, there have been no previous reports of the histology and immunofluorescence findings in these patients. Two cases are reported showing clinically a violaceous lichenoid eruption on the dorsal aspect of both hands with the histology and direct immunofluorescence typical of lichen planus. The association of lichen planus and dermatomyositis is discussed.

Autoimmune comorbid diseases associated with lichen planus: a nationwide case–control study

“…On gender‐stratified analyses, the associations of LP with Sjögren's syndrome were insignificant in male patients and with dermatomyositis in both genders. Although concurrence of LP with Sjögren's syndrome and with dermatomyositis has been reported, large‐scale studies are still lacking. Notably, aberrant activation of type I interferon has been recognized as a key element in the pathogenesis of various autoimmune diseases, including LP, SLE, Sjögren's syndrome and dermatomyositis .…”

A dermatomyositis/lichen planus overlap syndrome presenting with erythroderma: A case report

“…While a DM/LP overlap has not been formally defined, a publication from 1985 described two cases where the histopathology was consistent with LP but the clinical picture was typical of DM. 8…”

Lichen sclerosus and lichen planus: a spectrum of disease? Report of two cases and review of the literature

“…Whilst the aetiology of these conditions is unknown, there is some evidence to suggest that both are immunologically mediated. Thus, LP has occurred in association with a number of autoimmune disorders including primary biliary cirrhosis, 5 myasthenia gravis, 14 dermatomyositis, 15 alopecia areata and vitiligo, 16,17 while it has also been suggested that idiopathic LP represents an abnormal immune response to an unidentified antigen. 11 Lichenoid eruptions may further occur following the administration of certain drugs, for example gold, again possibly as an immune response to the drug, while a similar mechanism has been suggested in those cases of LP associated with hepatitis C virus infection.…”