Lichen planus complicated with thymoma: Report of three Japanese cases and review of the published work

Abstract

Thymoma is recognized to be complicated with autoimmune diseases, such as myasthenia gravis, pemphigus vulgaris and bullous pemphigoid. Abnormal regulation of autoreactive lymphocytes may be involved in the pathogenesis of the autoimmune diseases. The association of thymoma and lichen planus (LP) is relatively rare. Among 50 patients with LP, we identified three patients with LP accompanied by thymoma (6%; 3/50) in our department from 2004 to 2014. This is the first report identifying the frequency of thymoma accompanied by LP among patients with LP. We herein report three cases of LP accompanied by thymoma along with clinical and histological features. In addition, we summarize 29 LP patients accompanied by thymoma previously reported in the English-language published works. Regarding the complications, hypogammaglobulinemia accompanied 58.6% (17/29) of patients diagnosed with Good's syndrome. Alopecia was present in 13.8% (4/29) of patients, and myasthenia gravis was present in 17.2% (5/29) of patients with LP and thymoma. Among the 27 patients with thymectomy, only 25.9% (7/27) experienced the improvement of LP, suggesting that thymectomy may not be effective for the lesions of LP. Treatment-resistant LP was reported in 54.2% (13/24) of patients. In all our cases, oral lesions were intractable to treatment with oral predonisone and topical steroids and/or tacrolimus. It is important for dermatologists to recognize the clinical characteristics of the patients with both LP and thymoma.

Thymoma appearing 9�years after the resection of squamous cell carcinoma of the lip: A case report of triple primary tumors and literature review

“…However, the present patient did not have any autoimmune disease, including MG. Furthermore, thymoma is associated with lichen planus (70); however, the patient exhibited no clinical or pathological lesions indicative of lichen planus. Through our literature review, we attempted to identify possible reasons for thymoma following other extrathymic cancers, but previous cases show no common characteristics (see also Table IV of Engels) (54).…”

Thymoma-associated multiorgan autoimmunity

“…Regression of lichen planus by thymectomy, oral prednisolone, oral etretinate or immunoglobulin infusion has been described 9. According to a literature review of 30 case reports of lichen planus associated with thymoma, most patients presented with oral erosive lichen planus, and oral lesions usually did not regress after thymectomy 10. Given the available data, the association of intractable oral lichen planus and thymomas warrants further investigations.…”

A Good Case of Recurrent Pneumonia

“…About 58.6% of patients have a secondary autoimmune condition, most commonly pure red cell aplasia (34.8%), myasthenia gravis (15.7%), and oral lichen planus (12.4%). 5 , 8 , 9 The clinical course of Good’s syndrome has been reported to be more severe when compared with common variable immunodeficiency, with a 10-year survival of 33% versus 95%, respectively. 7 Interestingly, T-cell count does not accurately correlate with associated risk of OI for patients with Good’s syndrome.…”