Lichen planus in children

Kanwar, Amrinder J.; De, Dipankar

doi:10.4103/0378-6323.66581

Cited by 34 publications

(45 citation statements)

References 24 publications

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“…2 Though the world wide prevalence of childhood lichen planus is rare, for reasons unknown, it is not that uncommon in India, based on the fact that the largest case series on childhood LP are published NJDVL -2 from India. [3][4][5][6] In a study from UK also it was found that children originating from the Indian subcontinent represented 80.8% of children with lichen planus suggesting that children from South Asian origin are more susceptible to developing LP. 7 This could be attributed to the difference in the genetic background and environmental triggers or underreporting in other areas.…”

Section: Epidemiologymentioning

confidence: 99%

“…[3][4][5][6]8 Majority of the studies, either the sexes were equally affected or there was marginal male preponderance. 4 Familial LP occurs in 1-2% of all childhood cases and these differ from the classical form clinically, with earlier age at onset, more generalized involvement, more common mucosal involvement and an increased tendency for erosive, ulcerative and linear forms, with prolonged course and frequent relapses. 4 Etiology LP is a T-cell-mediated autoimmune damage to basal keratinocytes, which have been altered by viruses, medications, or other unknown allergens.…”

Section: Epidemiologymentioning

confidence: 99%

“…4 Familial LP occurs in 1-2% of all childhood cases and these differ from the classical form clinically, with earlier age at onset, more generalized involvement, more common mucosal involvement and an increased tendency for erosive, ulcerative and linear forms, with prolonged course and frequent relapses. 4 Etiology LP is a T-cell-mediated autoimmune damage to basal keratinocytes, which have been altered by viruses, medications, or other unknown allergens. Several exogenous antigens thought to trigger LP in children include infections like hepatitis C infection or HHV 7 infections, vaccination like hepatitis B vaccination, DPT, MMR, polio vaccine, dental amalgam fillings and drugs.…”

Section: Epidemiologymentioning

confidence: 99%

“…The presence of skin lesions along with nail changes suggestive of nail LP such as trachyonychia or idiopathic atrophy of the nails does not require nail biopsy. 4,12 Treatment Lichen planus may be completely asymptomatic or associated with significant pruritus. 17,18 In either cases, and even if it subsides spontaneously or is not associated with symptoms, post-LP, violaceous or brownish hyperpigmentation may persist for a long time and can be associated with significant cosmetic disability, particularly in pigmented races.…”

Section: 10mentioning

confidence: 99%

“…Classical LP was the most common variant observed in all the reported studies (42-76%). [3][4][5][6][7][8][9] The second most common variant differed between studies: lichen planus hypertrophicus (12%), actinic LP (11.5%), eruptive LP (13%). Actinic LP is common in tropical and sub-tropical countries including India.…”

Section: Clinical Featuresmentioning

confidence: 99%

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Management Of Childhood Lichen Planus

Thapa

Malathi

2016

Nepal J Dermatol Venereol & Leprol

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Childhood lichen planus (LP) is a rare entity, with less than 23% of all cases seen in patients under 20 years of age. LP in childhood is common in subtropical countries such as India. The most common clinical type of LP in Indian children is the classic form. Approximately 115% of patients with LP demonstrate nail involvement, but disease of the nails without skin involvement is rare. LP is diagnosed by history, clinical findings, biopsy results, and, in some cases, features on direct immunofluorescence (DIF). LP tends to have a chronic course. Depending on disease severity, however, LP may respond to a combination of topical or systemic therapies. The response to therapy may be similar to that seen in adults. Moderately potent or super potent steroids are the treatment of choice. Topical steroid can be combined with oral steroid in tapering doses over 2-12 weeks period. This is useful for children with widespread involvement or cutaneous LP lesions associated with significant morbidity. Intralesional steroid is effective for hypertrophic LP unresponsive to topical steroid. Topical steroid in adhesive base used several times a day for several months is a treatment of choice for symptomatic oral LP. Topical steroid in combination with systemic steroid can be given in a tapering dose over 3-6 weeks in very symptomatic cases in early stages. In severe unresponsive cases of both cutaneous and oral LP, oral retnoid are the preferred option. Treatment options for the nail LP in young children are oral steroid given as tapering dose over 4-12 weeks and oral retinoid. Intralesional steroid as nail matrix injection are the third option for older children. Most pediatric patients with LP respond to treatment with full clearance over 1-6 months. Poor response to treatment is a feature of hypertrophic LP and lichen planopilaris. Key words Children, Lichen planus, Nail lichen planus, Oral lichen planus IntroductionLichen planus is a pruritic papulosquamous dermatoses of unknown etiology characterized by presence of violaceous, polygonal, flat-topped papules, affecting the skin, nails and mucous membranes. It usually resolves after a variable period of time leaving behind residual areas of hyperpigmentation.

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