Lichen planus in children: review of 26 cases

Abstract

Lichen Planus (LP) is a common, very itchy papulosquamous disorder. Most reports of LP in children have come from the Indian subcontinent, suggesting that children of South Asian origin are more susceptible to developing LP. We conducted a retrospective, open, observational study of children with LP over a 10-year period, comparing the proportion of ethnicity in this group with the background ethnicity using UK census data from 2001. Of 26 children included in the study, 21 (80.8%) were from the Indian subcontinent, whereas the majority of the child population of Birmingham (0-17 years) was white (58%), with only 28% of the population being South Asian. Statistical analysis showed that the over-representation of South Asians in our series is significant (P < 0.001, 95% CI 56-91%). To our knowledge, this is the largest study on LP in children outside the Indian subcontinent.

A study on lichen planus in children

“…The scarcity of reports may further be due to overall rarity of LP in children, 2-3% of total LP occurring in children below 20 years of age. Under-reporting may also influence the apparent rarity of childhood LP [3].…”

Management Of Childhood Lichen Planus

“…[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. The rarity of associated autoimmune conditions, exposure to drugs and dental restorative materials, infective agents and other environmental triggers that have been known to initiate lichen planus and the overall rarity of LP in children may be responsible for the overall rarity of LP in children.…”

“…Autoimmune diseases such as chronic active hepatitis, primary biliary cirrhosis, autoimmune thyroiditis, myasthenia gravis, alopecia areata, thymoma, celiac disease, atopic dermatitis and autoimmune polyendocrinopathy have been reported to coexist with lichen planus. 7,9,10 …”

“…Depending on disease severity, LP may respond to a combination of topical or systemic therapies and the response to therapy may be similar to that seen in adults. 7,18 Cutaneous lichen planus Topical corticosteroid are the first line of treatment in localized classic form of lichen planus but, till date, no consensus exists regarding standardized therapy regimens for exanthematous LP in childhood. 4,5,[8][9][10]16,17 Topical corticosteroid (class II-IV) with or without occlusion along with antihistamines is the standard therapy for childhood lichen planus.…”

“…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.…”