Oral Lichen Planus in Patients With Good’s Syndrome: A Literature Review

Abstract

Good's syndrome is defined as the association of a thymoma with an immune deficiency. Many patients with Good's syndrome also have oral lichen planus involvement, and some authors have even considered it to be one of the clinical signs of Good's syndrome. In the literature, to our knowledge, clinical forms of oral lichen planus associated with Good's syndrome have not been described. We therefore aimed to characterize the forms of oral lichen planus occurring in the context of Good's syndrome. To this end, we carried out a scoping review of the literature according to the Joanna Briggs Institute guide and included 17 articles on the theme of "the forms and clinical locations of oral lichen planus associated with Good's syndrome". A total of 17 articles were selected, and 19 patients with Good's syndrome including oral lichen planus were identified. Most of them were women aged 60 years with erosive oral lichen planus of the tongue and inner cheeks. The treatments used were thymectomy, to which immunoglobulin infusions were added in some cases. All these treatments resulted in improvement of the oral lichen planus in 70.6% of cases. The management of Good's syndrome allows the improvement of oral lichen. In patients over 50 years of age with acute erosive oral lichen planus refractory to conventional therapies, Good's syndrome should be investigated.

Long COVID‐19 leading to Good's syndrome diagnosis: A clinical case‐report and literature review

“…Concurrently, a biopsy of the skin lesion revealed characteristics indicative of lichen planus; however, it is an uncommon complication of GS. 7 Neurological consultation attributed the patient's muscle weakness to myasthenia gravis.…”

Insights from a Case of Good’s Syndrome (Immunodeficiency with Thymoma)

“…Associated autoimmune features were pure red cell aplasia in 33%, myasthenia gravis in 27% and lichen planus in 23%. This latter manifestation has been reviewed recently [ 27 ]. Three clusters were proposed, based on predominance of infections related to either cellular immunity defects (51 cases), humoral immunodeficiency (34 cases) or other (other or unknown pathogens) defects (77 cases).…”

“…These were opportunistic infections which very rarely occurred in agammaglobulinemia, pointing to the presence of defects also in the cellular compartment of the immune response, dependent on thymus-derived lymphocytes. Moreover, other characteristic disorders accompanied the syndrome, most commonly pure red cell aplasia [ 23 , 24 ] and lichen planus [ 25 , 26 , 27 ]. Another typical aspect of this rare syndrome is the presence of chronic diarrhea [ 28 , 29 ], myelodysplastic syndrome [ 24 ], pancytopenia [ 30 ] and an association with autoimmune manifestations such as myasthenia gravis and pure red cell aplasia [ 13 , 31 ].…”

Thymoma-Associated Good Syndrome: A Case Report and Literature Review

“…The most common form of lichen planus found in those with GS was the erosive type concerning 89% of cases, followed by reticulated plaque and hyperkeratotic plaque in approximately 21% and 11% of cases, respectively. 7 In certain cases, LP lesions may be improved or resolved after thymectomy. 8 One interesting aspect of this case is that since the patient presented with severe pneumonia during the COVID-19 epidemic, the initial diagnosis of COVID-19 was at the top of the list.…”