Zero prevalence of hepatitis B and hepatitis C infections in clinicopathologically proven lichen planus cases: a cross sectional study at a tertiary care centre in south India

Abstract

INTRODUCTIONLichen planus (LP), which was first described by Jonathan Hutchinson in 1869, is a common chronic mucocutaneous inflammatory disorder of unknown etiology. It has characteristic clinical and pathological features affecting the skin, mucus membrane, nails, and hair. LP can present in many forms like actinic, annular, atrophic, erosive, follicular (lichen planopilaris), guttate, hypertrophic, linear, papular and vesiculobullous. Skin lesions are typically characterized by a white lace-like pattern (Wickham's striae) on papules, which is pathognomonic. Lesions may be confined to the mouth, or with minimal accompanying skin involvement, accounting for almost 15% of all cases.1 A clinically suspected case of LP may be confirmed histologically by a simple skin biopsy. ABSTRACTBackground: Lichen planus (LP) is a common chronic mucocutaneous inflammatory disorder of unknown etiology. Several editorials, chapters, studies have suggested an association between hepatitis C virus and hepatitis B virus (to a lesser extent) in LP. This association was not seen in various parts of the world including India. Methods: Patients attending the dermatology outpatient department with lichen planus confirmed by histopathologic examination were included in the study and along with clinic-epidemiological data, all the patients were tested for hepatitis B and hepatitis C infection. Results: A total of 84 patients of clinico-pathologically proven lichen planus were included in the study out of which 31 were males and 53 were females. The most common age group of lichen planus in our study group was 40-50 years. Major histopathological findings were basal cell degeneration (92.7%), hyperkeratosis (89%), pigment incontinence (73%) and lymphohistiocytic infiltration (70%). All patients in this study group tested negative for HBsAg and anti-HCV antibodies. Conclusions: Although numerous studies around the world have suggested an association between HCV and HBV infections with lichen planus-multiple subsequent studies including the present study shows contrasting results especially in this part of the world. The authors believe routine screening of lichen planus patients for presence of hepatitis B and hepatitis C infection is not warranted, particularly in Indian population.