Multiple autoimmune syndrome with isotopic phenomenon: association of lichen planus, vitiligo and alopecia areata with autoimmune hepatitis

Authors

  • Smitha S Prabhu Dept. of Dermatology Kasturba Medical College Manipal. Karnataka, India
  • Deepthi Ravi KMC,. Manipal
  • Shrutakirthi Damodar Shenoi KMC, Manipal
  • Kanthilatha Pai KMC, Manipal
  • Sudhir UK Nayak Dept. of Dermatology, KMC, Manipal

DOI:

https://doi.org/10.66344/jpad.v28i3.1131

Keywords:

Multiple autoimmune syndrome, lichen planus, vitiligo, alopecia areata, isotopic phenomenon

Abstract

Multiple autoimmune syndrome (MAS) is the presence of 3 or more autoimmune disorders in the same patient, and is being increasingly reported.  Here, we report a 31-year-old man who presented with lichen planus, vitiligo, alopecia areata and hepatitis. He also displayed isotopic phenomenon in the form of depigmented lichen planus lesions. Autoimmune tautology is implicated as the basis for  MAS, and is supported by the findings of polyautoimmunity and familial immunity in cross-sectional studies. There are reports of dermatological and systemic autoimmune diseases co-occurring as MAS

Author Biographies

  • Smitha S Prabhu, Dept. of Dermatology Kasturba Medical College Manipal. Karnataka, India

    Associate Professor

    Dept. of Dermatology & Dermatology & Venereology

    Kasturba Medical College, Manipal

  • Deepthi Ravi, KMC,. Manipal

    Junior Resident (Ex)
    Dept. of Dermatology
    Kasturba Medical College
    Manipal.
    Karnataka, India

  • Shrutakirthi Damodar Shenoi, KMC, Manipal

    Professor

    Dept. of Dermatology
    Kasturba Medical College
    Manipal.
    Karnataka, India

  • Kanthilatha Pai, KMC, Manipal

    Professor and Head
    Dept. of Pathology
    Kasturba Medical College
    Manipal.
    Karnataka, India

  • Sudhir UK Nayak, Dept. of Dermatology, KMC, Manipal

    Associate Professor

      
    Dept. of Dermatology
    Kasturba Medical College
    Manipal.
    Karnataka, India

References

1. Cojocaru M, Cojocaru IM, Silosi I. Multiple autoimmune syndrome. Maedica (Buchar). 2010;5:132-4.

2. Anaya J-M, Castiblanco J, Rojas-Villarraga A, Pineda-Tamayo R, Levy RA, Gomez-Puerta J et al. The multiple autoimmune syndromes. A clue for the autoimmune tautology. Clinic Rev Allerg Immunol. 2012;43:256-64.

3. Humbert P, Dupond JL, Vuitton D, Agache A. Dermatological autoimmune diseases and the multiple autoimmune syndromes. Acta Derm Venereol. 1989;148(Suppl):1-8.

4. Klisnick A, Schmidt J, Dupond JL, Bouchou K. Vitiligo in multiple autoimmune syndrome: A retrospective study of 11 cases and a review of the literature. Rev Med Interne. 1998;19:348-52

5. Khaled AI, Fazaa B, Mrabet N, Zeglaoui F, Kamoun MR. Multiple autoimmune syndrome in a patient with pemphigus vulgaris: a new combination. Tunis Med. 2008;86:595-7.

6. Sundaram M, Adikrishnan S, Murugan S. Co-existence of rheumatoid arthritis, vitiligo, and bullous pemphigoid as multiple autoimmune syndrome. Indian J Dermatol. 2014;59:306-7.

7. Thompson DM, Robinson TW, Lennard-Jones J. Alopecia areata, vitiligo, scleroderma and ulcerative colitis. Proc R Soc Med. 1974;67:1010-2.

8. Wolf R, Brenner S, Ruocco V, Filioli FG. Isotopic response. Int J Dermatol. 1995;34:341-8.

9. Madke B, Doshi B, Pande S, Khopkar U. Phenomena in dermatology. Indian J Dermatol Venereol Leprol. 2011;77:264-75.

10. Van den Boorn JG, Konijnenberg D, Dellemijn TA. Autoimmune destruction of skin melanocytes by perilesional T cells from vitiligo patients. J Invest Dermatol. 2009;129:2220-32.

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Published

13.12.2018

Issue

Section

Case Reports

How to Cite

1.
Multiple autoimmune syndrome with isotopic phenomenon: association of lichen planus, vitiligo and alopecia areata with autoimmune hepatitis. J Pak Assoc Dermatol [Internet]. 2018 Dec. 13 [cited 2026 Jul. 26];28(3):363-6. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/1131