Different clinical presentations of Lichen Planus

Abstract

Different clinical presentations of Lichen Planus Riffat Naseem, Safoora Aamir. Abstract Background: Lichen planus was considered a rare entity about two decades back and its clinical variants were even more infrequent. Over the  period  lichen planus and its rare variants have become more prevalent.  Objective: To determine the frequency of different clinical variants of LP. Methods: A prospective cross-sectional   study was done including 255 patients of all ages and both sexes attending Dermatology outdoor at Shaikh Zayed Hospital, Lahore  from January 2018 to December 2019. Results: Out  of  255  patients in  this  study, 134  (53%)  were  females  and 121 (47%)  were males. The mean age of the patients was 51 ± 23.35 years. Among cutaneous variants, classic  LP was the predominant clinical type (40.3%,  n=103),  followed by hypertrophic LP (n= 23, 9%), lichen planus pigmentosus ( n=19, 7.6 %),  lichen nitidis (n=17, 6.6 %), generalized  eruptive  lichen planus   (n=14, 5.5 %),  lichenoid drug eruption ( n=9, 3.5%),  follicular  (n=4, 1.5%), annular and actinic each (n=3, 1.17% ), bullous  (n=2,0.78% ),  and atrophic  (n=1,0.4 %) variety. Oral lichen planus was seen in 54 patients (21.7%). The most frequent occurrence was of reticular type (n=21, 8%), followed by pigmented (n=17, 7 %) and erosive variant (n=16, 6%).  Out of 54 patients with oral lesion of lichen planus , 43 of them (16. 9 %) oral  lesion in combination with cutaneous lesions most commonly with classic LP (n=28, 10.10%) , hypertrophic (n=12, 4.7%) , LPP  (n=1,0.4%), follicular LP (n=1,0.4%),  and nail ptrygium (n=1,0.4%).  Oral lesion were absent with other variant of LP like atrophic, annular and generalized eruptive. Koebner’s  phenomenon was seen  in 27 patients (10.6%) , while nail and genital involvement was noted  in 34 and 3 ( 13 % and 1.17 %)  patients respectively. Key words: Lichen planus; morphological variants.