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Tekin B, Xie F, Lehman JS. Lichen Planus: What is New in Diagnosis and Treatment? Am J Clin Dermatol 2024; 25:735-764. [PMID: 38982032 DOI: 10.1007/s40257-024-00878-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/11/2024]
Abstract
Lichen planus (LP), an idiopathic, multifaceted chronic inflammatory disease with a heterogeneous clinical presentation, affects approximately 0.5-1% of the population. The various clinical manifestations of LP fall into three broad categories, namely cutaneous, appendageal, and mucosal, with further subclassification depending on the morphology and distribution patterns of individual lesions. There is mounting evidence that LP has systemic associations, including autoimmune conditions, glucose intolerance, dyslipidemia, and cardiovascular disorders. Cutaneous hypertrophic and mucosal forms of LP are at a heightened risk for malignant transformation. Familiarity with these potential associations in conjunction with long-term follow-up and regular screening could lead to a timely diagnosis and management of concomitant conditions. In addition, the frequent quality of life (QoL) impairment in LP underscores the need for a comprehensive approach including psychological evaluation and support. Several treatment strategies have been attempted, though most of them have not been adopted in clinical practice because of suboptimal benefit-to-risk ratios or lack of evidence. More recent studies toward pathogenesis-driven treatments have identified Janus kinase inhibitors such as tofacitinib, phosphodiesterase-4 inhibitors such as apremilast, and biologics targeting the interleukin-23/interleukin-17 pathway as novel therapeutic options, resulting in a dramatic change of the treatment landscape of LP. This contemporary review focuses on the diagnosis and management of LP, and places emphasis on more recently described targeted treatment options.
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Affiliation(s)
- Burak Tekin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Julia S Lehman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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2
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Gonzalez Navarro B, Egido Moreno S, Omaña Cepeda C, Estrugo Devesa A, Jane Salas E, Lopez Lopez J. Relationship between Oral Lichen Planus and Cardiovascular Disease of Atherosclerotic Origin: Systematic Review and Meta-Analysis. J Clin Med 2024; 13:4630. [PMID: 39200771 PMCID: PMC11355525 DOI: 10.3390/jcm13164630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral mucosa that affects between 0.5% and 2% of the general population. In the last decade, several studies have associated cardiovascular diseases (CVDs) with some inflammatory skin diseases such as oral lichen planus, demonstrating the presence of dyslipidemia in these pathologies. The objective of this work is to review whether patients with OLP show higher dyslipidemia and CRP levels compared to a healthy control population without OLP. Methods: Searches were carried out in Medline, Scopus, and Cochrane. The studies had to perform a histopathological diagnosis for OLP and the patients could not take any medication to treat this disorder. Non-lichenoid reactions were included. Results: After an initial search that provided us with 254 papers, this number was reduced to 10 articles after a detailed evaluation. All of them were case-control studies that compared the presence of analytical cardiovascular risk factors in patients affected by OLP and in healthy subjects. Conclusions: There is no scientific evidence of the possible association between OLP and CVDs. The only association we can prove is the one between OPL and CVD risk factors, especially those related to the lipid profile. More studies are needed in order to evaluate this relationship in patients diagnosed with CVDs.
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Affiliation(s)
- Beatriz Gonzalez Navarro
- School of Dentistry, Oral Health and Masticatory System Group, (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, 08907 Barcelona, Spain; (B.G.N.); (A.E.D.); (E.J.S.)
| | - Sonia Egido Moreno
- School of Dentistry, University of Barcelona, 08907 Barcelona, Spain; (S.E.M.); (C.O.C.)
| | - Carlos Omaña Cepeda
- School of Dentistry, University of Barcelona, 08907 Barcelona, Spain; (S.E.M.); (C.O.C.)
| | - Albert Estrugo Devesa
- School of Dentistry, Oral Health and Masticatory System Group, (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, 08907 Barcelona, Spain; (B.G.N.); (A.E.D.); (E.J.S.)
| | - Enric Jane Salas
- School of Dentistry, Oral Health and Masticatory System Group, (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, 08907 Barcelona, Spain; (B.G.N.); (A.E.D.); (E.J.S.)
| | - Jose Lopez Lopez
- School of Dentistry, Oral Health and Masticatory System Group, (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, 08907 Barcelona, Spain; (B.G.N.); (A.E.D.); (E.J.S.)
- Dental Hospital Barcelona University, Faculty of Medicine and Health Sciences (School of Dentistry), Campus Bellvitge, University of Barcelona, C/Feixa LLaga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
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3
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Kho HS. Introduction of lifestyle dentistry in oral medicine. Oral Dis 2024. [PMID: 39039714 DOI: 10.1111/odi.15088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Affiliation(s)
- Hong-Seop Kho
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
- Institute on Aging, Seoul National University, Seoul, South Korea
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4
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Reeve MP, Vehviläinen M, Luo S, Ritari J, Karjalainen J, Gracia-Tabuenca J, Mehtonen J, Padmanabhuni SS, Kolosov N, Artomov M, Siirtola H, Olilla HM, Graham D, Partanen J, Xavier RJ, Daly MJ, Ripatti S, Salo T, Siponen M. Oral and non-oral lichen planus show genetic heterogeneity and differential risk for autoimmune disease and oral cancer. Am J Hum Genet 2024; 111:1047-1060. [PMID: 38776927 PMCID: PMC11179409 DOI: 10.1016/j.ajhg.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
Lichen planus (LP) is a T-cell-mediated inflammatory disease affecting squamous epithelia in many parts of the body, most often the skin and oral mucosa. Cutaneous LP is usually transient and oral LP (OLP) is most often chronic, so we performed a large-scale genetic and epidemiological study of LP to address whether the oral and non-oral subgroups have shared or distinct underlying pathologies and their overlap with autoimmune disease. Using lifelong records covering diagnoses, procedures, and clinic identity from 473,580 individuals in the FinnGen study, genome-wide association analyses were conducted on carefully constructed subcategories of OLP (n = 3,323) and non-oral LP (n = 4,356) and on the combined group. We identified 15 genome-wide significant associations in FinnGen and an additional 12 when meta-analyzed with UKBB (27 independent associations at 25 distinct genomic locations), most of which are shared between oral and non-oral LP. Many associations coincide with known autoimmune disease loci, consistent with the epidemiologic enrichment of LP with hypothyroidism and other autoimmune diseases. Notably, a third of the FinnGen associations demonstrate significant differences between OLP and non-OLP. We also observed a 13.6-fold risk for tongue cancer and an elevated risk for other oral cancers in OLP, in agreement with earlier reports that connect LP with higher cancer incidence. In addition to a large-scale dissection of LP genetics and comorbidities, our study demonstrates the use of comprehensive, multidimensional health registry data to address outstanding clinical questions and reveal underlying biological mechanisms in common but understudied diseases.
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Affiliation(s)
- Mary Pat Reeve
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - Mari Vehviläinen
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Shuang Luo
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Jarmo Ritari
- Finnish Red Cross Blood Service, Helsinki, Finland
| | - Juha Karjalainen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Javier Gracia-Tabuenca
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Juha Mehtonen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Shanmukha Sampath Padmanabhuni
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Nikita Kolosov
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, OH, USA; Ohio State University College of Medicine, Columbus, OH, USA
| | - Mykyta Artomov
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, OH, USA; Ohio State University College of Medicine, Columbus, OH, USA
| | - Harri Siirtola
- TAUCHI Research Center, Tampere University, Tampere, Finland
| | - Hanna M Olilla
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Daniel Graham
- Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Computational and Integrative Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Molecular Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | | | - Ramnik J Xavier
- Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Computational and Integrative Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Molecular Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Mark J Daly
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytical and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Tuula Salo
- Research Unit of Population Health, Department of Oral Pathology, University of Oulu and Oulu University Hospital, Oulu, Finland; Medical Research Center, Oulu University Hospital, Oulu, Finland; Department of Oral and Maxillofacial Diseases, and Translational Immunology Program (TRIMM), University of Helsinki, Helsinki, Finland
| | - Maria Siponen
- Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; Odontology Education Unit, and Oral and Maxillofacial Diseases Clinic, Kuopio University Hospital, Kuopio, Finland
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Yavuz Saricay L, Saeed HN, Yoon M, Stagner AM, MacFarlane LA, Gaier ED, Yin J, Hunter DG. Ocular lichen planus as a cause of recurrent restrictive strabismus. J AAPOS 2024:103920. [PMID: 38631481 DOI: 10.1016/j.jaapos.2024.103920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 04/19/2024]
Abstract
We report the case of an 80-year-old man with restrictive strabismus in lateral gaze following multiple oculoplastic procedures for idiopathic epiphora. Despite excellent initial response to nasal conjunctival recession with lysis of adhesions and a miminal recession of the medial rectus muscle, the patient suffered recurrence of diplopia associated with limitation of abduction due to aggressive, deep, subconjunctival scarring. Given the history of oral lichen planus (LP), the patient was diagnosed with ocular involvement of LP. He underwent a second conjunctival recession, this time accompanied by an intensive LP treatment regimen. Nine months after surgery, he remained diplopia free and orthophoric in primary gaze. Surgeons treating restrictive strabismus in patients with LP should consider implementing systemic and topical immunosuppressive treatment simultaneously with surgical management.
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Affiliation(s)
- Leyla Yavuz Saricay
- Boston Children's Hospital, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Hajirah N Saeed
- Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Michael Yoon
- Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Anna M Stagner
- Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Mass Eye and Ear, Cogan Laboratory of Ophthalmic Pathology, Harvard Medical School, Boston, Massachusetts
| | - Lindsey A MacFarlane
- Brigham and Women's Hospital, Department of Rheumatology, Harvard Medical School, Boston, Massachusetts
| | - Eric D Gaier
- Boston Children's Hospital, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Jia Yin
- Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - David G Hunter
- Boston Children's Hospital, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
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6
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Mathur M, Thakur N, Jaiswal S, Das G, Shah S, Maharjan S, Paudel S, Shrestha A, Upadhyay HP. Metabolic syndrome in patients with lichen planus: A case-control study. SKIN HEALTH AND DISEASE 2024; 4:e315. [PMID: 38312252 PMCID: PMC10831556 DOI: 10.1002/ski2.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/09/2023] [Accepted: 11/09/2023] [Indexed: 02/06/2024]
Abstract
Background Lichen Planus (LP) is a chronic dermatosis affecting the skin and mucous membranes. Chronic inflammation and oxidative stress in patients with LP is a trigger predisposing to Metabolic Syndrome. Objectives To study the association of Metabolic Syndrome in patients with LP. Materials and Methods A hospital-based prospective case-control study was conducted from April 2021 to January 2023 including 75 histopathologically confirmed patients with LP and 82 age and sex-matched controls according to the inclusion and exclusion criteria. Metabolic Syndrome was diagnosed using Modified National Cholesterol Education Programme Adult Treatment Panel III criteria. Statistical analysis of the data was performed using Statistical Package for the Social Sciences software, version 26. The chi-square test was used for data analysis. Results The majority (30.6%) of the patients belonged to the age group 31-40 years. The mean age of patients with LP was 46.13 ± 14.9 years. Female predominance (69.3%) was observed in our study. Patients with classic LP (54.6%) were predominantly observed. Metabolic Syndrome was significantly prevalent in LP patients than in controls (32% vs. 13.4%, p = 0.005, OR 3.037) and was significantly associated with morphology (only oral mucosal involvement, 61.5%, p 0.027, OR 3.9), severity (severe LP, 58.6%, p < 0.001, OR 7.79), and duration of the disease (≥6 months, 55.5%, p 0.001, OR 5.42). 71% of Metabolic Syndrome was observed in females (p 0.847). Among patients with metabolic syndrome, the majority belonged to the age group between 31 and 40 years (37.5%, p 0.378). Systolic and Diastolic Blood Pressure values (≥130/85 mm of Hg), Serum Triglycerides (≥150 mg/dl), and Low-Density Lipoprotein (>130 mg/dl) were significantly elevated, and High-Density Lipoprotein (<40 mg/dl) was significantly low in LP than in controls (p < 0.05). Conclusion The study showed a significant association of Metabolic Syndrome in patients with LP. Thus, patients with LP need to be screened to avoid complications associated with Metabolic Syndrome that is, Diabetes Mellitus, Cardiovascular Disease, colorectal cancer, and stroke.
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Affiliation(s)
- Mahesh Mathur
- Department of Dermatology, Venereology and LeprologyCollege of Medical Sciences and Teaching HospitalBharatpurNepal
| | - Neha Thakur
- Department of Dermatology, Venereology and LeprologyCollege of Medical Sciences and Teaching HospitalBharatpurNepal
| | - Sunil Jaiswal
- Department of Dermatology, Venereology and LeprologyCollege of Medical Sciences and Teaching HospitalBharatpurNepal
| | - Gautam Das
- Department of Dermatology, Venereology and LeprologyCollege of Medical Sciences and Teaching HospitalBharatpurNepal
| | - Swati Shah
- Department of Dermatology, Venereology and LeprologyCollege of Medical Sciences and Teaching HospitalBharatpurNepal
| | - Srijana Maharjan
- Department of Dermatology, Venereology and LeprologyCollege of Medical Sciences and Teaching HospitalBharatpurNepal
| | - Supriya Paudel
- Department of Dermatology, Venereology and LeprologyCollege of Medical Sciences and Teaching HospitalBharatpurNepal
| | - Anjali Shrestha
- Department of Dermatology, Venereology and LeprologyCollege of Medical Sciences and Teaching HospitalBharatpurNepal
| | - Hari Prasad Upadhyay
- Department of Community MedicineCollege of Medical Sciences and Teaching HospitalBharatpurNepal
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7
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Changes in Lipoprotein Particles in the Blood Serum of Patients with Lichen Planus. Metabolites 2023; 13:metabo13010091. [PMID: 36677016 PMCID: PMC9866152 DOI: 10.3390/metabo13010091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
Lichen planus is a chronic inflammatory mucocutaneous disease that belongs to the group of papulosquamous skin diseases among diseases like psoriasis, a widely studied disease in dermatology. The aim of the study was to identify the changes between the blood sera of lichen planus patients and healthy controls to widen the knowledge about the metabolomic aspect of lichen planus and gain a better understanding about the pathophysiology of the disease. We used high-throughput nuclear magnetic resonance (NMR) spectroscopy to measure the levels of blood serum metabolites, lipoproteins and lipoprotein particles. Dyslipidemia has relatively recently been shown to be one of the comorbidities of lichen planus, but the changes in the components of lipoproteins have not been described yet. We found statistically significant changes in the concentrations of 16 markers regarding lipoproteins, which included the components of intermediate-density lipoproteins, low-density lipoproteins and large low-density lipoproteins. We propose that the detected changes may increase the risk for specific comorbidities (e.g., dyslipidemia) and resulting cardiovascular diseases, as the turnover and hepatic uptake of the altered/modified lipoprotein particles are disturbed.
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Schruf E, Biermann MH, Jacob J, Häckl D, Reinhardt M, Hertl M, Wohlrab J. Lichen planus in Deutschland - Epidemiologie, Behandlung und Komorbidität. Eine retrospektive Krankenkassendatenanalyse. J Dtsch Dermatol Ges 2022; 20:1101-1111. [PMID: 35971586 DOI: 10.1111/ddg.14808_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Abstract
HINTERGRUND UND ZIELE Lichen planus (LP) ist eine chronisch entzündliche Hauterkrankung, die eine große Belastung für die betroffenen Patienten darstellt. Es liegen jedoch nur wenige Daten zu dieser Erkrankung vor. Ziel dieser Studie ist es, das Wissen über die Epidemiologie und die Behandlungsmuster des LP anhand von Abrechnungsdaten deutscher Krankenkassen zu erweitern. PATIENTEN UND METHODEN Diese retrospektive Beobachtungsstudie nutzte die InGef-Forschungsdatenbank. Es wurden prävalente und inzidente LP-Patienten aus den Jahren 2015 und 2018 identifiziert. Für demografische Charakteristika, Behandlungsmuster und Komorbidität wurden deskriptive Statistiken berechnet. ERGEBNISSE Die Prävalenz des LP lag bei 95,9 und die Inzidenz bei 20,1 pro 100 000 Personen im Jahr 2018, was 79 605 prävalenten LP-Fällen in Deutschland entspricht. Die erste LP-Diagnose wurde in der Regel von einem Dermatologen oder Hausarzt gestellt. Drei Viertel der inzidenten und die Hälfte der prävalenten Patienten erhielten eine topische Therapie, meist ohne zusätzliche systemische Therapie. Die Komorbidität des LP stand im Einklang mit bereits bekannten Assoziationen. SCHLUSSFOLGERUNGEN Die verfügbaren Therapieoptionen sind nach wie vor begrenzt, was den ungedeckten Bedarf an sicheren und wirksamen systemischen Behandlungsmodalitäten unterstreicht. Der LP ist häufig mit klinisch relevanter systemischer Komorbidität verbunden. Zusammengenommen könnten diese Beobachtungen zu einem verbesserten Verständnis der Krankheitslast führen und das diagnostische Bewusstsein für diese Erkrankung unter Klinikern schärfen.
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Affiliation(s)
- Eva Schruf
- Novartis Pharma GmbH, Nürnberg, Deutschland
| | | | - Josephine Jacob
- InGef-Institut für angewandte Gesundheitsforschung Berlin GmbH, Berlin, Deutschland
| | - Dennis Häckl
- WIG2 GmbH, Leipzig, Deutschland.,Universität Leipzig, Leipzig, Deutschland
| | | | - Michael Hertl
- Klinik für Dermatologie und Allergologie, Philipps-Universität Marburg, Marburg, Deutschland
| | - Johannes Wohlrab
- Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Schruf E, Biermann MH, Jacob J, Häckl D, Reinhardt M, Hertl M, Wohlrab J. Lichen planus in Germany - epidemiology, treatment, and comorbidity. A retrospective claims data analysis. J Dtsch Dermatol Ges 2022; 20:1101-1110. [PMID: 35913102 PMCID: PMC9546356 DOI: 10.1111/ddg.14808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Lichen planus (LP) is a chronic inflammatory skin disease and is a major burden for affected patients. However, data on this condition are scarce. This study aims to expand the knowledge on the epidemiology and treatment patterns of LP using German health claims data. PATIENTS AND METHODS This retrospective observational study was based on the InGef research database. Prevalent and incident LP patients were identified in the years 2015 and 2018. Descriptive statistics were calculated for demographic characteristics, treatment patterns, and comorbidity. RESULTS The prevalence of LP was 95.9 and the incidence was 20.1 per 100,000 individuals in 2018, corresponding to 79,605 prevalent LP cases in Germany. The first LP diagnosis was generally documented by a dermatologist or a primary care physician. Three-quarters of the incident and half of the prevalent patients received topical therapy, mostly without further systemic therapy. Comorbidity in LP patients was consistent with previously known associations. CONCLUSIONS Available treatment options remain limited, underscoring the unmet need for safe and efficacious systemic treatment modalities. Lichen planus is frequently accompanied by clinically relevant systemic comorbidity. Taken together, these observations may improve our understanding of the burden of this disease and increase diagnostic awareness among clinicians.
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Affiliation(s)
| | | | - Josephine Jacob
- InGef-Institute for Applied Health Research Berlin GmbH, Berlin, Germany
| | - Dennis Häckl
- WIG2 GmbH, Leipzig, Germany.,University Leipzig, Leipzig, Germany
| | | | - Michael Hertl
- Department of Dermatology and Allergology, Philipps-Universität, Marburg, Germany
| | - Johannes Wohlrab
- University Hospital and Polyclinic for Dermatology and Venerology, Martin Luther University, Halle (Saale), Germany
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10
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Association between lichen planus and dyslipidemia: an experience from North India. EUREKA: HEALTH SCIENCES 2022. [DOI: 10.21303/2504-5679.2022.002400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Association between lichen planus (LP) and dyslipidaemia and other cardiovascular risk factors has been reported in many studies in the past, with variable results between studies.
The aim: this study was undertaken to study the association of lichen planus with dyslipidaemia.
Methods: this was a prospective hospital-based case control study conducted over a period of three years, on 105 prospective newly diagnosed male patients of lichen planus and equal number of age and sex matched controls. Fasting serum lipid profile including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) were measured, and comparison done between cases and controls.
Results: dyslipidaemia was found in 44 (41.9 %) lichen planus patients (cases) as compared to 28 (26.7 %) controls, the difference being statistically significance (p 0.020). Triglycerides, total cholesterol, LDL cholesterol and VLDL cholesterol were significantly higher in cases than controls, whereas difference in the values of abdominal circumference and body mass index (BMI), although more in cases than controls was not statistically significant. Similarly, HDL-cholesterol values were less in cases than controls, but without statistical significance.
Conclusion: dyslipidaemia was more common in lichen planus (LP) patients, as compared to controls, suggesting that LP patients are at a higher risk of developing derangements of serum lipids and should be routinely and regularly monitored for dyslipidaemia and other cardiovascular risk factors, to detect cardiovascular diseases well in time. The result of present study strengthens the evidence of association between LP and dyslipidaemia.
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11
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Radic T, Cigic L, Glavina A, Hrboka A, Druzijanic A, Musa Leko I, Biocina-Lukenda D. Lipid Profiles and Cardiovascular Risk in Patients with Oral Lichen Planus. Dent J (Basel) 2022; 10:dj10040061. [PMID: 35448055 PMCID: PMC9028799 DOI: 10.3390/dj10040061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 02/04/2023] Open
Abstract
Background: It has been reported that dyslipidemia prevalence and cardiovascular disease risk were increased in subjects with oral lichen planus diagnose. On the other hand, so far, there is no available data on the topic of cardiovascular risk (CVR) in subjects with oral lichen planus (OLP). The main aim of this study, due to lack of any other study covering this topic, was to investigate lipid profile and assess CVR in patients with OLP. Materials and Methods: To create a routine lipid profile, we collected triglyceride serum levels, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol from 63 OLP patients and 63 healthy people representing control subjects. For every patient their individual cardiovascular risk was measured. Results: In comparison with the tested control subjects, patients with OLP had all parameters of the lipid profile elevated, with no differences of statistical importance. Furthermore, the experimental (OLP) and control groups shared similar mean values of the lipid profile parameters. Conclusions: The association of OLP with cardiovascular risk was not established and further studies with more subjects involved are required to validate this connection.
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Affiliation(s)
- Tomislav Radic
- Dental Polyclinic Arena, Zagreb, Remetinecki gaj 2k, 10000 Zagreb, Croatia;
| | - Livia Cigic
- Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia;
- Department of Dental Medicine, University Hospital of Split, Spinciceva 2, 21000 Split, Croatia;
- Correspondence: ; Tel.: +385-989209508
| | - Ana Glavina
- Dental Polyclinic Split, Matoseva 2, 21000 Split, Croatia;
| | - Ana Hrboka
- Private Dental Practice Ana Hrboka, Kralja Kresimira 1/1, 21214 Kastel Kambelovac, Croatia;
| | - Ana Druzijanic
- Department of Dental Medicine, University Hospital of Split, Spinciceva 2, 21000 Split, Croatia;
| | - Ivona Musa Leko
- Dental Polyclinic Musa, Kralja Tomislava 78, 88000 Mostar, Bosnia and Herzegovina;
| | - Dolores Biocina-Lukenda
- Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia;
- Dental Polyclinic Split, Matoseva 2, 21000 Split, Croatia;
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12
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Darlenski R, Mihaylova V, Handjieva-Darlenska T. The Link Between Obesity and the Skin. Front Nutr 2022; 9:855573. [PMID: 35369048 PMCID: PMC8965625 DOI: 10.3389/fnut.2022.855573] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity as a multi-organ disease that affects the entire human organism. Notably, the skin is no exclusion from this postulate. Skin changes in obese patients have been widely studied with regards to mechanical friction, skin infections, and skin hypertrophic conditions, such as acanthosis nigricans and, most commonly, fibromas (skin tags). Almost 60–70% of obese patients present with a variety of skin changes. Herein, we discuss our own experience and review the complex skin changes in obesity. The role of metabolic syndrome and obesity are responsible for the epidemiological prevalence and are involved in the pathogenesis of chronic inflammatory skin diseases, such as psoriasis, atopic dermatitis, and skin malignancies. Here, we comment on the role of nutritional interventions in these patients as it has been proven that low-calorie diet and weight loss is related to improvement of inflammatory skin diseases. The readership of this paper will receive up-to-date overview on the connection between obesity and the skin that is of a practical importance to any clinician working in the field.
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Affiliation(s)
- Razvigor Darlenski
- Department of Dermatology and Venereology, Acibadem Cityclinic Tokuda Hospital, Sofia, Bulgaria
- Department of Dermatology and Venereology, Trakia University, Stara Zagora, Bulgaria
- *Correspondence: Razvigor Darlenski,
| | - Vesselina Mihaylova
- Department of Pharmacology and Toxicology, Medical Faculty, Medical University, Sofia, Bulgaria
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Bilovol A, Tkachenko S, Havryliuk O, Berehehova A, Pustova N, Kolhanova N, Drozd Y. Comparative Characteristics of Metabolic Parameters in Patients with Psoriasis and Lichen Planus. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of the study was to assess metabolic parameters in patients with lichenoid dermatoses.
METHODS: The study of indicators of metabolic processes was performed on two groups of patients: first group consisted of 50 patients with psoriasis, of whom there were 20 women and 30 men, the average age was 41.3 years; second group included 50 patients with lichen planus, including 23 women and 27 men, the average age was 40.9 years. The control group consisted of 15 healthy individuals, comparable age and gender, whose indicators were considered normal.
CONCLUSIONS: Deviations of lipid metabolism in patients with psoriasis and lichen planus were detected, which were unidirectional with a significant increase in total cholesterol (27% and 30%, respectively) and low-density lipoprotein cholesterol (17% and 21%, respectively).
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Aryanian Z, Shirzadian A, Hatami P, Dadras H. High Incidence of Metabolic Syndrome Components in Lichen Planus Patients: A Prospective Cross-Sectional Study. Int J Clin Pract 2022; 2022:7184678. [PMID: 35685585 PMCID: PMC9159182 DOI: 10.1155/2022/7184678] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory dermatosis, involving the skin, appendages, and mucous membranes. There is a growing body of evidence about higher risk of metabolic syndrome and dyslipidemia in some dermatoses including LP. AIM To evaluate lipid profile, leptin, and CRP status among Iranian LP patients, compared to healthy controls, and peruse the relationship between abnormal values of these parameters with the disease duration and physical characteristics of patients. METHODS 40 LP patients and 40 age- and sex-matched healthy controls were enrolled in the study. Data on weight, height, lipid profile, leptin, and CRP values were recorded and compared. RESULTS The mean values for leptin, CRP, and lipid profile parameters (except for HDL) were higher in patients, compared to controls. Total cholesterol level was negatively associated with disease duration in patients (P value: 0.039, r: -0.33). Serum leptin level was positively correlated with BMI both in patients and controls (P value: 0.037 and 0.003, respectively). In the patient group, LDL level, although insignificant, was higher in men, but HDL and leptin levels were significantly higher in women in comparison with men (P value: 0.018). CONCLUSION Screening of LP patients in regard to their lipid profile might be more reasonable in men or those who have other cardiovascular risk factors to prevent morbidity and mortality in result of developing cardiovascular events.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Azar Shirzadian
- Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadiyeh Dadras
- Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
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15
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Boch K, Langan EA, Kridin K, Zillikens D, Ludwig RJ, Bieber K. Lichen Planus. Front Med (Lausanne) 2021; 8:737813. [PMID: 34790675 PMCID: PMC8591129 DOI: 10.3389/fmed.2021.737813] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/11/2021] [Indexed: 12/17/2022] Open
Abstract
Lichen planus (LP) is a T cell-mediated disease affecting the stratified squamous epithelia of the skin and/or mucus membrane. Histologically, the disease is characterized by a lichenoid inflammatory infiltrate and vacuolar degeneration of the basal layer of the epidermis. LP has three major subtypes: Cutaneous, mucosal and appendageal LP. Rarely, it may affect the nails in the absence of skin and/or mucosal changes. LP may also be induced by several drugs, typically anti-hypertensive medication or be associated with infections, particularly viral hepatitis. The diagnosis is based on the clinical presentation and characteristic histological findings. Although the disease is often self-limiting, the intractable pruritus and painful mucosal erosions result in significant morbidity. The current first-line treatment are topical and/or systemic corticosteroids. In addition, immunosuppressants may be used as corticosteroid-sparing agents. These, however are often not sufficient to control disease. Janus kinase inhibitors and biologics (anti-IL-12/23, anti-IL17) have emerged as novel future treatment options. Thus, one may expect a dramatic change of the treatment landscape of LP in the near future.
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Affiliation(s)
- Katharina Boch
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Ewan A Langan
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Dermatological Sciences, University of Manchester, Manchester, United Kingdom
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Detlef Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Ralf J Ludwig
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Katja Bieber
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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Daye M, Temiz SA, Işık B, Durduran Y. Relationship between acanthosis nigricans, acrochordon and metabolic syndrome in patients with lichen planus. Int J Clin Pract 2021; 75:e14687. [PMID: 34331725 DOI: 10.1111/ijcp.14687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/14/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022] Open
Abstract
AIM In the literature, there are no data examining the association with lichen planus with acanthosis nigricans and acrochordon, which are skin findings of metabolic syndrome (MS). MATERIALS A total of 108 lichen planus (LP) patients, age and sex-matched 109 controls, 217 patients in total were prospectively included in the study. RESULTS Metabolic Syndrome was found in 55 (50.9%) of 108 patients with lichen planus and 36.7% in the control group. The frequency of MS in the lichen planus group was found to be significantly higher than that in the control group (P = .03). The incidence of acanthosis nigricans (AN) was statistically higher in the LP group (P = .009). In addition, while 38 of 47 AN patients in the LP group had MS, 17 of 61 patients without AN had MS, and the presence of MS was found significantly higher in LP patients with AN (p˂0.001). The incidence of acrochordon was statistically higher in the LP group (P = .03). In addition, while 43 of 62 patients with acrochordon in the LP group had MS, 12 of 46 patients without acrochordon had MS, and the presence of MS was found significantly higher in patients with LP with acrochordon (P ˂ .001). CONCLUSION In our study, it was found that skin findings such as AN and acrochordon increased in patients with lichen planus. This increase was also observed in lichen planus patients with metabolic syndrome. Therefore, the association of acanthosis nigricans and acrochordon may be a predictive of metabolic syndrome in patients with lichen planus admitted to the dermatology outpatient clinic.
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Affiliation(s)
- Munise Daye
- Department of Dermatology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | | | - Begüm Işık
- Department of Dermatology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Yasemin Durduran
- Department of Public Health, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Fatima F, Das A, Kumar P, Datta D. Skin and Metabolic Syndrome: An Evidence Based Comprehensive Review. Indian J Dermatol 2021; 66:302-307. [PMID: 34446955 PMCID: PMC8375528 DOI: 10.4103/ijd.ijd_728_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Metabolic syndrome is currently considered to be a global epidemic, causing a significant increase in the cost of health care, apart from deteriorating the quality of life. Skin serves as a mirror of underlying metabolic sinister. Various dermatological conditions like psoriasis, acanthosis nigricans, lichen planus, acne vulgaris, acrochordons, atopic dermatitis, etc. have been reported to be associated with metabolic syndrome. We hereby present an evidence-based review of the various dermatological conditions and their association with the development of metabolic syndrome.
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Affiliation(s)
- Farhat Fatima
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Piyush Kumar
- Department of Dermatology, Katihar Medical College and Hospital, Katihar, Bihar, India
| | - Debatri Datta
- Consultant Dermatologist, Oliva Skin and Hair Clinic, Kolkata, West Bengal, India
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Toader MP, Taranu T, Constantin MM, Olinici D, Mocanu M, Costan VV, Toader S. High serum level of interleukin-6 is linked with dyslipidemia in oral lichen planus. Exp Ther Med 2021; 22:987. [PMID: 34345269 PMCID: PMC8311226 DOI: 10.3892/etm.2021.10419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/16/2020] [Indexed: 12/13/2022] Open
Abstract
Oral lichen planus (OLP) is a complex chronic inflammatory disorder in which autocytotoxic CD8+ T cells, locally present in the affected tissue, induce basal keratinocyte apoptosis, through the release of several cytokines, such as interleukin-6 (IL-6). IL-6 is a proinflammatory cytokine that is related to alterations in lipid metabolism in psoriasis patients. Impaired lipid metabolism together with high serum levels of triglycerides have been found in association with OLP. However, the correlation between serum levels of IL-6 and dyslipidemia has not yet been studied in this disorder. The present study aimed to demonstrate the association between OLP, systemic inflammation through increased release of inflammation mediators such as IL-6 and alteration of lipid metabolism, in order to support the concept of OLP as a marker of systemic inflammation and a potential risk factor of cardiovascular morbidities. For this purpose, we designed a case-control study using a cohort of 18 patients with different clinical forms of OLP compared with 18 control group patients with other oral conditions, to identify a potential correlation between serum levels of IL-6 and serum lipid levels. High plasma serum levels of IL-6 were found to be correlated with cholesterol, high density lipoprotein cholesterol and triglyceride serum levels in the patients with OLP. There was a significant association between erosive and atrophic clinical forms of OLP and the pathological serum values of IL-6 and triglycerides, respectively, making these two parameters good predictive factors of the clinical form of OLP. Further studies of other biomarkers of systemic inflammation using larger cohorts of OLP patients are necessary in order to consider LP as a marker of systemic inflammation and to support the screening of these patients for lipid metabolism changes and treatment with specific antagonists in order to prevent cardiovascular events.
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Affiliation(s)
- Mihaela Paula Toader
- Department of Oral Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Tatiana Taranu
- Department of Oral Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Maria Magdalena Constantin
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 020125 Bucharest, Romania
| | - Doinita Olinici
- Department of Morphofunctional Sciences 2, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Madalina Mocanu
- Department of Oral Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Victor Vlad Costan
- Department of Oral and Maxillofacial Surgery, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Stefan Toader
- Department of Pathophysiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Çetinarslan T, Türel Ermertcan A, Özyurt B, Gündüz K. Evaluation of the laboratory parameters in hidradenitis suppurativa: Can we use new inflammatory biomarkers? Dermatol Ther 2021; 34:e14835. [PMID: 33527638 DOI: 10.1111/dth.14835] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 11/30/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic, recurrent, and debilitating skin disease. Recent studies showed that inflammatory biomarkers, such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), Lymphocyte/HDL ratio (LHR), Neutrophil/HDL ratio (NHR), and Monocyte/HDL ratio (MHR) are an indicator of inflammatory diseases and may be associated with disease severity and disease activity. To investigate NLR, PLR, LHR, NHR, and MHR in HS patients. In addition, to compare erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complete blood count, leukocyte profile, and biochemical parameters between the control and the patient group. Clinical and biochemical data of patients and healthy subjects were collected from medical records, retrospectively. In total, 166 patients with HS and 124 control subjects were included. We found no significant difference in NLR (P = .207) and PLR (P = .257). LHR (P < .001), NHR (P < .001), and MHR (P < .001) were significantly higher in the patient group. No positive correlation was found between any of these markers and disease severity according to Hurley staging system. However, MCV (Mean corpuscular volume), RDW (Red cell distribution width), and CRP showed a significant positive correlation with disease severity. Among these markers, only MHR was positively correlated with disease duration. Our study shows that CRP still maintains its value for HS patients compared to new inflammation markers. Unlike the studies in other inflammatory diseases, no significant relationship was found with most of these inflammatory parameters. MHR may be more useful in patients with HS as an indicator of inflammation compared to other parameters.
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Affiliation(s)
| | - Aylin Türel Ermertcan
- Medical Faculty, Department of Dermatology, Manisa Celal Bayar University, Manisa, Turkey
| | - Beyhan Özyurt
- Department of Public Health, Manisa Celal Bayar University, Manisa, Turkey
| | - Kamer Gündüz
- Medical Faculty, Department of Dermatology, Manisa Celal Bayar University, Manisa, Turkey
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20
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Daye M, Temiz SA, Isık B. The relationship between lichen planus and metabolic syndrome. J Cosmet Dermatol 2020; 20:2635-2639. [PMID: 33355985 DOI: 10.1111/jocd.13905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/31/2020] [Accepted: 12/01/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Lichen planus (LP) is an idiopathic, chronic inflammatory disease. Chronic inflammatory diseases can cause metabolic complications. In the literature, data related to the relationship between lichen planus and metabolic syndrome (MS) are limited. We aimed to evaluate the relationship between MS and lichen planus with disease activity. METHODS The patients diagnosed with lichen planus at the dermatology outpatient clinic between January 2018 and January 2020 were retrospectively analyzed. 98 lichen planus cases, age- and sex-matched 99 controls, 197 cases in total were included in the study. RESULTS Of the 98 lichen planus cases included in the study, 60 (61%) were women. The mean age of the patients was 49.3 ± 14.4, and the average disease duration was 33.5 ± 31.4 months. 55 (55%) of the patients in the control group were female, and the mean age of the control group was 50 ± 13.2. The body mass index of LP cases was 29.5 ± 5.8, in the control group was 25.8 ± 3.7. Metabolic syndrome was found in 47 (48%) of 98 cases with lichen planus and 32.3% in the control group. MS in the lichen planus group was significantly higher than the control group (P = .025). Metabolic syndrome was detected in the oral lichen planus at the rate of 60% (12 cases). Although the incidence of MS was more common in the oral lichen planus, it was not statistically significant (P = .29). While no significant relationship was found between oral disease severity and metabolic syndrome (P = .19), a significant correlation was found between cutaneous disease severity and metabolic syndrome (P = .023). DISCUSSION The risk of mucosal malignancy that can occur when following LP cases has been known for a long time. According to our results, caution should be taken in terms of metabolic complications in the follow-up of LP cases, especially oral LP cases.
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Affiliation(s)
- Munise Daye
- Department of Dermatology, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey
| | | | - Begüm Isık
- Department of Dermatology, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey
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21
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Risk of metabolic syndrome in patients with lichen planus: A systematic review and meta-analysis. PLoS One 2020; 15:e0238005. [PMID: 32822406 PMCID: PMC7444576 DOI: 10.1371/journal.pone.0238005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/07/2020] [Indexed: 12/23/2022] Open
Abstract
Background Studies have investigated whether patients with lichen planus are at a high risk of metabolic syndrome; however, currently, no conclusive data are available in this regard. Objective This meta-analysis was performed to analyze the published literature investigating the association between metabolic syndrome and lichen planus. Method Two reviewers independently searched 4 databases (PubMed, Embase, the Cochrane Library and Web of Science) for observational studies assessing the prevalence of metabolic syndrome in patients with lichen planus. Review Manager 5.3 software was used to statistically analyze the data. Results 200 relevant articles were searched. After a further reading, 12 studies with 1422 participants (715 with LP and 707 controls) fulfilled the eligibility criteria. Overall, the pooled odds ratio based on random effects analysis was 2.81 (95% confidence interval: 1.79–4.41, P<0.00001). This meta-analysis shows that compared with the general population, patients with lichen planus are more likely to develop metabolic syndrome. Subgroup analysis of prevalence of metabolic syndrome showed higher odds ratio in studies using International Diabetes Federation diagnostic criteria (odds ratio 4.65) and the Harmonized criteria (odds ratio 26.62) than studies using National Cholesterol Education Program Adult Treatment Panel III criteria (odds ratio 1.75), and thus might be more appropriate for diagnosing metabolic syndrome. Conclusions This meta-analysis shows that compared with the general population, patients with lichen planus are more likely to develop metabolic syndrome. Therefore, early diagnosis and prompt initiation of first-line therapy for metabolic disorders are important in patients with lichen planus.
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Ioannides D, Vakirlis E, Kemeny L, Marinovic B, Massone C, Murphy R, Nast A, Ronnevig J, Ruzicka T, Cooper S, Trüeb R, Pujol Vallverdú R, Wolf R, Neumann M. European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol 2020; 34:1403-1414. [DOI: 10.1111/jdv.16464] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/31/2020] [Indexed: 12/15/2022]
Affiliation(s)
- D. Ioannides
- Department of Dermatology and Venereology Aristotle University of Thessaloniki Medical School Thessaloniki Greece
| | - E. Vakirlis
- Department of Dermatology and Venereology Aristotle University of Thessaloniki Medical School Thessaloniki Greece
| | - L. Kemeny
- Department of Dermatology and Allergology University of Szeged Szeged Hungary
| | - B. Marinovic
- Department of Dermatology and Venereology University Hospital Center and School of Medicine Zagreb Zagreb Croatia
| | - C. Massone
- Department of Dermatology Medical University of Graz Graz Austria
| | - R. Murphy
- Department of Dermatology Nottingham University Hospital Nottingham UK
| | - A. Nast
- Department of Dermatology, Venereology and Allergy Division of Evidence‐Based Medicine Charité ‐ Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | | | - T. Ruzicka
- Department of Dermatology and Allergology LMU Munich Germany
| | - S.M. Cooper
- Department of Dermatology Oxford University Hospitals NHS Trust and University of Oxford Oxford UK
| | - R.M. Trüeb
- Center for Dermatology and Hair Diseases Wallisellen Switzerland
| | | | - R. Wolf
- Department of Dermatology and Allergology LMU Munich Germany
| | - M. Neumann
- Department of Dermatology Erasmus MC Rotterdam The Netherlands
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Mushtaq S, Dogra D, Dogra N, Shapiro J, Fatema K, Faizi N, Gupta G. Cardiovascular and Metabolic Risk Assessment in Patients with Lichen Planus: A Tertiary Care Hospital-based Study from Northern India. Indian Dermatol Online J 2020; 11:158-166. [PMID: 32477972 PMCID: PMC7247656 DOI: 10.4103/idoj.idoj_228_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: The association between lichen planus (LP) and cardiovascular disease (CVD) risk factors has been demonstrated in previous reports. However, the evidence of CVD risk factors in Indian patients with LP is limited. Objective: To compare CVD risk factors in LP patients and healthy controls. Methods: We performed a cross-sectional study on 122 subjects, 61 LP patients, and 61 controls who visited the outpatient clinic of the dermatology department of a tertiary care hospital. Patients with skin diseases known to be associated with CV risk, pregnant, and lactating women were excluded from the study. CVD risk factors were compared between LP cases and controls using anthropometric measures, hemodynamic and metabolic parameters, and inflammatory marker (ESR). Results: The proportion of metabolic syndrome (MS) was significantly higher in LP patients than the controls (29.5% vs. 9.8%, odds ratio [OR] 3.83; 95% confidence interval [CI] 1.40–10.50; P = 0.006). The proportion of dyslipidemia was also significantly higher in LP patients (70.5% vs. 42.6%; P = 0.002). LP patients had a high proportion of obesity (P = 0.004), hypertension (P = 0.004), impaired fasting glucose (P = 0.025), and raised ESR (P = 0.006) as compared to controls. A multivariate regression model demonstrated that dyslipidemia and obesity were significantly associated with LP even after controlling for confounders such as age, gender, sedentarism, dietary habits, alcohol, and impaired fasting glucose. There was no significant association between the extent of LP and the proportion of MS or dyslipidemia. Conclusion: The present study found a significant association of LP with individual CVD risk factors as well as MS.
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Affiliation(s)
- Sabha Mushtaq
- Department of Dermatology, Government Medical College, Jammu, Jammu and Kashmir, India
| | - Devraj Dogra
- Department of Dermatology, Government Medical College, Jammu, Jammu and Kashmir, India
| | - Naina Dogra
- Department of Dermatology, Government Medical College, Jammu, Jammu and Kashmir, India
| | | | - Kaniz Fatema
- Centre for Health Equity Training, Research and Evaluation (CHETRE), UNSW, Sydney, Australia
| | - Nafis Faizi
- Department of Community Medicine, Jawahar Lal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India
| | - Gunjan Gupta
- Department of Dermatology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
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Impairment of myocardial functions and arterial stiffness in patients with lichen planus. An Bras Dermatol 2020; 95:180-186. [PMID: 32146010 PMCID: PMC7175034 DOI: 10.1016/j.abd.2019.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/30/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Lichen planus is a chronic inflammatory mucocutaneous disease. Recent studies have suggested that it is associated with an increased risk of cardiovascular comorbidities. OBJECTIVE The purpose of this study was to assess and compare arterial stiffness and cardiovascular hemodynamics in patients with lichen planus and a healthy control group. METHODS Fifty-five patients with lichen planus and 42 healthy controls were enrolled. All patients underwent echocardiographic examination, and arterial stiffness was measured using applanation tonometry. RESULTS No statistically significant difference was determined between the patient and control groups in terms of arterial stiffness, but stiffness was markedly higher in patients with erosive lichen planus compared to the control group and other patients (p=0.006, and p=0.023, respectively). Moderate positive correlation was determined between duration of disease and arterial stiffness. Impairment of systolic and diastolic functions was also determined in patients with lichen planus compared to the control group (p<0.001, and p=0.005, respectively). STUDY LIMITATIONS Relatively low number of patients. CONCLUSION The positive correlation observed between duration of disease and arterial stiffness in patients with lichen planus suggests that these patients should be followed-up in terms of cardiovascular risk in the presence of resistant and long-term disease, particularly in case of erosive lichen planus.
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Epidemiologic and Clinical Differences Between Classic and Hypertrophic Lichen Planus in Nigeria. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2019. [DOI: 10.2478/sjdv-2019-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction. Lichen planus is a chronic inflammatory skin disease known to have several clinical variants with attended variable clinical outcomes. Certain complications have been observed in the hypertrophic type, which were not found in association with the classic variant.
Objective: To identify the epidemiologic and clinical differences between the classic and hypertrophic lichen planus and clinical correlates.
Material and Methods. Of 104 participants with lichen planus included in the study, 49 had classic and 55 hypertrophic lichen planus. Demographic and clinical information was obtained. Diagnosis of lichen planus was made clinically and confirmed with histology. The participants were screened for metabolic syndrome, hepatitis B, and C.
Results: Mean age of all patients was 37.20±13.39 years, with no age and gender differences between the participants with classic and hypertrophic lichen planus. Classic lichen planus was more likely to be painful, (8.2% vs 0.0, p=0.046), generalized (95.9% vs 16.4%, p<0.001), involve the oral mucosa (38.8% vs 0.0, p<0.001), the nails (38.8% vs 1.8, p<0.001), present with kobnerisation (55.1% vs 5.5%,<0.001), Wickhiam striae (69.4% vs 16.4%, p<0.001), associated with Hepatitis B vaccination (16.3% vs 3.6%, p<0.028) and anti HCV positivity (16.3% vs 0.0%, p=0.002). Hypertrophic lichen planus was significantly associated with impaired glucose tolerance/diabetes mellitus (16.4% vs 2.0%, p=0.013), dyslipidemia (74.5% vs 40.8%, p=0.001) and saw-tooth histologic appearance compared to classic type.
Conclusion: Hypertrophic lichen planus is more likely to be associated with metabolic complications compared to the classic type. Further studies are needed to loink this difference t chronic inflamation.
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Hasan S, Ahmed S, Kiran R, Panigrahi R, Thachil JM, Saeed S. Oral lichen planus and associated comorbidities: An approach to holistic health. J Family Med Prim Care 2019; 8:3504-3517. [PMID: 31803644 PMCID: PMC6881968 DOI: 10.4103/jfmpc.jfmpc_749_19] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 09/08/2019] [Accepted: 09/23/2019] [Indexed: 02/06/2023] Open
Abstract
Lichen planus (LP) is a chronic inflammatory disorder with involvement of skin, oral and genital mucosa, scalp, and nail appendages. Oral lichen planus (OLP) lesions demonstrate a number of morphologic presentations, persist for a long time with rare self-resolution, and undergo malignant changes. OLP has been associated with numerous systemic connotations such as metabolic syndrome, diabetes mellitus, hypertension, thyroid diseases, psychosomatic ailments, chronic liver disease, gastrointestinal diseases, and genetic susceptibility to cancer. The oral health physician should be aware of these systemic associations and should work in close connect with the primary healthcare physicians to rule out the predisposing factors for the associated comorbidities. This article aims to highlight the various systemic associations of OLP and warrants the screening of these ailments in OLP for prevention and effective management.
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Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Sameer Ahmed
- Department of Periodontology, Darshan Dental College and Hospitals Udaipur, Rajasthan, India
| | - Ravi Kiran
- Department of Periodontology, Darshan Dental College and Hospitals Udaipur, Rajasthan, India
| | - Rajat Panigrahi
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, SOA University, Bhubaneswar, Odisha, India
| | | | - Shazina Saeed
- Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
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Singla R, Ashwini PK, Jayadev B. Lichen Planus and Metabolic Syndrome: Is There a Relation? Indian Dermatol Online J 2019; 10:555-559. [PMID: 31544075 PMCID: PMC6743384 DOI: 10.4103/idoj.idoj_499_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Recent data suggests association of lichen planus (LP) with various systemic disorders. Relationship between LP and metabolic syndrome (MS) is not yet taken into account. MS has been associated with increased risk of cardiovascular diseases. Hence, earlier detection and treatment could potentially decrease mortality and improve the quality of life in these patients. OBJECTIVES To find out the association of LP with MS. MATERIALS AND METHODS About 100 LP patients and 50 healthy adults were investigated for fasting blood glucose (FBS) and lipid profile. MS was diagnosed as per National Cholesterol Education Program's Adult Treatment Panel III guidelines. RESULTS Serum cholesterol, triglycerides, low density lipoprotein (LDL-C), and very low density lipoprotein (VLDL-C) values were significantly increased in cases as compared to controls (P < 0.05 in all). About 42% of patients showed raised FBS level as compared to 10% controls (P = 0.0003). MS was more prevalent in cases than in controls (43% versus 26% respectively, P = 0.045). Odds ratio was highest in FBS and waist circumference. LIMITATIONS As the cases and controls are included from a local area, the result may differ from other parts of the world. CONCLUSION Diabetes mellitus, dyslipidemia, and MS are seen more commonly in LP patients.
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Affiliation(s)
- Rohit Singla
- Department of Dermatology and Venereology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
- Department of Dermatology and Venereology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - P. K. Ashwini
- Department of Dermatology and Venereology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Betkerur Jayadev
- Department of Dermatology and Venereology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Misitzis A, Cunha PR, Kroumpouzos G. Skin disease related to metabolic syndrome in women. Int J Womens Dermatol 2019; 5:205-212. [PMID: 31700973 PMCID: PMC6831757 DOI: 10.1016/j.ijwd.2019.06.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 06/23/2019] [Accepted: 06/27/2019] [Indexed: 12/13/2022] Open
Abstract
Sex hormones are involved in pathways of metabolic syndrome (MetS), an observation supported by animal studies. The relationships of sex hormones with components of MetS, such as insulin resistance and dyslipidemia, have been studied in pre- and postmenopausal women. High testosterone, low sex hormone-binding globulin, and low estrogen levels increase the risks of MetS and type 2 diabetes in women. Cutaneous diseases that are sex hormone mediated, such as polycystic ovary syndrome, acanthosis nigricans, acne vulgaris, and pattern alopecia, have been associated with insulin resistance and increased risk for MetS. Furthermore, inflammatory skin conditions, such as hidradenitis suppurativa and psoriasis, increase the risk for MetS. Patients with such skin conditions should be followed for metabolic complications, and early lifestyle interventions toward these populations may be warranted.
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Affiliation(s)
- Angelica Misitzis
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Paulo R Cunha
- Department of Dermatology, Medical School of Jundiaí, Jundiaí, São Paulo, Brazil
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island.,Department of Dermatology, Medical School of Jundiaí, Jundiaí, São Paulo, Brazil.,GK Dermatology, PC, South Weymouth, Massachusetts
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Khattab FM, Said NM. Chitinase‐3‐like protein 1 (YKL‐40): novel biomarker of lichen planus. Int J Dermatol 2019; 58:993-996. [DOI: 10.1111/ijd.14551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/30/2019] [Accepted: 05/21/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Fathia M. Khattab
- Dermatology, Venereology, and Andrology Departments, Faculty of Medicine Zagazig University Zagazig Egypt
| | - Nora M. Said
- Lecturer of Clinical Pathology Department, Faculty of Medicine Zagazig University Zagazig Egypt
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Ozbagcivan O, Akarsu S, Semiz F, Fetil E. Comparison of serum lipid parameters between patients with classic cutaneous lichen planus and oral lichen planus. Clin Oral Investig 2019; 24:719-725. [PMID: 31129877 DOI: 10.1007/s00784-019-02961-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Previous studies have shown that patients with lichen planus (LP) have an increased occurrence of inflammation-related dyslipidemia. Although classic cutaneous LP (CCLP) and oral LP (OLP) are basically known as the different subtypes of the same disease sharing the common histopathological features, they actually have significant differences both in the clinical behavior and in the molecular inflammatory pathogenesis. We aimed to compare the lipid profile of patients with CCLP and OLP. MATERIALS AND METHODS This study included 120 patients, 30 with isolated CCLP, 30 with isolated OLP, 30 with CCLP + OLP, and 30 controls consecutively admitted to the outpatient clinics of Dermatology Department of Dokuz Eylul University Hospital, Izmir, Turkey. RESULTS Triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) values, TC/high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C atherogenic indexes were significantly higher, and HDL-C values were significantly lower in all LP subtypes compared with the controls. Among LP subtypes, although the differences were not statistically significant, TG, TC, and LDL-C values were markedly higher in OLP and OLP + CCLP patients compared with CCLP patients. OLP and CCLP + OLP patients also showed significantly higher TC/HDL-C and LDL-C/HDL-C atherogenic indexes compared with CCLP patients. CONCLUSIONS Patients with OLP have a more impaired lipid metabolism and significantly higher atherogenic indexes compared with patients with CCLP. The differences in the molecular inflammatory pathways between OLP and CCLP and the longer disease duration of OLP leading to long-lasting inflammation may elucidate this distinction. CLINICAL RELEVANCE We recommend to pay close attention to the early recognition of coexisting atherogenic dyslipidemia and to apply the early protective measures against the development of cardiovascular disease in OLP patients.
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Affiliation(s)
- Ozlem Ozbagcivan
- Department of Dermatology Faculty of Medicine, Dokuz Eylul University, Inciraltı, 35340, Izmir, Turkey.
| | - Sevgi Akarsu
- Department of Dermatology Faculty of Medicine, Dokuz Eylul University, Inciraltı, 35340, Izmir, Turkey
| | - Fatma Semiz
- Department of Dermatology Faculty of Medicine, Dokuz Eylul University, Inciraltı, 35340, Izmir, Turkey
| | - Emel Fetil
- Department of Dermatology Faculty of Medicine, Dokuz Eylul University, Inciraltı, 35340, Izmir, Turkey
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Duman H, Dilek N, Değirmenci H, Duman H, Tüfekçi D, Uslu A, Şatiroğlu Ö, Çiçek Y. Decreased left atrial strain parameters are associated with prolonged total atrial conduction time in lichen planus. Interv Med Appl Sci 2019; 10:150-156. [PMID: 30713754 PMCID: PMC6343578 DOI: 10.1556/1646.10.2018.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Lichen planus (LP) carries the increased risk of cardiovascular events as it is a chronic inflammatory disease. This study aimed at determining the relationship between total atrial conduction time (TACT), P-wave dispersion, and the left atrium (LA) global strain in the patients with LP. Methods Forty people as a control group and 40 patients with LP were included in this study. Patient assessed global longitudinal LA strain by two-dimensional speckle-tracking strain echocardiography. Results The global peak systolic LA myocardium strain during the left ventricular systole (LAGLSRs) and the global peak negative LA myocardial strain rate during the early ventricular diastole (LAGLSRe) values were significantly lower in the patients with LP in proportion to the control group according to the strain measurements (1.7 ± 0.07 vs. 1.9 ± 0.1%, p = 0.001; 1.23 ± 0.04 vs. 1.2 ± 0.08 s−1, p = 0.001), respectively. TACT value was found to be significantly longer (102.6 ± 6.3 ms) in the patients with LP than the control group (96.3 ± 5.3 ms, p = 0.001), considering the terms of the artial conduction features. Conclusion This study demonstrated that the subclinical cardiac involvement in LP can determine the prolonged TACT and the impaired left atrial myocardial deformation values.
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Affiliation(s)
- Hakan Duman
- Faculty of Medicine, Department of Cardiology, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Nursel Dilek
- Faculty of Medicine, Department of Dermatology, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Hüsnü Değirmenci
- Faculty of Medicine, Department of Cardiology, Erzincan University, Erzincan, Turkey
| | - Handan Duman
- Family Care Center Rize, Ministry of Health, Rize, Turkey
| | - Damla Tüfekçi
- Faculty of Medicine, Department of Internal Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Abdulkadir Uslu
- Cardiology Clinic, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Ömer Şatiroğlu
- Faculty of Medicine, Department of Cardiology, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Yüksel Çiçek
- Faculty of Medicine, Department of Cardiology, Recep Tayyip Erdoğan University, Rize, Turkey
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Okpala IC, Akinboro AO, Ezejoifor IO, Onunu AN, Okwara BU. Metabolic Syndrome and Dyslipidemia among Nigerians with Lichen Planus: A Cross-Sectional Study. Indian J Dermatol 2019; 64:303-310. [PMID: 31516140 PMCID: PMC6714181 DOI: 10.4103/ijd.ijd_111_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Lichen planus (LP) is an inflammatory skin disease of unknown etiology associated with chronic inflammation, oxidative stress induction, and cardiovascular risk factors. Objectives: To document the prevalence of metabolic syndrome (MetS), dyslipidemia, and associated factors in Nigerian patients with LP. Methods: A cross-sectional design was made to evaluate 90 patients with LP and 90 controls for MetS and dyslipidemia in two Nigerian teaching hospitals. Diagnosis of LP was made with the aid of histology, and MetS and dyslipidemia were diagnosed using the National Cholesterol Education Program Adult Treatment Panel III criteria. Results: The prevalence of MetS was insignificantly higher in LP than in control (18.9% vs. 13.5, P = 0.311), and dyslipidemia was significantly associated with LP (60% vs. 40%, P = 0.007). LP was associated with higher mean of serum triglyceride (1.21 ± 0.34 vs. 1.08 ± 0.32 mmol/L, P = 0.003), low-density lipoprotein cholesterol (3.47 ± 0.89 vs. 3.12 ± 0.77 mmol/L, P = 0.007), and T-cholesterol (5.32 ± 0.88 vs. 4.92 ± 0.86, P = 0.002). LP patients with MetS were older (P < 0.001) and less likely to have Wickham's striae (P = 0.028) compared to those without MetS. Female LP patients were older (P = 0.047), obese (P = 0.043), and had insignificant increase in MetS prevalence compared to the males. Hypertrophic LP was more frequent in patients with dyslipidemia (63.0% vs. 27.8%, P = 0.002), and the family history of diabetes mellitus (DM) was an independent predictor of MetS in LP patients (odds ratio: 4.4, confidence interval: 1.0–19.1, P = 0.047). Limitation: Availability of fund is a significant factor that limited the sample size to the minimum required as always in a poor-resource setting. Conclusions: LP has an insignificant association with MetS and a significant association with dyslipidemia among Nigerians. The family history of DM is an independent predictor of MetS in LP patients. LP patients should be routinely screened for MetS and its components.
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Affiliation(s)
- Ifeanyi Chibuzor Okpala
- Department of Medicine, Dermatology Unit, Nnamdi Azikiwe University Awka and Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Adeolu Oladayo Akinboro
- Department of Internal Medicine, Dermatology Unit, Ladoke Akintola University of Technology, Ogbomoso and LAUTECH Teaching Hospital, Ogbomoso, Oyo State, Nigeria
| | - Ifeanyi Ogochukwu Ezejoifor
- Department of Medicine, Dermatology Unit, Nnamdi Azikiwe University Awka and Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Abel N Onunu
- Department of Medicine, Dermatology Unit, University of Benin and University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | - Benson Uchechukwu Okwara
- Department of Medicine, Dermatology Unit, University of Benin and University of Benin Teaching Hospital, Benin, Edo State, Nigeria
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Cassol-Spanemberg J, Rodríguez-de Rivera-Campillo ME, Otero-Rey EM, Estrugo-Devesa A, Jané-Salas E, López-López J. Oral lichen planus and its relationship with systemic diseases. A review of evidence. J Clin Exp Dent 2018; 10:e938-e944. [PMID: 30386529 PMCID: PMC6203921 DOI: 10.4317/jced.55145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 08/06/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is one of the most common dermatological diseases which are present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. OBJECTIVE Review the relevant information to OLP and its relationship with systemic diseases. MATERIAL AND METHODS Searches were carried out in the Medline/PubMed, Lilacs, Bireme, BVS, and SciELO databases by using key-words. After an initial search that provided us with 243 papers, this number was reduced to 78 from the last seven years. One of the first criteria adopted was a selective reading of the abstracts of articles for the elimination of publications that presented less information regarding the subject proposed for this work. All the selected articles were read in their entirety by all of the authors, who came to a consensus about their level of evidence. The Scottish Intercollegiate Guidelines Network (SIGN) criteria were used as the criteria of methodological validation. RESULTS Only 9 articles showed an evidence level of 1+, 2+, 3 or 4, as well as a recommendation level of A, B, C or D. Three of them were non-systematic reviews, one was a cohort study and only one was a controlled clinical trial. Three of the studies were case series, with respective sample sizes of 45, 171 and 633 patients. CONCLUSIONS Several factors have been associated with OLP. Patients with OLP are carriers of a disease with systemic implications and may need the care of a multidisciplinary team. The correct diagnosis of any pathology is critical to making effective treatment and minimizes iatrogenic harm. For OLP is no different, taking into account its association with numerous systemic diseases that require special attention from health professionals. Periodic follow-up of all patients with OLP is recommended. Key words:Oral lichen planus, etiopathogenesis, systemic diseases.
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Affiliation(s)
- Juliana Cassol-Spanemberg
- PhD. Postdoctoral Research Fellow. Specialist in Stomatology and Public Health. Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, Spain
| | - María-Eugenia Rodríguez-de Rivera-Campillo
- MD, DDS, PhD, Dermatologist and Dentist. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - Eva-María Otero-Rey
- DDS, PhD, Odontology. Professor of Master of Daily Practice Dentistry. Department of Stomatology. School of Dentistry. University of Santiago de Compostela, Spain
| | - Albert Estrugo-Devesa
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - Enric Jané-Salas
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - José López-López
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona - Head of the Medical Surgical Area and Medical Director of Dentistry Hospital Barcelona University / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
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Stefanadi EC, Dimitrakakis G, Antoniou CK, Challoumas D, Punjabi N, Dimitrakaki IA, Punjabi S, Stefanadis CI. Metabolic syndrome and the skin: a more than superficial association. Reviewing the association between skin diseases and metabolic syndrome and a clinical decision algorithm for high risk patients. Diabetol Metab Syndr 2018; 10:9. [PMID: 29483947 PMCID: PMC5822485 DOI: 10.1186/s13098-018-0311-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 02/12/2018] [Indexed: 02/08/2023] Open
Abstract
There is ongoing scientific interest regarding comorbidities associated with the metabolic syndrome (MeTS). MeTS comprises a combination of parameters that predispose individuals to the development of type 2 diabetes and cardiovascular disease (CVD). Three or more of the following criteria are necessary: fasting glucose > 110 mg/dl (5.6 mmol/l), hypertriglyceridemia > 150 mg/dl (1.7 mmol/l), HDL levels < 40 mg/dl (men)/< 50 mg/dl (women), blood pressure > 130/85 mmHg, waist circumference (values for Mediterranean populations > 94 cm (men)/> 89 cm (women). In this review we attempted to summarize relevant data by searching dermatological literature regarding associations between various skin conditions and MeTS. A multitude of studies was retrieved and a further goal of the present article is to present plausible mechanistic connections. The severity of skin conditions like psoriasis has been linked with MeTS. Parameters of MeTS like insulin resistance are present in patients with early onset androgenic alopecia, hidradenitis suppurativa acne and rosacea. Since MeTS can lead to CVD and type 2 diabetes early detection of patients would be very important. Also therapeutic intervention on MeTS could lead to improvement on the severity of skin conditions. This reciprocal relationship between skin diseases and MeTS in our opinion holds great interest for further investigation.
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Affiliation(s)
- Ellie C. Stefanadi
- Dermatology Department, Athens Medical Centre, Athens, Greece
- National and Kapodistrian University of Athens and Athens Medical Center, Papadiamantopoulou 20, Ilisia, Athens, Greece
| | | | | | | | | | | | - Sangeeta Punjabi
- Dermatology Department, Northwick Park and Middlesex Hospitals, London, UK
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Aniyan KY, Guledgud MV, Patil K. Alterations of Serum Lipid Profile Patterns in Oral Lichen Planus Patients: A Case-Control Study. Contemp Clin Dent 2018; 9:S112-S121. [PMID: 29962775 PMCID: PMC6006884 DOI: 10.4103/ccd.ccd_111_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Oral lichen planus (OLP) is a chronic disease of established immune-mediated pathogenesis. It most commonly, protractedly, and persistently involves the mucosa of the oral cavity. Antigen-specific and nonspecific mechanisms play a role in its pathogenesis, leading to T-cell accumulation in superficial lamina propria, intraepithelial T-cell migration, and keratinocyte apoptosis in OLP. Previous studies have indicated the possibility of serum lipid derangement in chronic inflammatory diseases such as systemic lupus erythematosus and psoriasis, which in turn results in elevated cardiovascular disease risk. Inflammation causes disturbances in lipid metabolism such as decrease in high-density lipoprotein-cholesterol (HDL-C) and increase in very low-density lipoprotein (VLDL)-cholesterol and hypertriglyceridemia due to direct effect on T-cell responses. Prolonged dyslipidemia, due to chronic inflammatory condition, enhances the formation of atherosclerotic plaques and thereby augments the risk of cardiovascular disease in such patients. With this background, a possible correlation between OLP and serum lipid level derangement can be anticipated. Hence, this study was taken up to probe into an association between the two. Aims: To determine and compare the serum lipid levels in OLP patients and healthy controls, to inquire into the possible association of OLP with alterations in serum lipid profile patterns, and to determine if the clinical characteristics of OLP differed with alterations in serum lipid profile patterns. Subjects and Methods: Sixty patients comprising 30 cases and 30 controls were enrolled for the study. Thirty cases of clinically and pathologically diagnosed OLP and 30 age- and sex-matched controls were subjected to blood examination for the assessment of serum lipid level, i.e., HDL, LDL, VLDL, and triglyceride. The obtained data were compared with standard values to assess any alterations of the serum lipid levels. Statistical Analysis Used: Cramer's V-test was performed for all the tests to measure association between two nominal variables. A P ≤ 0.05 was considered statistically significant. Results: Dyslipidemia was observed in 13 (46.67%) cases as against 7 (23.33%) controls. Thus, a significant number of cases were found to have an associated serum dyslipidemia. However, pertaining to individual serum lipid levels in cases and controls, the association was found to be statistically insignificant. Conclusions: The current study suggested an evident association between dyslipidemia and OLP. We recommend imminent studies on a larger population to additionally substantiate a positive association between the two.
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Affiliation(s)
- K Yesoda Aniyan
- Department of Oral Medicine and Radiology, JSS Dental College and Hospital, Jagadguru Shivrathreeshwara University, Mysuru, Karnataka, India
| | - Mahima V Guledgud
- Department of Oral Medicine and Radiology, JSS Dental College and Hospital, Jagadguru Shivrathreeshwara University, Mysuru, Karnataka, India
| | - Karthikeya Patil
- Department of Oral Medicine and Radiology, JSS Dental College and Hospital, Jagadguru Shivrathreeshwara University, Mysuru, Karnataka, India
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Aditi R, Sathasivasubramanian S, Bhaskar ME. Association of Oral Lichen Planus and Electrocardiographic P-Wave Dispersion - An Original Research. Braz Dent J 2017; 28:699-703. [PMID: 29211124 DOI: 10.1590/0103-6440201701570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/11/2017] [Indexed: 11/22/2022] Open
Abstract
Lichen planus (LP) is considered to be a T-cell-mediated inflammatory disorder. Inflammation is considered to produce disturbances of lipid metabolism which may affect the myocardium. Increased P-Wave Dispersion (PWD) is demonstrated as an independent risk factor for developing atrial fibrillation (AF). Hence the present study has been conducted to explore the possible relationship of oral lichen planus (OLP) with AF by the evaluation of PWD. Twelve-lead electrocardiographs (ECG) were obtained from 45 OLP patients and 45 age and gender-matched healthy controls. The P-wave durations (Pmax and Pmin) were calculated in all 12 leads. The difference between Pmax and Pmin was defined as P-Wave Dispersion (PWD). After the PWD was recorded, the results were statistically analyzed. The study showed that PWD increased on surface ECG measurements in OLP patients who were otherwise asymptomatic in relation to cardiac conditions. The p value obtained was <0.001 which was highly significant. The present study suggests a highly statistically significant association of OLP with increased P-wave dispersion. Hence the patients with OLP should undergo cardiac evaluation and follow up for early detection of atrial fibrillation.
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Affiliation(s)
- R Aditi
- Department of Oral Medicine and Radiology, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - S Sathasivasubramanian
- Department of Oral Medicine and Radiology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - M Emmanuel Bhaskar
- Department of General Medicine, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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Evaluation of atherosclerosis risk by measurement of intima media thickness and pulse wave velocity in lichen planus patients; A prospective case-control study. JOURNAL OF SURGERY AND MEDICINE 2017. [DOI: 10.28982/josam.344718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
The metabolic syndrome represents an important association of cutaneous maladies with cardiovascular illnesses. Chronic inflammation, shared risk factors (ie, smoking and alcohol consumption), treatment (ie, immunosuppressive agents and drugs that alter the lipid profile), and shared genetic risk loci have been proposed to the cause metabolic syndrome and cardiovascular morbidity of autoimmune diseases. There are many possible inflammatory mediators that are suggested to play a role in insulin resistance pathogenesis, such as tumor necrosis factor-α, interleukin-6, leptin, and adiponectin. These mediators are also abnormal in autoimmune skin disorders. We discuss several autoimmune skin diseases, connective tissue diseases, bullous diseases, vitiligo, psoriasis, lichen planus, chronic urticaria, and atopic dermatitis.
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Conrotto D, Barattero R, Carbone M, Gambino A, Sciannameo V, Ricceri F, Conrotto F, Broccoletti R, Arduino PG. Can atrophic-erosive oral lichen planus promote cardiovascular diseases? A population-based study. Oral Dis 2017. [PMID: 28627728 DOI: 10.1111/odi.12700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Lichen planus has been recently associated with an increased risk of cardiovascular diseases (CVDs). The oral manifestations can be divided into white hyperkeratotic lesions (WL) and atrophic and erosive lesions (RL). The aim of this report was to compare the presence of CVDs between patients affected by WL or RL, to test the hypothesis that RL are associated with an increased incidence of CVDs. SUBJECTS AND METHODS Patients were analysed through a complete collection of all the risk factors for CVDs. The primary endpoint was the occurrence of a cardiovascular event-acute coronary syndrome (ACS), any revascularization or stroke/TIA. A multivariable logistic regression model, adjusted for age at diagnosis, body mass index, smoking, alcohol consumption, diabetes, hypertension, CVDs familiarity and periodontitis, was performed. RESULTS A prospective cohort of 307 patients has been evaluated; 185 (60.3%) had WL and 122 RL (39.7%). Twenty-four patients had a CVD. ACS occurred more frequently in RL (adjusted odds ratio 5.83; 95% CI: 1.16-29.39), mainly due to the higher risk of it after the histological diagnosis of Oral lichen planus OLP (odds ratio 4.23; 95% CI: 0.66-27.23). CONCLUSION Patients with RL could possibly have a higher risk of developing ACS. Further analysis on larger cohort is however warranted.
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Affiliation(s)
- D Conrotto
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - R Barattero
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - M Carbone
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - A Gambino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - V Sciannameo
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - F Ricceri
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - F Conrotto
- Division of Cardiology, Città della Salute e della Scienza Hospital, Turin, Italy
| | - R Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - P-G Arduino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
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Redler S, Messenger AG, Betz RC. Genetics and other factors in the aetiology of female pattern hair loss. Exp Dermatol 2017; 26:510-517. [DOI: 10.1111/exd.13373] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Silke Redler
- Institute of Human Genetics; University Clinic Düsseldorf; Heinrich-Heine-University; Düsseldorf Germany
| | | | - Regina C. Betz
- Institute of Human Genetics; University of Bonn; Bonn Germany
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Kar BR, Panda M, Patro N. Metabolic Derangements in Lichen Planus - A Case Control Study. J Clin Diagn Res 2017; 10:WC01-WC03. [PMID: 28050485 DOI: 10.7860/jcdr/2016/21993.8818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 08/13/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION An association between psoriasis and metabolic syndrome has been established in previous studies. Lichen Planus (LP) is also a chronic inflammatory disease morphologically related to psoriasis and few studies have shown association of metabolic derangements in LP. AIM To study the association of metabolic derangements in LP. MATERIALS AND METHODS A prospective case control study was undertaken for a period of one year. Age and sex matched patients of LP and other non-inflammatory diseases were taken as cases and controls respectively. Data on height, weight, lipid profile and fasting blood glucose levels were collected for all the patients. Body Mass Index (BMI) was calculated. RESULTS A total of 80 patients were recruited, 40 cases and 40 controls. The mean values for all the lipid and glucose parameters were high in cases as compared to controls with significant p-values. CONCLUSION In the present study metabolic derangements were seen in patients with LP.
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Affiliation(s)
- Bikash Ranjan Kar
- Professor, Department of Skin and VD, IMS and SUM Hospital , Bhubaneswar, Odisha, India
| | - Maitreyee Panda
- Assistant Professor, Department of Skin and VD, All India Institute of Medical Sciences (AIIMS) , Bhubaneswar, Odisha, India
| | - Nibedita Patro
- Assistant Professor, Department of Skin and VD, IMS and SUM Hospital , Bhubaneswar, Odisha, India
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Ertem AG, Erdogan M, Koseoglu C, Akoglu G, Ozdemir E, Koseoglu G, Sivri S, Keles T, Durmaz T, Aktas A, Bozkurt E. Epicardial fat tissue thickness is increased in patients with lichen planus and is linked to inflammation and dyslipidemia. Rev Port Cardiol 2016; 35:525-30. [DOI: 10.1016/j.repc.2016.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/24/2016] [Accepted: 04/05/2016] [Indexed: 12/12/2022] Open
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Epicardial fat tissue thickness is increased in patients with lichen planus and is linked to inflammation and dyslipidemia. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2016.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ozlu E, Karadag AS, Toprak AE, Uzuncakmak TK, Gerin F, Aksu F, Ozakpınar O, Akdeniz N. Evaluation of Cardiovascular Risk Factors, Haematological and Biochemical Parameters, and Serum Endocan Levels in Patients with Lichen Planus. Dermatology 2016; 232:438-43. [PMID: 27508489 DOI: 10.1159/000447587] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 06/01/2016] [Indexed: 02/05/2023] Open
Affiliation(s)
- Emin Ozlu
- Department of Dermatology, Kayseri Training and Research Hospital, Kayseri, Turkey
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Yaman M, Arslan U, Beton O, Asarcıklı LD, Aksakal A, Dogdu O. Atrial Electromechanical Coupling in Patients with Lichen Planus. Korean Circ J 2016; 46:530-5. [PMID: 27482262 PMCID: PMC4965432 DOI: 10.4070/kcj.2016.46.4.530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 11/15/2015] [Accepted: 12/01/2015] [Indexed: 11/17/2022] Open
Abstract
Background and objectives A chronic inflammatory disease, lichen planus may cause disturbance of atrial electromechanical coupling and increase the risk of atrial fibrillation. The aim of this study was to evaluate atrial electromechanical delay with both electrocardiography (ECG) and echocardiography in patients with lichen planus (LP). Subjects and Methods Seventy-two LP patients (43 males [59.7%], mean age: 44.0±16.7 years) were enrolled in this cross-sectional case-control study. The control group was selected in a 1:1 ratio from 70 patients in an age and sex matched manner. P wave dispersion was measured by ECG to show atrial electromechanical delay. All of the patients underwent transthoracic echocardiography for measuring inter- and intra-atrial electromechanical delays. Results The baseline characteristics of the patients and the control group were similar except for the presence of LP. P-wave dispersion measured by ECG was significantly higher in patients with LP (p<0.001). Patients with LP had significantly prolonged intra- and interatrial electromechanical delays when compared to the control group (p<0.001). In addition, all of these variables were significantly correlated with high sensitive C-reactive protein (hsCRP) levels. Conclusion Atrial electromechanical coupling, which is significantly correlated with increased hsCRP levels, is impaired in patients with LP.
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Affiliation(s)
- Mehmet Yaman
- Department of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Uğur Arslan
- Department of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Osman Beton
- Department of Cardiology, Diskapi Education and Research Hospital, Ankara, Turkey
| | - Lale Dinç Asarcıklı
- Department of Cardiology, Diskapi Education and Research Hospital, Ankara, Turkey
| | - Aytekin Aksakal
- Department of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Orhan Dogdu
- Department of Cardiology, Firat University, Faculty of Medicine, Elazig, Turkey
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Expósito Casabella Y, Monteagudo Sánchez B, Neira de Paz C, López López D. Liquen plano, a propósito de un caso poco frecuente. REVISTA ESPAÑOLA DE PODOLOGÍA 2016. [DOI: 10.1016/j.repod.2016.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Godoy-Gijón E, Meseguer-Yebra C, Palacio-Aller L, Godoy-Rocati DV, Lahoz-Rallo C. [New populations at increased cardiovascular risk: Cardiovascular disease in dermatological diseases]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28:143-153. [PMID: 26383179 DOI: 10.1016/j.arteri.2015.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 06/05/2023]
Abstract
The increased cardiovascular risk in some dermatological diseases has been demonstrated in recent decades. Diseases such as psoriasis and systemic lupus erythematosus are currently included in the guidelines for prevention of cardiovascular disease. Other diseases such as androgenic alopecia, polycystic ovary syndrome, hidradenitis suppurativa or lichen planus have numerous studies that point to an increased risk, however, they have not been included in these guidelines. In this article we review the evidence supporting this association, in order to alert the clinician to the need for greater control in cardiovascular risk factors in these patients.
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Affiliation(s)
- Elena Godoy-Gijón
- Servicio de Dermatología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
| | - Carmen Meseguer-Yebra
- Servicio de Dermatología, Hospital Virgen de la Concha, Complejo Asistencial de Zamora, Zamora, España
| | | | | | - Carlos Lahoz-Rallo
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
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Does Lichen Planus Cause Increased Carotid Intima-Media Thickness and Impaired Endothelial Function? Can J Cardiol 2016; 32:1246.e1-1246.e6. [PMID: 26948036 DOI: 10.1016/j.cjca.2015.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 11/12/2015] [Accepted: 11/12/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lichen planus (LP) has been associated with cardiovascular disease (CVD) risk factors, but there are no studies on the association between LP and subclinical atherosclerosis. We investigated the presence of subclinical atherosclerosis in patients with LP not known to have CVD using carotid intima-media thickness (CIMT) and flow-mediated dilatation (FMD). METHODS The study included 30 patients with LP and 30 controls. High-resolution ultrasonography was used to assess CIMT and FMD. Participants' biochemical parameters, body mass index (BMI), and waist circumference were recorded in both groups. RESULTS FMD was significantly lower (7.45% ± 3.63% vs 11.01% ± 5.34%; P = 0.004) and CIMT was higher (0.8 mm [range, 0.7-0.9 mm] vs 0.6 mm [0.4-0.6 mm]; P < 0.001) in the LP group compared with the control group. After adjustment for age, sex, BMI, high-density lipoprotein cholesterol levels, and C-reactive protein levels, the presence of LP was associated with impairment of FMD (β = -0.441; 95% CI, -9.336 to -0.321; P = 0.037) and an increase in CIMT (β = 0.459; 95% CI, 0.057 to -0.351; P = 0.008). CONCLUSIONS Reduced FMD and increased CIMT levels are sensitive indicators of target-organ damage and display increased risk for cardiovascular morbidity and mortality. Our study found that patients with LP showed a tendency toward impaired levels of FMD and increased CIMT. LP may be a novel predictor of early vascular dysfunction and structural changes.
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Lai YC, Yew YW, Schwartz RA. Lichen planus and dyslipidemia: a systematic review and meta-analysis of observational studies. Int J Dermatol 2016; 55:e295-304. [PMID: 26873870 DOI: 10.1111/ijd.13234] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/25/2015] [Accepted: 11/04/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory disease that has been shown to be positively associated with dyslipidemia. However, the magnitude and types of the underlying lipid abnormalities have not been investigated. This study aims to conduct a systematic review and meta-analysis to investigate the qualitative and quantitative association between LP and dyslipidemia. METHODS A systematic search of studies published from inception to April 1, 2015, was conducted using MEDLINE, EMBASE, Web of Science, and Cochrane library databases. Meta-analyses of observational studies with both categorical and continuous outcome were performed. DerSimonian and Lard random effects models were utilized to calculate the pooled odds ratio and weighted mean difference (WMD). Publication bias was evaluated by funnel plot and Egger's test. RESULTS Seven studies with 5242 subjects were included in this meta-analysis. Patients with LP were significantly more likely to have dyslipidemia, with a pooled odds ratio of 1.74 (95% confidence interval [CI]: 1.19-2.54, P = 0.004). LP was associated with higher levels of triglycerides (WMD 83.37 mg/dl, 95% CI 0.62-166.12, P = 0.048), low-density lipoprotein (18.75 mg/dl, 95% CI -17.21 to 54.72, P = 0.307), total cholesterol (19.22 mg/dl, 95% CI -8.80 to 47.25, P = 0.179), and lower levels of high-density lipoprotein cholesterol (-8.96 mg/dl, 95% CI -21.22 to 3.30, P = 0.152). CONCLUSIONS Despite considerable heterogeneity, this study demonstrated that LP was significantly associated with an increased risk of dyslipidemia and higher triglyceride levels. For patients presenting with LP, physicians should be cognizant of this association and consider screening them for dyslipidemia.
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Affiliation(s)
- Yi C Lai
- Rutgers New Jersey Medical School, Newark, NJ, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yik W Yew
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,National Skin Centre, Singapore
| | - Robert A Schwartz
- Departments of Dermatology, Preventive Medicine, and Pathology, Rutgers New Jersey Medical School, Newark, NJ, USA.,Rutgers University School of Public Affairs and Administration, Newark, NJ, USA
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Koseoglu C, Erdogan M, Ertem A, Koseoglu G, Akoglu G, Aktas A, Ozdemir E, Kurmus O, Durmaz T, Keles T, Bozkurt E. Aortic Elastic Properties and Myocardial Performance Index Are Impaired in Patients with Lichen Planus. Med Princ Pract 2016; 25:247-53. [PMID: 26683851 PMCID: PMC5588385 DOI: 10.1159/000443478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 12/17/2015] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the elastic properties of the aorta and the myocardial performance index of the left ventricle (LV) in patients with lichen planus (LP). SUBJECTS AND METHODS A total of 54 patients with LP and 50 controls were enrolled in the study. The 2 groups were well-matched regarding age, gender, body mass index, any smoking history, diabetes mellitus and systolic and diastolic blood pressure (SBP and DBP). The echocardiographic examination was performed on the study subjects and the controls. Aortic elasticity parameters and the myocardial performance index of the LV were calculated. The Student t test, the x03C7;2 test and multiple linear regression were used for the statistical analysis. RESULTS Aortic strain (AS, 4.77 ± 1.81 vs. 8.95 ± 2.22; p < 0.001) and aortic distensibility (AD, 0.25 ± 0.009 vs. 0.42 ± 0.120; p < 0.001) were significantly lower, and aortic stiffness index β (ASIβ, 3.65 ± 1.03 vs. 2.70 ± 0.91; p < 0.001) was significantly higher in the LP group than in the controls. The myocardial performance index (Tei index) was significantly higher in the LP group than in the control group (p = 0.001). The duration of the LP was negatively correlated with AS (r = -0.364, p < 0.001) and AD (r = -0.279, p = 0.006), and positively correlated with the Tei index (r = 0.324, p = 0.001) and ASIβ (r = 0.364, p < 0.001). After adjustment for relevant confounders (age, male gender, smoking, SBP, DBP, diabetes mellitus and low- and high-density lipoprotein cholesterol), LP and its duration were still associated with AS, AD and ASIβ. CONCLUSION In this study, AS and AD were lower and ASIβ and myocardial performance index higher in LP patients than in controls.
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Affiliation(s)
- C. Koseoglu
- Department of Cardiology, Ankara Training and Research Hospital, Departments of, Mersin, Turkey
- *Cemal Koseoglu, MD, Ankara Training and Research Hospital, Sukriye District, Ulucanlar Street, TR-06340 Altýndag, Ankara (Turkey), E-Mail
| | - M. Erdogan
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - A.G. Ertem
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - G. Koseoglu
- Department of Dermatology, Ankara University Faculty of Medicine, Ankara, Mersin, Turkey
| | - G. Akoglu
- Dermatology of Ataturk Training and Research Hospital, Mersin, Turkey
| | - A. Aktas
- Dermatology of Ataturk Training and Research Hospital, Mersin, Turkey
| | - E. Ozdemir
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - O. Kurmus
- Department of Cardiology, Tarsus State Hospital, Mersin, Turkey
| | - T. Durmaz
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - T. Keles
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - E. Bozkurt
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
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