What lichen planus patients die of. A retrospective study

A Case of Lichen Ruber Planus in a Patient with Familial Multiple Sclerosis

Multiple sclerosis and lichen ruber planus are clinically and histologically distinct complex disorders of putative autoimmune aetiology that are fairly commonly observed in isolation but rarely found in combination. Only two previous reports have described lichen skin disorders in association with multiple sclerosis. The present report describes the case of a 51-year old Caucasian woman exhibiting both familial multiple sclerosis and lichen ruber planus. This combination may have occurred by chance or it might imply that these disorders share common mechanisms in their pathogenesis.

Primary carcinoid tumor of the skin

We describe the case of a 64-year-old man with a cutaneous carcinoid tumor. Clinical investigation and diagnostic studies failed to reveal an internal primary tumor. Five cases of primary cutaneous carcinoid tumor have been reported in the literature. Interestingly, our patient had coexisting lichen planus, which has been reported previously in association with carcinoid.

[Development of squamous epithelial carcinoma on the lower leg in long-term verrucous lichen planus]

Lichen ruber planus and squamous cell carcinoma are common diseases of the skin. Several publications have dealt with the association between these two types of dermatosis. Extensive trials have shown the potentially premalignant nature of lichen planus of the oral mucosa. However, no study conducted so far was able to show that lichen planus of the skin increases the risk for squamous cell carcinoma. We report a 65-year-old man who developed a squamous cell carcinoma in a long standing verrucous lichen planus in the lower leg.

Lichen planus and liver diseases: a multicentre case-control study. Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED)

OBJECTIVE

To assess the association of lichen planus with liver complaints and with known aetiological factors of liver diseases.

DESIGN

Multicentre case-control study. Interviews were conducted by trained medical investigators on the basis of a structured questionnaire. At the interview patients and controls were asked for consent to blood samples being taken to determine transaminase activities and the presence of hepatitis B virus surface antigen.

SETTING

Outpatient departments of 27 Italian general and teaching hospitals that were collaborating in the Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED).

SUBJECTS

Incident cases and controls were eligible. A total of 577 patients with lichen planus and 1031 controls with dermatological diseases other than lichen planus were interviewed. Less than 1% of the people contacted refused to participate. Patients and controls were matched for sex and age in five year intervals.

RESULTS

The risk of lichen planus was higher in patients with a history of liver diseases requiring hospital admission or specialist consultation (relative risk = 1.6; 95% confidence interval = 1.2 to 2.2), those who had had liver biopsy (5.5; 1.9 to 15.6), and those with a history of viral hepatitis (1.9; 1.1 to 3.1). High activities of liver enzymes and positive results of tests for hepatitis B virus surface antigen were also associated with lichen planus. The association with alcohol consumption was not clearly confirmed by a dose-risk relation.

CONCLUSION

This study adds quantitative epidemiological evidence to the clinical observation that liver disease is a risk factor for lichen planus although not a specific marker of it.