Five year descriptive study of the histomorphological features of lichen planus

Abstract

Background: Lichen planus is a chronic or sub-acute disorder characterized by small, flat-topped, shiny, erythematous or violaceous, pruritic polygonal papules most commonly involving the wrists and/or ankles in symmetric fashion. The spectrum of clinical diseases related to the lichenoid tissue reaction is getting wider with a recent increase in new subgroups of the lichenoid clinical picture. Lichen Planus contributes to the major bulk of cases of lichenoid tissue reactions. This study is designed to study the histopathology of clinical variants of lichen planus and its distribution in relation to age, sex and site of lesion. Objectives of the study: To study the histopathological features of lichen planus and its variants and clinicopathological correlation with respect to age and sex. Methods: This study was carried out over 5 years (retro and prospective) at Mahadevappa Rampure Medical College, Kalaburagi on clinically diagnosed cases of lichen planus. The tissue was fixed in 10% formalin and paraffin embedded sections were obtained for microscopic examination. Results: We studied 107 skin biopsy specimens. The variants of lichen planus received were classical lichen planus (55), hypertrophic lichen planus (27), follicular lichen planus (12), actinic lichen planus (6), isolated oral lichen planus (3), lichen planus pigmentosus (3), lichen planus pemphigoides (1). Maximum number of cases occurred in 2nd decade (29.9%). A slight female preponderance was noted (53.2%). Extremities were the most common site affected in 59 cases (55.1%). Conclusion: Lichen planus presents with varied morphology and microscopy, hence detailed clinical examination with data collection and proper histopathological examination is necessary for categorization and understanding of lichen planus and differentiation from various, diverse and perplexing lichenoid tissue reactions.