Prevalence and characteristics of various types of lichen planus in the Moscow Region

Abstract

Rationale: Lichen planus (LP) is an important problem for the healthcare due to its increasing prevalence, as well as typical, atypical and prone to malignization types of the disease that can be both severe and poorly responding to treatment. Accurate data on the prevalence of LP are lacking. Aim: To assess the prevalence of various LP types in the patient population of the Moscow Region. Materials and methods: We analyzed the results of examination of 338 patients with LP, who were getting standard treatment in the Department of Dermatovenereology and Dermato-oncology of the Moscow Regional Research and Clinical Institute (MONIKI) in 1999 to 2017. Results: Among 338 LP patients, atypical LP of the skin was diagnosed in 81 (23.96%): hypertrophic type, in 31 (38.27%), pigmented, in 23 (28.4%), atrophic, in 11 (13.58%), follicular, in 8 (9.88%), lichen obtusus, in 3 (3.7%), bullous, in 1 (1.23%), erythematous, in 1 (1.23%), vulvovaginal-gingival syndrome, in 2 (2.47%), and Grinspan's syndrome, in 1 (1.23%). In 35 (43.21%) of patients, cutaneous LP was associated with atypical oral LP (OLP): in 17 (48.57%) of cases with hyperkeratotic, in 11 (31.43%), with erosive, and in 7 (20%), with exudative-hyperemic type. In 19 (23.46%) cases, atypical cutaneous LP was associated with LP of the genital mucosae, including in 12 (63.16%) cases with a typical reticular type, in 6 (31.58%), with atypical erosive, and in 1 (5.26%), with hypertrophic type. In 16 (4.73%) of the patients there was atypical OLP only; in 6 (37.5%) of them it had the exudative-hyperemic type, in 5 (31.25%), erosive, and in 5 (31.25%), hyperkeratotic. The most severe course of the dermatosis was observed for follicular, atrophic, hypertrophic types of cutaneous LP, vulvovaginal-gingival syndrome, and erosive OLP. Conclusion: Atypical LP was diagnosed in 81 (23.96%) cases, and in 45 (55.6%) cases it was associated with the OLP. The latter in 35 (43.21%) of cases was characterized by atypical lesions of OLP, including 11 (31.43%) cases of obligate precancerous erosive LP, which necessitates that this patient category should be managed with high cancer vigilance.