The frequency of different morphological variants of lichen planus in HCV seropositive patients

Rabia Javaid, Saelah Batool, Ashba Cheema, Ayesha Anwar, Anila Asghar, Aisha Ghias, Muhammad Azam Bokhari, Shahbaz Aman


Background Pakistan has a high prevalence of hepatitis C virus (HCV) infection. There is a well known association between HCV infection and lichen planus (LP), which is an immune mediated mucocutaneous disorder.


Objective To determine the frequency of different morphological variants of lichen planus in HCV seropositive patients in a tertiary care hospital.


Materials and Methods In this cross-sectional study, a total of 200 patients of LP who were seropositive for HCV infection (detected by third generation ELISA) were enrolled after written informed consent. Cutaneous examination was done in all the patients and the morphological types of LP were ascertained.


Results Out of 200 patients in the study, 101 (50.5%) were males and 99 (49.5%) were females. The mean age of the patients was 38.5 ± 13.7 years. Isolated variants were found in 89% (n=178) while mixed lesions (combination of 2 or more clinical types) were found in 11% (n=22) of patients. Among isolated variants, hypertrophic LP was the predominant clinical type (25%, n=50) followed by classic (21%, n=42), oral (17.5%, n=35), pigmented (11%, n=22), annular (5.5%, n=11), follicular (4.5%, n=9), atrophic (4%, n=8) and plaque-like (0.5%, n=1). Oral involvement was most common in hypertrophic LP and was absent in pigmented, annular, follicular, atrophic and plaque-like LP. Among the mixed variants, hypertrophic and classic was the most frequent combination (3.5%, n=7), followed by hypertrophic and pigmented (3%, n=6), classic and pigmented (1.5%, n=3), atrophic and follicular (1%, n=2), annular and follicular (0.5%, n=1), annular and atrophic (0.5%, n=1), annular and hypertrophic (0.5%, n=1) and classic and plaque-like (0.5%, n=1)..


Conclusion There are various morphological types of lichen planus in association with HCV infection in our patients. Recognition of these types of LP should raise the vigilance for HCV workup. This would lead to early diagnosis of this miserable chronic infection and prevent its complications.



lichen planus; morphological types; hepatitis C virus infection

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