Clinical and laboratory presentation of lichen planus patients with chronic liver disease

doi:10.1016/0923-1811(92)90054-F

Journal of Dermatological Science

Volume 4, Issue 1, July 1992, Pages 38-41

https://doi.org/10.1016/0923-1811(92)90054-F Get rights and content

Abstract

A recent case-control study on 577 lichen planus (LP) patients and 1008 controls confirmed that LP patients may significantly associate with a chronic liver disease (CLD) which is independent from drug or alcohol intake and has some connection with hepatitis B virus (HBV) infection. The study, however, failed to define the nature of CLD. This has been investigated through the clinical and laboratory features of 50 patients with LP and impaired liver function tests. Overall, the laboratory signs of cell necrosis prevailed over those of cholestasis and a good relationship with the HBV and HCV infections was found. Ninety percent of patients with LP and CLD had antibodies to one or another of the major viruses involved in infectious hepatitis. No patient had anti-liver kidney microsomal antibodies type 1. Liver biopsies were done in 12 cases and mostly revealed a chronic active hepatitis evolving into cirrhosis. No evident cases of primary biliary cirrhosis were found. It appears that LP associated CLD is post-viral in nature.

References (20)

A Rebora
Lichen planus and the liver
Lancet
(1981)
W Korkij et al.
Liver abnormalities in patients with lichen planus. A retrospective case-control study
J Am Acad. Dermatol
(1984)
MC Kew et al.
Hepatitis C virus antibodies in southern African blacks with hepatocellular carcinoma
Lancet
(1990)
IG McFarlane et al.
Hepatitis C virus antibodies in chronic active hepatitis: pathogenetic factor or false-positive result?
Lancet
(1990)
M Lenzi et al.
Type 2 autoimmune hepatitis and hepatitis C virus infection
Lancet
(1990)
TB Reynolds et al.
Primary biliary cirrhosis with scleroderma, Raynaud's phenomenon and teleangiectasia. New syndrome
Am J Med
(1971)
A Rebora et al.
Erosive lichen planus and cirrhotic hepatitis
It Gen Rev Dermatol
(1978)
RA Graham Brown et al.
Lichen planus and primary biliary cirrhosis
Br J Dermatol
(1982)
F Rongioletti et al.
Lichen planus and chronic active hepatitis. A retrospective survey
Acta Derm Venereol
(1984)
Lichen planus and liver disease: a multicentre case-control study
Br Med J
(1990)

There are more references available in the full text version of this article.

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In this respect, it is interesting that CD4+ T cells and CD8+ T cells account for the majority of the cells in the band-like lymphocytic infiltrate immediately subjacent to the epithelium in OLP,5 and autoantibodies have been found in subsets of OLP.3,32,33 One case report has been published reporting LKM-1 autoantibodies in a patient with OLP and hypothyroidism,32 but 2 case series did not find any LKM-1 autoantibodies in patients with LP.34,35 However, it is not clear if these studies investigated OLP or cutaneous LP.
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Clinical and laboratory presentation of lichen planus patients with chronic liver disease

Abstract

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Lancet

Lancet

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