Clinical and histopathological study of cutaneous lichen planus in a tertiary care center of central India

Abstract

Background: Lichen planus (LP) is an idiopathic, chronic inflammatory disease of the skin, mucous membrane, and nails. Worldwide distribution is seen, with 0.38% of the lesions prevalent in India. Objective: The present study was conducted to study the demographic profiles (such as age and gender) and histopathology of LP and their clinical presentation. Materials and Methods: The present study was conducted in the Department of Pathology at Sri Aurobindo Medical College and Post Graduate Institute, Indore. All cases presenting with LP and undergoing skin biopsy from December 2018 to May 2021 were included in the study. Detailed clinical history was taken, and histomorphological evaluation was performed for all the included cases. Results: A total of 155 cases of LP were analyzed. The mean age of presentation was 34.89 ± 16.02 years, with slight male predominance. The mean duration of the disease was 7.82 ± 5.34 months. Clinically, most cases presented with mild to moderate pruritis (64.51%), followed by intense pruritis (25.16%). Violaceous papules and plaques were the predominant findings in 80.64% of patients, followed by hyperpigmented papules and macules (13.54%). Histomorphologically, hyperkeratosis was observed in almost all cases (99.35%), followed by wedge-shaped hypergranulosis (65.80%). The most common variant found was classic LP (30.96%), followed by hypertrophic LP (29.6%) and LP pigmentosus (26.4%). Clinicopathological discordance was seen in ~14 (10%) cases. Conclusion: Detailed history, clinical examination, and careful histological assessment help diagnose LP and differentiate its variants.

Keywords

• hyperkeratosis
• hypertrophic
• lichen planus
• violaceous papules