Serum lipid profile pattern in lichen planus: A cross-sectional study in northeast India

Background: Lichen planus (LP) is a chronic idiopathic T cell-mediated papulosquamous disorder clinically characterized by firm, shiny, polygonal, pruritic, 1–3 mm, flat-topped, erythematous to violaceous papules and plaques. Oral LP has a characteristic whitish streak in a reticular pattern (Wickham striae). Recent scientific literature has emphasized the strong association between chronic inflammation in LP and cardiovascular disease. This study was undertaken to study if dyslipidemia is associated with LP. Materials and Methods: After informed consent, thirty-eight willing patients aged between 10 and 80 years of age with clinical presentations suggestive of lichen planus who had attended the Dermatology OPD of RIMS in Manipur, India, were included in the study. Histopathology was done to confirm doubtful cases. Detailed history, examination, and investigations were conducted for all patients. Dermoscopic examination was done to aid in clinical diagnosis. Results: Females outnumbered males (m/f: 1:1.7). A majority of the patients (84.2%) had a duration of disease above six months. Dyslipidemia was found in 50% of the patients (n = 19). The mean levels of HDL, TC, LDL, TG, and VLDL were 47 ± 8.89 mg%, 166.11 ± 34.93 mg%, 107.95 ± 26.17 mg%, 152.95 ± 63.46 mg%, and 19.55 ± 5.94 mg%, respectively. The single most common lipid abnormality found was deranged HDL (13.2%), followed by abnormal TC (10.5%), TG (7.9%), and deranged VLDL (2.6%). 15.8% of the patients had multiple lipid abnormalities. The 40–49 year (31.5%) group was the most commonly associated with dyslipidemia, which was statistically significant. Dyslipidemia was the most commonly seen in the reticular type (42.1%) of LP, although not statistically significant. No statistically significant correlation was found between dyslipidemia and clinical types nor with the symptoms of LP. Conclusions: Dyslipidemia was present in half of the patients, and the most common single abnormality was low HDL. A majority had multiple lipid abnormalities. A statistically significant portion of the patients in their 40s had dyslipidemia. Statistically significant abnormal TG and LDL were observed in age groups 40–49 years and 60–79 years, respectively. Hence, all patients with LP should undergo lipid profile testing for early detection and primary prevention of metabolic syndrome and cardiovascular complications. Key words: Lichen planus, Inflammation, Dyslipidemia, Cardiovascular morbidity