Assessment of cardiovascular risk in lichen planus cases with epicardial adipose tissue thickness and plasma atherogenic index

Background Lichen planus (LP) is an idiopathic, chronic, inflammatory dermatosis that can affect the skin, its appendages, and mucous membranes. Chronic inflammatory dermatoses may contribute to metabolic complications and increase cardiovascular risk. This study aimed to evaluate cardiovascular risk in patients with LP by assessing the Plasma Atherogenic Index (PAI) and Epicardial Adipose Tissue (EAT) thickness.Methods A case–control study was conducted, including a total of 150 individuals, comprising 75 patients with LP and 75 age-, sex-, and body mass index (BMI)–matched controls. Lipid profiles were analyzed, and the PAI (log10[triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C)]) was calculated. EAT thickness was measured using transthoracic echocardiography.Results In the study, 40% of participants were male and 60% female in both groups. Dyslipidemia was identified in 66.7% of the case group and 50.7% of the control group, with the presence of dyslipidemia being significantly higher in the LP group (p < 0.05). Among the cases, 82.7% were in the high, 6.7% in the moderate, and 10.7% in the low cardiovascular risk category. PAI values and mean EAT thickness were significantly higher in the LP group than in controls (both p < 0.05).Conclusions The findings support an association between LP and markers of increased subclinical cardiovascular risk rather than established cardiovascular disease. Early recognition and regular screening for cardiometabolic risk factors in dermatology practice, as well as multidisciplinary collaboration with cardiologists, may help prevent long-term cardiovascular complications in patients with LP.