Clinical and Histopathological Study of 50 Cases of Lichen Planus

Background: Lichen Planus (LP) is a unique, common inflammatory disorder that affects the skin, mucous membrane, nail and hair. Though lichen planus has distinct colour, morphology and distribution it can present with variability. Objective: To know the incidence, various clinical manifestations, and correlation with histopathological findings. Methods: A total of 50 Lichen planus patients attending outpatient department of Dermatology at Chigateri and Bapuji hospital, Davangere, Karnataka were included. Detailed history, thorough physical examination and relevant investigations were done. The study design employed was a cross sectional study and the sample size was calculated with α=5% and absolute error of 3% for incidence 0.8%, the sample size was calculated to be 36. Statistical Method: Frequency, proportion, Chi-Square test for association, contingency co-efficient and related statistical techniques with graphs using R software. Inclusion Criteria: Clinically diagnosed Lichen Planus case. Exclusion Criteria: Patients not willing for biopsy. Result: Out of all Dermatology out patients LP constituted 0.57%. Majority (52%) of patients belongs to the age group of 21-40 years, with a male to female ratio of 1.5:1. Majority (68%) of patients presented within 3 months of duration, 90% of patients had pruritus. Papular LP was the commonest type, only skin was involved in 80%, skin and mucous membrane was involved in 18%. The commonest site involved was extremities in 72% followed by trunk in 38%. Reticular type was the commonest among oral lesions. Koebner phenomenon observed in 64% and nail involvement was seen in 20% of patients. In our study hyperkeratosis(86%), hypergranulosis(86%), acanthosis(78%), saw toothing of rete ridges(59%) and liquefaction degeneration of basal cells(73%) were consistent features, civatte bodies were seen in 10% of cases, band like infiltrate (89%) and melanin incontinence(77.7%) were seen in dermis. Conclusion: This study emphasizes the need for detailed history, clinical examination and as LP presents with various clinical morphological types, the histopathological features are very useful in differentiating its variants.