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  In this article
    Abstract
    Introduction
    Subjects and Methods
    Result
    Discussion
    References

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ORIGINAL ARTICLE
Year : 2002  |  Volume : 68  |  Issue : 5  |  Page : 273-274

Lichen planus and hepatitis c virus (HCV) - Is there an association? A serological study of 65 cases


Department of Dermatology and Venereology, Medical College Hospital, Calicut-673 008, India

Correspondence Address:
Department of Dermatology and Venereology, Medical College Hospital, Calicut-673 008, India

   Abstract 

Sixty-five patients (48 females, 15 males and 2 children) with lichen planus were tested for anti HCV antibodies. None gave positive result.

How to cite this article:
Prabhu S, Pavithran K, Sobhanadevi G. Lichen planus and hepatitis c virus (HCV) - Is there an association? A serological study of 65 cases. Indian J Dermatol Venereol Leprol 2002;68:273-4


How to cite this URL:
Prabhu S, Pavithran K, Sobhanadevi G. Lichen planus and hepatitis c virus (HCV) - Is there an association? A serological study of 65 cases. Indian J Dermatol Venereol Leprol [serial online] 2002 [cited 2014 Nov 22];68:273-4. Available from: http://www.ijdvl.com/text.asp?2002/68/5/273/12490



   Introduction Top

Lichen planus is a relatively common dermatological disease, with a frequency of prevalence of 1.4% in the world and 0.76% in India. Many agents have been implicated in its etiology, but none could be proved. It was found to be more frequent in patients with hepatic dysfunction. With the discovery of hepatitis C virus, a single stranded RNA virus in 1989, and with the availability of tests for anti HCV antibodies in 1991, an increased prevalence of lichen planus (LP), especially oral and erosive LP was found in people with HCV infection. Various studies conducted in different parts of the world have proved or disproved a causative role for HCV in LP 1-8,10

   Subjects and Methods Top

At the Department of Dermato Venereo-Leprology, Calicut Medical College, 65 patients with lichen planus, clinically or histologically proven, were tested for anti HCV antibodies. There were 48 females (75.4%), 15 males (52.3%) and 2 children below the age of 12 years (one male and one female). 34 cases (52.3%) were in the third and fourth decades. 43 (66.15%) had oral lesions. Mean age was 39.52 years. Mean duration of the disease was 19.91 months, 50 cases (76.92%) being in the range of 0-12 months.
The morphology of the lesions, sites involved, and associated disease, if any were noted down. Routine laboratory tests on blood including liver function tests and urinalysis were done in all cases. All patients were undergoing treatment with topical or intralesional steroids.
The kit used was Hepatitis C Virus Encoded Antigen (Recombinant c22-3, c200 and NS5) ORTHO HCV 3.0 ELISA Test System with Enhanced SAVe. This is a second generation ELISA containing Hepatitis C Virus Encoded Antigen (Recombinant c22-3, c200 and NS5).

   Result Top

Of all 65 patients, none were HCV positive.

   Discussion Top

HCV infection is wide spread, with an estimated 3% of the world population being infected and it has been implicated as an etiological factor for the occurrence of lichen planus. It is a single stranded RNA virus mainly transmitted via transfusion of blood or blood products. The proposed mechanisms for the causation of lichen planus are:1) HCV is capable of cytopathic replication in cell types outside the liver.[6] 2) It may trigger an auto-immune process that is directed against antigens expressed on extra-hepatic cells.[9] 3) Persistent infection can lead to immune complex formation with antibodies, followed by deposition on small blood vessels. 4) The trigger of immunological processes leading to dermatological manifestations are the activated CD8 T cells, cytokines and expansion of certain B cell clones.[9],[12]
The first case was reported from France in 1991. So far, many case control studies have been undertaken implicating or refuting HCV association in LP Most of the positive studies are from Japan, Spain and Italy.[2],[3],[4],[10] Northern UK studies have persistently failed to depict an association between Hepatitis C infection and lichen planus.[13],[14]
In India, studies conducted in New Delhi have failed to demonstrate statistically significant association between HCV and LP, whereas studies conducted in Hyderabad and Bangalore have shown a significant association.
We have not found any association between lichen planus (oral and non-oral) and HCV infection in our patients. Probably regional variation in HCV prevalence accounts for the positive correlation between HCV infection and lichen planus, especially oral and erosive varieties, in most series. Routine liver function tests and further screening on the basis of abnormal values will be a fair enough protocol to follow, especially in areas where the prevalence of HCV infection is low. 

   References Top

1.del Olmo JA, Pascoul J, Bagan JV, et al. Prevalence of hepatitis C virus infection in patients of lichen planus of oral cavity and chronic liver disease. Eur J Oral Sci 2000;108: 378-382.  Back to cited text no. 1    
2.Nagoo Y, Sato M, Fukuzumi K, et al. High incidence of oral lichen planus in an hepatitis C virus endemic area. Gastroenterology 2000;119: 882-883.  Back to cited text no. 2    
3.Van der Meij EH, van der Wal I. Hepatitis C virus and oral lichen planus: a report from the Netherlands. J Oral Pathol Med 2000;29: 225-258.  Back to cited text no. 3    
4.Dupond AS, Locour JP, Lafout C, et al. Prevalence of hepatitis C virus in oral erosive lichen. Ann Dermatol Venereol 1998;125: 676-678.  Back to cited text no. 4    
5.Migogna MD, Lo Muzio L, Favia G, et al. Oral lichen planus and hepatitis C virus infection: a clinical evaluation of 263 cases. Int J Dermatol 1998;37:573-578.  Back to cited text no. 5    
6.Lodi G, Porter SR. Hepatitis C viral infection and lichen planus: a short review. Oral Dis 1997;3: 77-81.  Back to cited text no. 6  [PUBMED]  
7.Migogna MD, Lo Muzio L, To Russo L, et al. Oral lichen planus: \different clinical features in HCV-positive and HCV-negative patients. Int J Dermatol 2000;39: 134-139.  Back to cited text no. 7    
8.Chuang TY, Stitle L, Brashear R, et al. Hepatitis C virus and lichen planus: a case control study of 340 patients. J Am Acad Dermatol 1999;41: 787-789.  Back to cited text no. 8    
9.Tanei R, Watanable V, Nishiyama S. Clinical and histopathological analysis of the relationship between lichen planus and chronic hepatitis C. J Dermatol 1995; 22: 316-232.  Back to cited text no. 9    
10.Criber B, Garnier C, Laustrat D, et al. lichen planus and hepatitis C virus infection: an epidemiologic study. J Am Acad Dermatol 1994; 31: 1070-1072.  Back to cited text no. 10    
11.Kirtak N, Inaloz HS, Ozgoztasi, et al. The prevalence of hepatitis C virus infection in patients with lichen planus in Gaziantep region of Turkey. Eur J Epidemiol 2000;16: 1156-1161.  Back to cited text no. 11    
12.Carrozzo M, Gondolfi S, Lodi G, et al. Oral Lichen planus in patients infected or non infected with hepatitis C virus: the role of autoimmunity. J Oral Pathol Med 1999;28: 16-19.  Back to cited text no. 12    
13.Roy KM, Dickson EM, Stains KS, et al. Hepatitis C and oral lichen planus: lack of evidence for association. Clin Lab 2000;46: 251-254.  Back to cited text no. 13    
14.Ingafov M, Porter RS, Scully C, et al. No evidence of hepatitis C viral infection or liver disease in British patients with oral lichen planus. Int J Oral Maxillofac Surg 1998;27: 65-66.  Back to cited text no. 14    

 

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