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Lichen Planus and Hepatitis C Virus— Related Chronic Active Hepatitis

Lichen Planus and Hepatitis C Virus— Related Chronic Active Hepatitis Abstract Background and Design: An increased prevalence of chronic liver disease has been reported in patients with lichen planus (LP). We report six cases of LP associated with chronic active hepatitis and actively replicating hepatitis C virus (HCV). Results: We studied six patients (three men and three women; mean age, 61 years; age range, 47 to 70 years) with various forms (cutaneous and/or mucosal) of LP and abnormal liver test results. Four patients had severe mucosal lesions. Cutaneous and mucosal lesions had a long-term evolution. Liver disease was discovered 2 to 6 years before LP in three cases and was diagnosed at the same time as LP in the three other cases. Liver biopsy performed in five patients showed chronic active hepatitis without cirrhosis in all five cases. Anti—HCV antibodies were detected in all cases by second-generation enzyme-linked immunosorbent assay and confirmed by second-generation recombinant immunoblot assay. Hepatitis C virus RNA was evidenced by means of polymerase chain reaction in the serum samples from the six patients, proving active viral replication. Conclusions: Lichen planus may be associated with HCV-related chronic active hepatitis. As interferon treatment may induce viral inactivation in some patients with HCV-related chronic liver disease, a search for HCV infection should be systematically performed in patients with chronic LP.(Arch Dermatol. 1994;130:73-76) References 1. Boyd A, Neldner K. Lichen planus . J Am Acad Dermatol. 1991;25:593-619.Crossref 2. Gruppo Italiano Studi Epidemiologici in Dermatologia. Lichen planus and liver diseases: a multicentre case control study . BMJ. 1990;300:227-230.Crossref 3. Rebora A, Rongioletti F, Grosshans E. Le syndrome lichen-hepatite . Ann Dermatol Venereol. 1985;112:27-32. 4. Graham-Brown R, Sarkany I, Sherlock S. Lichen planus and primary biliary cirrhosis . Br J Dermatol. 1982;106:699-703.Crossref 5. Katz M, Pisanti S. Oral erosive lichen planus and chronic active hepatitis . J Am Acad Dermatol. 1985;12:719.Crossref 6. Rebora A, Rongioletti F. Lichen planus and chronic active hepatitis . Acta Derm Venereol (Stockh) . 1984;64:52-56. 7. Rebora A, Rongioletti F. Lichen planus and chronic active hepatitis . J Am Acad Dermatol. 1984;10:840-841.Crossref 8. Rebora A, Robert E, Rongioletti F. Clinical and laboratory presentation of lichen planus patients with chronic liver disease . J Dermatol Sci. 1992;4:38-41.Crossref 9. Agner T, Fogh H, Weismann K. The relation between lichen planus and hepatitis C: a case report . Acta Derm Venereol (Stockh) . 1992;72:380. 10. Divano MC, Parodi A, Rebora A. Lichen planus, liver-kidney microsomal (LKM1) antibodies and hepatitis C virus antibodies . Dermatology . 1992;185: 132-133.Crossref 11. Pawlotsky JM, DeForges L, Bretagne S, et al. Hepatitis C virus infection can mimic type 1 (antinuclear antibody positive) autoimmune chronic active hepatitis . Gut. 1993;34( (suppl) ):S66-S68.Crossref 12. Korkij W, Chuang TY, Soltani K. Liver abnormalities in patients with lichen planus: a retrospective case-control study . J Am Acad Dermatol. 1984;11:609-615.Crossref 13. Ayala F, Balato N, Tranfaglia A, Guadagnino V, Orlando R. Oral erosive lichen planus and chronic liver disease . J Am Acad Dermatol. 1986;14:139-140.Crossref 14. Choo QL, Kuo G, Weiner A, Overby LR, Bradley DW, Houghton M. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome . Science . 1989;244:359-362.Crossref 15. Alter HJ, Purcell RH, Shih JW, et al. Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis . N Engl J Med. 1989;321:1494-1500.Crossref 16. Hopf U, Möller B, Küther D, et al. Long-term follow-up of post-transfusion and sporadic chronic hepatitis non-A, non-B and frequency of circulating antibodies to hepatitis C virus (HCV) . J Hepatol. 1990;10:69-76.Crossref 17. Mokni M, Rybojad M, Puppin D, et al. Lichen planus and hepatitis C virus . J Am Acad Dermatol. 1991;24:792.Crossref 18. Doutre MS, Beylot C, Couzigou P, Long P, Royer P, Beylot J. Lichen planus and virus C hepatitis: disappearance of the lichen under interferon alfa therapy . Dermatology . 1992;184:229.Crossref 19. Roudot-Thoraval F, Pawlotsky JM, DeForges L, Girollet PP, Dhumeaux D. Anti-HCV seroprevalence in pregnant women in France . Gut. 1993;34( (suppl) ):S55-S56.Crossref 20. Divano MC, Parodi A, Rebora A. Anti—liver-kidney microsome type 1 antibodies in lichen planus . Arch Dermatol. 1992;128:991.Crossref 21. Mobacken H, Nilsson LA, Olsson R, Sloberg K. Incidence of liver disease in chronic lichen planus of the mouth . Acta Derm Venereol (Stockh) . 1984;64: 70-73. 22. Monk B. Lichen planus and the liver . J Am Acad Dermatol. 1985;12:122-123.Crossref 23. El Kabir M, Scully C, Porter S, Porter K, MacNamara E. Liver function in UK patients with oral lichen planus . Clin Exp Dermatol. 1993;18:12-16.Crossref 24. Mishiro S, Hoshi Y, Takeda K, et al. Non-A, non-B hepatitis specific antibodies directed at host-derived epitope: implication for an autoimmune process . Lancet 1990;336:1400-1403.Crossref 25. Lenzi M, Ballardini G, Fusconi M, et al. Type 2 autoimmune hepatitis and hepatitis C virus infection . Lancet . 1990;335:258-259.Crossref 26. Cottoni F, Tedde G, Solinas A, Deplano A. Lichen planus associated with anti— liver-kidney microsome—positive chronic active hepatitis and hyperthyroidism . Arch Dermatol. 1991;127:1730-1731.Crossref 27. Magrin S, Craxi A, Fabiano C, Fiorentino G, Almasio P, Houghton M. Hepatitis C virus replication in 'autoimmune' chronic hepatitis . J Hepatol. 1991;13:364-367.Crossref 28. Ferri C, Greco F, Longombardo G, et al. Association between hepatitis C virus and mixed cryoglobulinemia . Clin Exp Rheumatol. 1991;9:621-624. 29. Haddad J, Deny P, Munz-Gotheil C, et al. Lymphocytic sialadenitis of Sjögren's syndrome associated with chronic hepatitis C virus liver disease . Lancet . 1992; 339:321-323.Crossref 30. Durand JM, Lefevre P, Harle JR, Boucrat J, Vitviski L, Soubeyrand J. Cutaneous vasculitis and cryoglobulinemia type II associated with hepatitis C virus infection . Lancet . 1991;337:499-500.Crossref 31. Fargion S, Piperno A, Cappellini MD, et al. Hepatitis C virus and porphyria cutanea tarda: evidence of a strong association . Hepatology . 1992;16:1322-1326.Crossref 32. Antinori S, Esposito R, Aliprandi C, Tadini G. Erythema multiforme and hepatitis C . Lancet . 1991;337:428.Crossref 33. Tine F, Magrin S, Craxi A, Pagliaro L. Interferon for non-A, non-B chronic hepatitis: a meta-analysis of randomized clinical trials . J Hepatol. 1991;13:192-199.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1994.01690010077011
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Abstract

Abstract Background and Design: An increased prevalence of chronic liver disease has been reported in patients with lichen planus (LP). We report six cases of LP associated with chronic active hepatitis and actively replicating hepatitis C virus (HCV). Results: We studied six patients (three men and three women; mean age, 61 years; age range, 47 to 70 years) with various forms (cutaneous and/or mucosal) of LP and abnormal liver test results. Four patients had severe mucosal lesions. Cutaneous and mucosal lesions had a long-term evolution. Liver disease was discovered 2 to 6 years before LP in three cases and was diagnosed at the same time as LP in the three other cases. Liver biopsy performed in five patients showed chronic active hepatitis without cirrhosis in all five cases. Anti—HCV antibodies were detected in all cases by second-generation enzyme-linked immunosorbent assay and confirmed by second-generation recombinant immunoblot assay. Hepatitis C virus RNA was evidenced by means of polymerase chain reaction in the serum samples from the six patients, proving active viral replication. Conclusions: Lichen planus may be associated with HCV-related chronic active hepatitis. As interferon treatment may induce viral inactivation in some patients with HCV-related chronic liver disease, a search for HCV infection should be systematically performed in patients with chronic LP.(Arch Dermatol. 1994;130:73-76) References 1. Boyd A, Neldner K. Lichen planus . J Am Acad Dermatol. 1991;25:593-619.Crossref 2. Gruppo Italiano Studi Epidemiologici in Dermatologia. Lichen planus and liver diseases: a multicentre case control study . BMJ. 1990;300:227-230.Crossref 3. Rebora A, Rongioletti F, Grosshans E. Le syndrome lichen-hepatite . Ann Dermatol Venereol. 1985;112:27-32. 4. Graham-Brown R, Sarkany I, Sherlock S. Lichen planus and primary biliary cirrhosis . Br J Dermatol. 1982;106:699-703.Crossref 5. Katz M, Pisanti S. Oral erosive lichen planus and chronic active hepatitis . J Am Acad Dermatol. 1985;12:719.Crossref 6. Rebora A, Rongioletti F. Lichen planus and chronic active hepatitis . Acta Derm Venereol (Stockh) . 1984;64:52-56. 7. Rebora A, Rongioletti F. Lichen planus and chronic active hepatitis . J Am Acad Dermatol. 1984;10:840-841.Crossref 8. Rebora A, Robert E, Rongioletti F. Clinical and laboratory presentation of lichen planus patients with chronic liver disease . J Dermatol Sci. 1992;4:38-41.Crossref 9. Agner T, Fogh H, Weismann K. The relation between lichen planus and hepatitis C: a case report . Acta Derm Venereol (Stockh) . 1992;72:380. 10. Divano MC, Parodi A, Rebora A. Lichen planus, liver-kidney microsomal (LKM1) antibodies and hepatitis C virus antibodies . Dermatology . 1992;185: 132-133.Crossref 11. Pawlotsky JM, DeForges L, Bretagne S, et al. Hepatitis C virus infection can mimic type 1 (antinuclear antibody positive) autoimmune chronic active hepatitis . Gut. 1993;34( (suppl) ):S66-S68.Crossref 12. Korkij W, Chuang TY, Soltani K. Liver abnormalities in patients with lichen planus: a retrospective case-control study . J Am Acad Dermatol. 1984;11:609-615.Crossref 13. Ayala F, Balato N, Tranfaglia A, Guadagnino V, Orlando R. Oral erosive lichen planus and chronic liver disease . J Am Acad Dermatol. 1986;14:139-140.Crossref 14. Choo QL, Kuo G, Weiner A, Overby LR, Bradley DW, Houghton M. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome . Science . 1989;244:359-362.Crossref 15. Alter HJ, Purcell RH, Shih JW, et al. Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis . N Engl J Med. 1989;321:1494-1500.Crossref 16. Hopf U, Möller B, Küther D, et al. Long-term follow-up of post-transfusion and sporadic chronic hepatitis non-A, non-B and frequency of circulating antibodies to hepatitis C virus (HCV) . J Hepatol. 1990;10:69-76.Crossref 17. Mokni M, Rybojad M, Puppin D, et al. Lichen planus and hepatitis C virus . J Am Acad Dermatol. 1991;24:792.Crossref 18. Doutre MS, Beylot C, Couzigou P, Long P, Royer P, Beylot J. Lichen planus and virus C hepatitis: disappearance of the lichen under interferon alfa therapy . Dermatology . 1992;184:229.Crossref 19. Roudot-Thoraval F, Pawlotsky JM, DeForges L, Girollet PP, Dhumeaux D. Anti-HCV seroprevalence in pregnant women in France . Gut. 1993;34( (suppl) ):S55-S56.Crossref 20. Divano MC, Parodi A, Rebora A. Anti—liver-kidney microsome type 1 antibodies in lichen planus . Arch Dermatol. 1992;128:991.Crossref 21. Mobacken H, Nilsson LA, Olsson R, Sloberg K. Incidence of liver disease in chronic lichen planus of the mouth . Acta Derm Venereol (Stockh) . 1984;64: 70-73. 22. Monk B. Lichen planus and the liver . J Am Acad Dermatol. 1985;12:122-123.Crossref 23. El Kabir M, Scully C, Porter S, Porter K, MacNamara E. Liver function in UK patients with oral lichen planus . Clin Exp Dermatol. 1993;18:12-16.Crossref 24. Mishiro S, Hoshi Y, Takeda K, et al. Non-A, non-B hepatitis specific antibodies directed at host-derived epitope: implication for an autoimmune process . Lancet 1990;336:1400-1403.Crossref 25. Lenzi M, Ballardini G, Fusconi M, et al. Type 2 autoimmune hepatitis and hepatitis C virus infection . Lancet . 1990;335:258-259.Crossref 26. Cottoni F, Tedde G, Solinas A, Deplano A. Lichen planus associated with anti— liver-kidney microsome—positive chronic active hepatitis and hyperthyroidism . Arch Dermatol. 1991;127:1730-1731.Crossref 27. Magrin S, Craxi A, Fabiano C, Fiorentino G, Almasio P, Houghton M. Hepatitis C virus replication in 'autoimmune' chronic hepatitis . J Hepatol. 1991;13:364-367.Crossref 28. Ferri C, Greco F, Longombardo G, et al. Association between hepatitis C virus and mixed cryoglobulinemia . Clin Exp Rheumatol. 1991;9:621-624. 29. Haddad J, Deny P, Munz-Gotheil C, et al. Lymphocytic sialadenitis of Sjögren's syndrome associated with chronic hepatitis C virus liver disease . Lancet . 1992; 339:321-323.Crossref 30. Durand JM, Lefevre P, Harle JR, Boucrat J, Vitviski L, Soubeyrand J. Cutaneous vasculitis and cryoglobulinemia type II associated with hepatitis C virus infection . Lancet . 1991;337:499-500.Crossref 31. Fargion S, Piperno A, Cappellini MD, et al. Hepatitis C virus and porphyria cutanea tarda: evidence of a strong association . Hepatology . 1992;16:1322-1326.Crossref 32. Antinori S, Esposito R, Aliprandi C, Tadini G. Erythema multiforme and hepatitis C . Lancet . 1991;337:428.Crossref 33. Tine F, Magrin S, Craxi A, Pagliaro L. Interferon for non-A, non-B chronic hepatitis: a meta-analysis of randomized clinical trials . J Hepatol. 1991;13:192-199.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Jan 1, 1994

References