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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 . 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Archives of Dermatology – American Medical Association
Published: Jan 1, 1994
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