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Pediatric lichen planus: a systematic review of 985 published cases

Reine Merhy1, Anne-Sophie Sarkis1, Joy Assaf1

  • 1Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon.

International Journal of Dermatology
|August 9, 2021
PubMed

Insights

Pediatric Lichen Planus (LP) presents diversely, often as linear variants, with topical corticosteroids being the primary treatment. This rare childhood condition, Lichen Planus Pemphigoides (LPP), shows higher recurrence rates and often requires systemic corticosteroids.

Area of Science:

  • Dermatology
  • Pediatric Medicine
  • Inflammatory Disorders

Background:

  • Lichen planus (LP) is a chronic inflammatory condition typically affecting adults, with limited data available on pediatric cases.
  • Understanding pediatric LP is crucial due to its distinct clinical characteristics and management needs.

Purpose of the Study:

  • To comprehensively describe the patient demographics, clinical manifestations, and treatment strategies for pediatric Lichen Planus.
  • To analyze the specific characteristics and treatment outcomes of Lichen Planus Pemphigoides (LPP) in children.

Main Methods:

  • A systematic literature review was conducted on Medline and Cochrane databases up to February 1, 2020.
  • Data extraction included demographics, clinical signs, laboratory and histology findings, treatments, and treatment responses for pediatric LP cases.
  • Lichen Planus Pemphigoides (LPP) cases were analyzed separately.

Main Results:

  • The review included 164 articles representing 985 pediatric patients, with most cases originating from India.
  • Flat-topped papules were the most common clinical sign (51%), followed by the linear variant (9%). Oral involvement was noted in 22% of cases.
  • Topical corticosteroids were the most frequent treatment, followed by systemic corticosteroids. LPP cases showed shorter disease duration, more frequent prior treatment failure, and higher recurrence rates.

Conclusions:

  • Pediatric Lichen Planus exhibits a polymorphous clinical presentation, with the linear variant being more prevalent and oral mucosa less frequently affected compared to adults.
  • Lichen Planus Pemphigoides is a rare subtype in children, often requiring systemic corticosteroids and demonstrating a higher propensity for recurrence.
  • The study highlights a lack of randomized controlled trials and potential publication bias in the existing literature on pediatric LP.
Abstract

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