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Erosive lichen planus: an unmet disease burden
John H Macken1,2, Amal Senusi1, Edel A O'Toole3
1Centre for Oral Immunobiology and Regenerative Medicine, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
Frontiers in Medicine
|November 1, 2024
Summary
Erosive lichen planus (ELP) presents unique challenges, including delayed diagnosis and increased medical needs, particularly in white populations. Early education and research are vital for better management and treatment outcomes.
Area of Science:
- Oral Medicine
- Dermatology
- Epidemiology
Background:
- Erosive lichen planus (ELP) is a severe variant of lichen planus.
- Understanding its demographic and clinical profile is crucial for effective management.
- Ethnic variations in disease presentation and outcomes require investigation.
Purpose of the Study:
- To explore the demographic and clinical profile of erosive lichen planus (ELP) across multiple ethnicities.
- To compare disease severity, progression, and outcomes of ELP versus reticular lichen planus (RLP).
Main Methods:
- A longitudinal retrospective cohort study.
- Involved 57 ELP patients and 35 RLP patients from diverse East London population.
- Compared clinical characteristics, diagnosis times, and treatment responses.
Main Results:
- ELP showed higher prevalence in white populations and was associated with delayed diagnosis (median 452 days vs. 312 days for RLP).
- ELP patients experienced more multisite involvement, dental issues, depression, and scarring (55%), often requiring systemic immunosuppression.
- Ex-smokers were at higher risk for ELP, while current smokers were linked to RLP.
Conclusions:
- ELP necessitates longer diagnostic periods and tertiary care, with greater resistance to treatment compared to RLP.
- Patients with ELP have increased medical and oral health needs and a higher risk of scarring.
- Enhanced education for primary care providers and further research into ELP mechanisms are needed to improve diagnostics and therapeutics.
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