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Changes in Skin Color: Clinical Perspectives01:14

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Comorbidity in Lichen Planus: A Retrospective Population-Based Case-Control Study in Sweden.

Hilda Odell1, Sandra Jerkovic Gulin2,3, Oliver Seifert2,3

  • 1The Faculty of Medicine and Health Sciences, Linkoping University, 58183 Linköping, Sweden.

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Summary

Lichen planus (LP) is uncommon in Sweden, with a prevalence of 185 per 100,000. This immune-mediated disease is linked to thyroid, metabolic, autoimmune, and malignant conditions, necessitating thorough patient evaluation.

Keywords:
Swedencase–control studiescomorbidityepidemiologylichen planusmalignancymetabolic syndromepositive predictive valueregister studythyroid disease

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Area of Science:

  • Dermatology
  • Immunology
  • Epidemiology

Background:

  • Lichen planus (LP) is a chronic, immune-mediated inflammatory condition affecting skin and mucous membranes.
  • Etiology remains largely unknown, and associations with comorbidities require further investigation, especially in specific populations.
  • Limited data exists on LP prevalence, incidence, and comorbidities within Swedish populations.

Purpose of the Study:

  • To determine the prevalence and incidence of Lichen planus (LP) in a Swedish population.
  • To assess the diagnostic validity of ICD-10 coding for LP (L43).
  • To identify comorbidities associated with LP and evaluate treatment patterns.

Main Methods:

  • Retrospective, population-based case-control study of 361,812 individuals in Region Jönköping, Sweden (2013-2022).
  • Calculated incidence and prevalence rates.
  • Assessed diagnostic validity via medical record review of 70 cases to determine positive predictive value (PPV); analyzed comorbidity associations using logistic regression.

Main Results:

  • Calculated prevalence of 235.5 and incidence of 19.6 per 100,000 inhabitants.
  • The PPV of ICD-10 coded LP diagnosis was 78.6%, yielding an adjusted prevalence of 184.9 per 100,000.
  • Significant associations found between LP and thyroid, malignant, metabolic, and autoimmune conditions; over one-third of patients received topical corticosteroids.

Conclusions:

  • Lichen planus is relatively uncommon in this Swedish population.
  • ICD-10 coding for LP demonstrates acceptable diagnostic validity.
  • The identified comorbidities underscore the importance of comprehensive patient assessment in managing LP.