[Lichen planus in children: 12 cases]

Area of Science:

• Pediatric Dermatology
• Dermatology
• Immunology

Background:

• Lichen planus is rare and poorly understood in children.
• Classical descriptions of lichen planus in adults do not fully apply to pediatric cases.

Purpose of the Study:

• To analyze the clinical features, etiology, and outcomes of lichen planus in a cohort of 12 children.
• To compare childhood lichen planus presentations with those typically seen in adults.

Main Methods:

• Retrospective analysis of 12 pediatric cases of lichen planus from two hospitals (February 1994 - March 1996).
• Data collected included demographics, medical history, physical examination, histology, laboratory tests (liver function, hepatitis B/C serology), treatment, and outcomes.
• Histological confirmation was obtained in all but one case.

Main Results:

• Childhood lichen planus presented atypically, with rapidly extensive eruptions in 6 cases and unusual localization (limbs, trunk, face, scalp) in 5 cases.
• Mucosal involvement (1/12 children) and ungual involvement were uncommon compared to adult cases.
• No cases were linked to drugs or hepatitis B/C infection; however, three children developed lichen planus after anti-hepatitis B infection, with four similar cases reported in literature.

Conclusions:

• Pediatric lichen planus exhibits distinct clinical features from adult presentations, necessitating tailored diagnostic and management approaches.
• The etiology remains multifactorial, potentially involving ethnic, genetic, and climatic factors, with a possible link to anti-hepatitis B vaccination.
• Further prospective studies are crucial to elucidate the incidence, prognosis, and optimal therapeutic strategies for childhood lichen planus.