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[Lichen planus in children: 12 cases]

M Rybojad1, I Moraillon, S Laglenne

  • 1Hôpital Saint-Louis, Paris.

Annales De Dermatologie Et De Venereologie
|December 4, 1998
PubMed
Summary
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Childhood lichen planus presents atypically, often with widespread eruptions and unusual locations, differing from adult cases. Etiology is unclear, with no drug or hepatitis links observed in this study, highlighting the need for further research.

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.

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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.