A study of clinical and histopathological correlation of lichen planus

Introduction: Lichenoid tissue reaction or interface dermatitis embraces several clinical conditions, the prototype of which is lichen planus and its variants. Others include drug induced lichenoid dermatitis, special forms of lichenoid dermatitis, lichenoid dermatitis in lupus erythematosus, and other disorders all of which have salient clinical and histological features. The aim of this study was to correlate the clinical features with histopathological findings in all clinically suspected cases of lichen planus and assess the clinical diagnostic accuracy. Materials and methods: This study had been carried out over a period of 2 years from July 2015 to June 2017 in the Department of Pathology, Gandhi Hospital. Histopathological sections of skin biopsies from 85 patients were studied after routine H and E staining and morphological changes were noted. The patients' clinical findings were then correlated with the histological changes. The results were then analysed. Results: Total numbers of biopsies inclusive of LP and LP like lesions were 85. Among them, the number of patients having LP was 50. The age ranged from 18 to 65 years (mean 37.1 years). The mean duration of the lesion was 12.02 months (approx 1 year). Males were affected more than females. Out of the 85 cases, 50 were Lichen planus and 35 were lichenoid eruptions. Of the Lichen planus, 31 (61.6%) cases were of classical lichen planus, 6 (13.3%) cases were of hypertrophic lichen planus, 4 (8.3%) cases were of lichen planus pigmentosus, 4 (6.6%) cases were of actinic lichen planus, 3 (5%) cases were of eruptive lichen planus, 1 (1.6%) case each of atrophic lichen planus, annular lichen planus. Conclusion: In the present study, maximum number of cases occurred in age group of 18-28 years. Though pruritis is a common symptom, it is nonspecific. Therefore, histopathology remains the most important diagnostic tool for proper evaluation of Lichenoid eruptions/ Lichen planus.