Lichen planus autoimmune comorbidities: A retrospective case-control study

Abstract

Lichen planus (LP) is a rare, chronic inflammatory disorder affecting both skin and mucous membranes. LP has been associated with autoimmune conditions, glucose intolerance, dyslipidemia, and cardiovascular disorders; however, comprehensive data on these associations is limited. This study utilized data from the TrinetX Linked Network, comprising over 112 million patients, to assess the risk of comorbidities in LP patients from July 1, 2016, to December 9, 2024. LP patients were identified using International Classification of Diseases, 10th Revision, Clinical Modification codes, and propensity score matching was applied to compare comorbidity risks with a control cohort. The analysis revealed a significant association between LP and autoimmune dermatologic and rheumatologic conditions, including localized scleroderma, alopecia areata, vitiligo, psoriasis, lupus erythematous, Sjögren syndrome, autoimmune hepatitis, and autoimmune thyroiditis. Additionally, a lower risk was observed for hepatitis C and B infections in LP patients. The study highlights the stronger association between LP and autoimmune comorbidities, which could be linked to the higher prevalence of autoimmune diseases in women, explaining LP’s female predilection. These findings emphasize the need for heightened awareness of LP’s autoimmune nature. Limitations include diagnostic misclassification and potential geographic biases in the dataset.