Hypertrophic Variant of Lichen Planus in the Anogenital Area: A Clinical Case

Document Type : Case Report

Authors

1 Novosibirsk State Medical University, Novosibirsk, Russia

2 Department of Obstetrician-Gynecologists and Dermatologists, Novosibirsk, Russia

3 Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia

Abstract

Introduction: Dermatoses localized to the anogenital area (AGA) are an urgent problem of modern medicine. The similar clinical pictures of most skin diseases in this area pose a challenge to clinicians as the effectiveness of treatment depends on the accuracy of the diagnosis. The article presents modern data on various forms of lichen planus in the AGA. We discuss the relationship of the disease with pathological conditions, such as dyslipidemia, hypothyroidism, and diabetes mellitus. Special attention is paid to the hypertrophic variant of lichen planus in the AGA, which has the most complex clinical picture for diagnosis and is least described in the scientific literature. 
Case Presentation: The authors present a complex interdisciplinary clinical case of lichen planus in the anogenital region. 
Conclusion: The joint work of a dermatovenerologist, proctologist, obstetrician-gynecologist, urologist, oncologist, pathologist, and surgeon provides a faster and more accurate diagnosis of diseases, facilitating timely and adequate treatment tactics. The presented clinical case will help practitioners better navigate the issues of diagnosing skin diseases in the anogenital area.

Keywords


  1. Khurana A, Tandon S, Marfatia YS, Madnani N. Genital lichen planus: An underrecognized entity. Indian journal of sexually transmitted diseases and AIDS. 2019;40(2):105-12.
  2. Day T, Wilkinson E, Rowan D, Scurry J. Clinicopathologic Diagnostic Criteria for Vulvar Lichen Planus. Journal of lower genital tract disease. 2020;24(3):317-29.
  3. Amsellem J, Skayem C, Duong TA, Bagot M, Fouéré S, Dauendorffer JN. Male genital lichen planus: A retrospective study of 89 cases. Annales de dermatologie et de venereologie. 2022;149(1):28-31.
  4. Cassol-Spanemberg J, Blanco-Carrión A, Rodríguez-de Rivera-Campillo ME, Estrugo-Devesa A, Jané-Salas E, López-López J. Cutaneous, genital and oral lichen planus: A descriptive study of 274 patients. Medicina oral, patologia oral y cirugia bucal. 2019;24(1):e1-e7.
  5. Ioannides D, Vakirlis E, Kemeny L, Marinovic B, Massone C, Murphy R, et al. European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. Journal of the European Academy of Dermatology and Venereology : JEADV. 2020;34(7):1403-14.
  6. Chew A, Stefanato CM, Savarese I, Neill SM, Fenton DA, Lewis FM. Clinical patterns of lichen planopilaris in patients with vulval lichen planus. The British journal of dermatology. 2014;170(1):218-20.
  7. Goldstein AT, Metz A. Vulvar lichen planus. Clinical obstetrics and gynecology. 2005;48(4):818-23.
  8. Weston G, Payette M. Update on lichen planus and its clinical variants. International journal of women’s dermatology. 2015;1(3):140-9.
  9. Regauer S, Reich O, Eberz B. Vulvar cancers in women with vulvar lichen planus: a clinicopathological study. Journal of the American Academy of Dermatology. 2014;71(4):698-707.
  10. Day T, Otton G, Jaaback K, Weigner J, Scurry J. Is Vulvovaginal Lichen Planus Associated With Squamous Cell Carcinoma? Journal of lower genital tract disease. 2018;22(2):159-65.
  11. Ramos-e-Silva M, Jacques C, Carneiro SC. Premalignant nature of oral and vulval lichen planus: facts and controversies. Clinics in dermatology. 2010;28(5):563-7.
  12. Moyal-Barracco M, Edwards L. Diagnosis and therapy of anogenital lichen planus. Dermatologic therapy. 2004;17(1):38-46.
  13. Khryanin AA, Sokolovskaya A, Bocharova VK. Lichen planus associated with viral hepatitis C: clinical case. %J Iranian Journal of Colorectal Research. Iranian Journal of Colorectal Research. 2022;10(3):110-4.
  14. Ramer MA, Altchek A, Deligdisch L, Phelps R, Montazem A, Buonocore PM. Lichen planus and the vulvovaginal-gingival syndrome. Journal of periodontology. 2003;74(9):1385-93.
  15. Eisen D. The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. Journal of the American Academy of Dermatology. 2002;46(2):207-14.
  16. Cooper SM, Wojnarowska F. Influence of treatment of erosive lichen planus of the vulva on its prognosis. Archives of dermatology. 2006;142(3):289-94.
  17. Rodríguez-Zúñiga MJM, García-Perdomo HA. Systematic review and meta-analysis of the association between psoriasis and metabolic syndrome. Journal of the American Academy of Dermatology. 2017;77(4):657-66.e8.
  18. Gorouhi F, Davari P, Fazel N. Cutaneous and mucosal lichen planus: a comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis. TheScientificWorldJournal. 2014;2014:742826.
  19. Patterson JW HG. Tissue reaction patterns, Section 2, and The dermis and subcutis, Section 4.  Weedon’s Skin Pathology: Elsevier; 2014.
  20. Ashton KA, Scurry J, Rutherford J, Otton G, Scott RJ, Bowden NA. Nodular prurigo of the vulva. Pathology. 2012;44(6):565-7.