A Study of Depression and Quality of Life in Patients of Lichen Planus

Abstract

The precise cause of lichen planus is unknown, but the disease seems to be immunologically mediated. It is a psychocutaneous disorder. Due to scarcity of Indian studies in this field, we decided to study in patients of lichen planus the prevalence of depression and quality of life with comparison of the same in both the genders. Patients diagnosed as having lichen planus by consultant dermatologist were enrolled after informed consent and ethics approval. 45 patients were screened, of which 35 who satisfied the criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of dermatology life quality index and Beck's depression inventory. While 25% were depressed with females being more affected than males, quality of life was impaired in more than 90% patients. Impairment was maximum due to symptoms and illness feelings, disturbed daily activities, or work and time consumption in treatment. There was a strong association between depression and impairment in quality of life in both the genders. This study helps in early identification of psychological problems in lichen planus patients and in planning their future course of management, hence reducing the lack of productivity and improving the prognosis and quality of life.

Stress Evaluation Using Das Scale and Salivary Cortisol in Patients With Oral Lichen Planus, Oral Submucous Fibrosis, Leukoplakia and Squamous Cell Carcinoma.

“…Studies by Pekiner FN et al 17 , who stated that higher 21 also found higher anxiety and depression levels in OLP patients but using different psychometric tests which were in accordance with present study which proves strong association of OLP with stress, anxiety and depression levels.…”

Current review of conections between lichen planus and mental disorders

“…Some authors didn't demonstrate this connection [23], however others confirmed that disorders connected with depression more often includes women (77,7 %, 7 from 9 people, who are affected with lichen planus with depression are women) [22]. The cause of it is that women have higher vulnerability to stress, more often they are not satisfied with their appearance, and lower self-esteem than men [22]. These differences between sexes were observed in the school and work, not in other environments [22].…”

“…There is the connection between mental state and prevalence of dermatological illnesses. From one point of view psychiatric disorders can have impact on exacerbation or acceleration of dermatological disease, and in other hand disorders, which are connected with the skin can be the reason of psychiatric illnesses [22]. Because of this and lack of well-known knowledge about etiopathogenesis of LP, it is consider to be psychosomatic illness [23].…”

“…There was also checked correlation between quality of life of sick people, level of perceived stress and techniques of coping with stress and sex. Some authors didn't demonstrate this connection [23], however others confirmed that disorders connected with depression more often includes women (77,7 %, 7 from 9 people, who are affected with lichen planus with depression are women) [22]. The cause of it is that women have higher vulnerability to stress, more often they are not satisfied with their appearance, and lower self-esteem than men [22].…”

Annular atrophic lichen planus as a psychiatric problem

“…Our skin is a reflection of our health, and numerous diseases caused by organic or psychological factors may manifest as either pathologically altered structures of the skin or as subjective symptoms with normal skin. Lichen planus (LP) was recently reported to be a psychocutaneous disorder that affects skin, mucosa, hair follicles, and nails (Sawant et al, 2015). The most common psychogenic conditions that may lead to LP are depression, anxiety, and stress (Pokupec, Gruden, & Gruden, 2009).…”