Evaluation of carotid intima-media thickness and serum homocysteine level as markers of subclinical atherosclerosis in lichen planus

Abstract

Background Lichen planus (LP) is a chronic mucocutaneous inflammatory disease. Its etiology remains unknown and may be caused by a cell-mediated immunological response, where autoreactive cytotoxic T lymphocytes are the effector cells, which cause degeneration and destruction of keratinocytes. Inflammation produces disturbances of lipid metabolism such as serum increase of triglycerides or decrease of high-density lipoprotein. Hyperhomocysteinemia has been regarded as a new modifiable risk factor for atherosclerosis and vascular disease. Homocysteine increases the damage to the cardiovascular system in different ways. It is widely seen now as an independent risk factor of cardiovascular disease in adults. Carotid intima-media thickness (CIMT) is a well-recognized clinical predictor of subclinical atherosclerosis. In several previous studies, patients with psoriasis exhibited greater CIMT than did the controls. In light of these studies, authorities might think that LP would also be associated with the formation of subclinical atherosclerosis, given the similarity between the pathogenesis of psoriasis and that of LP. Aim To assess carotid intima thickness and serum homocysteine level as markers of subclinical atherosclerosis in patients with LP. Patients and methods Abstract Peripheral blood samples were collected from 25 patients with LP and 25 controls to assess serum homocysteine level, blood glucose, cholesterol, and triglycerides. CIMT was measured by B mode ultrasound. Results Both serum homocysteine and CIMT were significantly higher in patients with LP than controls. Conclusion Serum homocysteine and CIMT could be reliable predictors of subclinical atherosclerosis in LP.