Lupus erythematosus and lichen planus overlap syndrome: a case report with a rapid response to topical corticosteroid therapy

Abstract

Lupus erythematosus (LE) and lichen planus (LP) may occur as an overlap syndrome. We report the clinical characteristics of a young man with lesions diagnosed as LE and LP by histopathological and direct immunoflurosence examinations. We achieved remarkable clinical response from the treatment with topical corticosteroids and no recurrence was seen in a 6 months of follow up time. We found this case interesting because of the rapid improvement with corticosteroid and discussed if there is a real overlap or a coexistence according to the literature.

Synchronous presentation of systemic lupus erythematosus and oral reticular lichen planus

“…Several reports are available in the literature on lupus erythematosus and lichen planus overlap syndrome, a disease in which the features of discoid lupus erythematosus and cutaneous lichen planus (CLP) are combined. 7 , 8 , 9 A variant of the overlap syndrome, consisting of CLP and subacute cutaneous lupus erythematosus, has also been described. 10 The common etiology of the 2 diseases is frequently cited as the reason for this coexistence.…”

“… 10 The common etiology of the 2 diseases is frequently cited as the reason for this coexistence. 9 , 10 …”

“…Coexistence of immunologic features of both discoid lupus erythematosus and CLP are essential for diagnosing the overlap syndrome; however, the DIF assay of our mucosal biopsy yielded negative results for SLE. 9 Therefore, instead of diagnosing our case as an oral variant of the overlap syndrome, we prefer using the term synchronous presentation.…”

Cutaneous Manifestations of “Lupus”: Systemic Lupus Erythematosus and Beyond

“…Cutaneous LE and lichen planus (LP) are distinct dermatoses that can in some circumstances occur as an overlap syndrome, or as a syndrome with mixed clinical and histopathological features of both LE and LP [ 88 ]. There is some controversy regarding the definition of this rare syndrome.…”

“…There is some controversy regarding the definition of this rare syndrome. Some experts suggest that true LE/LP overlap is defined as the presence of LE and LP within the same lesion [ 88 , 89 ]. However, many believe the coexistence of LE and LP lesions in the same patient could be recognized as an overlap syndrome.…”