Prevalence and incidence of comorbid diseases and mortality risk associated with lichen planopilaris: a Korean nationwide population-based study

Abstract

Background Various comorbid diseases have been reported in patients with lichen planopilaris (LPP); however, data regarding the risks of incident diseases and mortality are lacking. Methods This was a retrospective nationwide population-based study, using data from the National Health Insurance Service Database of Korea from 2002 to 2019. Patients aged ≥18 years with ≥3 documented medical visits for LPP were included. The adjusted hazard ratios (aHRs) for incident disease outcomes and mortality were compared with 1:20 age-, sex-, insurance type-, and income level-matched controls. Results In total, 2,026 patients with LPP and 40,520 controls were analysed. The risks of incident systemic lupus erythematosus (aHR, 1.91; 95% confidence interval [CI], 1.21–3.03), psoriasis (aHR, 3.42; 95% CI, 2.83–4.14), rheumatoid arthritis (aHR, 1.39; 95% CI, 1.19–1.63), lichen planus (aHR, 10.07; 95% CI, 7.17–14.15), atopic dermatitis (aHR, 2.15; 95% CI, 1.90–2.44), allergic rhinitis (aHR, 1.29; 95% CI, 1.13–1.49), thyroid diseases (hyperthyroidism [aHR, 1.42; 95% CI, 1.14–1.77], hypothyroidism [aHR, 1.19; 95% CI, 1.01–1.41], and thyroiditis [aHR, 1.35; 95% CI, 1.08–1.69]), non-melanoma skin cancer (aHR, 2.33; 95% CI, 1.00–5.44), and vitamin D deficiency (aHR, 1.23; 95% CI, 1.03–1.47) were higher in patients with LPP. Patients with LPP had a higher mortality rate than controls (aHR, 1.30; 95% CI, 1.04–1.61), although the risk was not significant after adjusting for comorbidities (aHR, 1.08; 95% CI, 0.87–1.34). Conclusions Patients with LPP had a higher risk of various diseases following LPP diagnosis. Close follow-up is needed to optimize comprehensive patient care.

Lichen Planopilaris As Part of Multiple Autoimmune Syndrome: A Case Report of New Association

“…Two studies, one by López-Jornet et al and another by Brankov et al found no significant association between LPP and autoimmune diseases, except for thyroid disease [1,8]. More recent studies revealed a higher prevalence of LPP and autoimmune disease, especially hypothyroidism, inflammatory bowel disease (IBD), rheumatoid arthritis, and systemic lupus erythematosus [7,[9][10][11]. Two of these conditions, hypothyroidism and IBD, were also found in the present case, with the main complaint of LPP.…”

Análise da expressão de HLA-G, TLR 2, 3, 4 e 5 e Cav-1 no folículo piloso do couro cabeludo de pacientes com líquen plano pilar

“…Apesar de um estudo ter concluído que o LPP é associado a menor risco de hipotireoidismo 55 , na maioria das publicações o LPP é associado a um risco maior de hipotireoidismo [56][57][58][59] . Outras doenças autoimunes como doença inflamatória intestinal, artrite reumatoide e lúpus eritematoso sistêmico mostraram correlação positiva em um trabalho que avaliou LPP incluindo todas as suas variantes 58,59 , mas não foram relacionadas em estudo que avaliou o LPP clássico isoladamente 57 .…”

“…A associação com deficiência de vitamina D 57,59,60 , depressão 57,58 , ansiedade 57,58 e distúrbios do sono 57,58 teve resultados conflitantes nos estudos, assim como a associação com hiperlipidemia, hipertensão e doença cardíaca isquêmica, que permanece controversa 29,55,58,59 . Em alguns estudos, diabetes mellitus tipo 2 mostrou correlação negativa com LPP 57,61 .…”

“…Quanto a doenças dermatológicas, o LPP foi associado à psoríase 55,58,59,61 , rosácea 29,58 , dermatite atópica 58,59 e aos cânceres de pele (carcinoma basocelular, carcinoma de células escamosas e melanoma) 29,58,59 , sendo estes últimos não associados em outro estudo 57 .…”