Radiation-associated lichen planus: a case report and literature review

Abstract

Percutaneous radiotherapy (RT) may cause a range of acute and chronic cutaneous side-effects on irradiated areas. Localized or generalized lichen planus (LP) has occasionally been reported after RT. The mechanisms of LP are unclear. A case report and a systematic review of the literature were performed. Including the present case, 12 cases of LP have been reviewed in association with oncologic radiotherapy since 2002. Of these, 83% of patients developed LP after RT. LP occurred with a median delay of 30.7 days after RT completion and a median dose of 50 Gy. LP is a rare complication during RT that mainly occurs at the site of radiation and can sometimes spread and become generalized. Its physiopathogeny remains unclear. In some cases, patients may have preexisting but asymptomatic LP before RT. RT would therefore act as an indicator of the disease. The treatment of RT-associated LP is similar to that for any LP.

Radiation-induced Bullous Lichen Planus: An Isomorphic Manifestation of Radiotherapy

“…Bullous pemphigoid and pemphigus are the most frequent isoradiotopic dermatoses. LP has been reported in association with radia- Accepted Jul 9, 2019; E-published Jul 10, 2019 www.medicaljournals.se/acta tion treatment in 15 patients since 2002 (1)(2)(3)(4)(5)(6). LP may occur as an isoradiotopic response or as an isomorphic response, i.e.…”

Radiation induced lichen planus - an uncommon side effect

“…Risk factors for lichen planus include trauma, hepatitis, certain medications, autoimmune diseases, and malignancies [2]. Lichen planus following radiotherapy is extremely rare, and to the best of our knowledge, lichen planus following radiotherapy for prostate cancer has not been previously reported in the literature [3]. The cases of oncological radiotherapy-associated lichen planus reported in the English literature are summarized in Table 1.…”

“…Upon review of the literature, including our case, the average age of onset was 58 years, and 54% (7/13) of patients were female [3][4][5][6][7][8][9][10][11][12][13][14][15], (Table 1). The average onset of lichenoid reaction was within three months of a mean total radiation dose of 50 Gy [3][4][5][6][7][8][9][10][11][12][13][14][15], (Table 1). Most cases reported a generalized distribution extending beyond the localized radiation field [3][4][5], (Table 1).…”

“…The average onset of lichenoid reaction was within three months of a mean total radiation dose of 50 Gy [3][4][5][6][7][8][9][10][11][12][13][14][15], (Table 1). Most cases reported a generalized distribution extending beyond the localized radiation field [3][4][5], (Table 1).…”

“…Cutaneous reactions to radiation therapy include acute dermatitis, chronic dermatitis, keratosis-like nodules (called pseudorecidives), and lichen planus [1,3]. Radiation-associated dermatitis may present with erythematous, edematous, desquamating, ulcerative, or fibrotic changes, whereas pseudorecidives present as spontaneously resolving keratoses, which tend to appear immediately after irradiation [1,2].…”