Thyroid disorders associated with lichen sclerosus: a case–control study in the All of Us Research Program

Fan, Ryan; Leasure, Audrey C; Maisha, Fahrisa I.; Little, Alicia J.; Cohen, Jeffrey M.

doi:10.1111/bjd.21702

Cited by 11 publications

(6 citation statements)

References 8 publications

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“…The current study did not find a significant association between thyroiditis and LS despite the already established relationship in women [ 28 ]. However, this study shows that patients with LS have an increased risk for thyrotoxicosis, which is in line with previous studies [ 27 ]. Lichen ruber planus is commonly found coexisting with LS lesions [ 18 ].…”

Section: Discussionsupporting

confidence: 93%

“…Their findings revealed that individuals affected by LS displayed a higher prevalence of being overweight or obese when compared to the broader Italian population [ 26 ]. An American study confirming older data suggested that autoimmune thyroid disease is more common in patients with LS with 2.67-, 2.88-, 2.34- and 2.05-fold increases in odds of having thyroiditis, autoimmune thyroiditis, hypothyroidism and hyperthyroidism, respectively [ 27 ]. The current study did not find a significant association between thyroiditis and LS despite the already established relationship in women [ 28 ].…”

Section: Discussionmentioning

confidence: 70%

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Comorbidity in patients with Lichen sclerosus: a retrospective cohort study

Gulin,

Lundin,

Seifert

2023

Eur J Med Res

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Lichen sclerosus (LS) is a chronic lymphocyte mediated inflammatory mucocutaneous disease of unknown aetiology with a predilection for the anogenital region, and affecting both sexes. The disease is characterized by pain, intolerable itching and scarring. In late stages of LS, disfiguring scarring can drastically alter the structural anatomical architecture of the genitals. The association between genital LS and different malignant tumours is a concern that needs to be further investigated. An association between LS and several autoimmune diseases has been confirmed in recent studies. All registered citizens of Region Jönköping, Sweden were included in the present study. Patients diagnosed with LS (n = 5680) between 2001 and 2021 were identified using ICD-10 code L90.0 and selected as cases. All other individuals (n = 362 568) served as controls. Odds ratios (ORs) for the selected comorbidity were calculated and adjusted for age and sex. The cumulative incidence of LS for the entire population over a 20-year period was 1.54% (15.4 per 1000 people). The cumulative incidences over a 20-year period for females and males were 2.13% and 0.97%, respectively. This study confirmed the association between LS and vulvar cancer (OR = 17.4; 95% CI 12.1–25.3), penis cancer (OR = 9.1; 95% CI 4.3–18.9), prostate cancer (OR = 2.0; 95% CI 1.6–2.4) and breast cancer (OR = 1.6; 95% CI 1.4–1.8). LS was also associated with Crohn´s disease (OR = 2.0; 95% CI 1.6–2.6) and diabetes mellitus type 1 (OR = 1.9; 95% CI 1.6–2.1). The present study revealed novel important data regarding the association of LS with cancer and autoimmune diseases, emphasising the importance of sufficient treatment and follow-up of patients with LS. However, future studies are needed to confirm these results and the potential role of LS in the development of cancer.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 70%

Comorbidity in patients with Lichen sclerosus: a retrospective cohort study

Gulin,

Lundin,

Seifert

2023

Eur J Med Res

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“…In a case–control study of 765 cases of VLS, it was found a 2.88-, 2.34-, and 2.05-fold increase in odds of having autoimmune thyroiditis, hypothyroidism, and hyperthyroidism, respectively. This study provides further evidence that screening for thyroid disorders in LS patients should be considered ( 112 ).…”

Section: Associationsmentioning

confidence: 52%

Lichen sclerosus: The 2023 update

et al. 2023

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Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. Postmenopausal women are predominantly affected and, to a lesser extent, men, prepubertal children, and adolescents. The etiology of LS is still unknown. Hormonal status, frequent trauma and autoimmune diseases are well-known associations for LS, yet infections do not seem to be clear risk factors. LS pathogenesis involves factors such as a genetic predisposition and an immune-mediated Th1-specific IFNγ-induced phenotype. Furthermore, there is a distinct expression of tissue remodeling associated genes as well as microRNAs. Oxidative stress with lipid and DNA peroxidation provides an enabling microenvironment to autoimmunity and carcinogenesis. Circulating IgG autoantibodies against the extracellular matrix protein 1 and hemidesmosome may contribute to the progression of LS or simply represent an epiphenomenon. The typical clinical picture includes chronic whitish atrophic patches along with itching and soreness in the vulvar, perianal and penile regions. In addition to genital scarring, and sexual and urinary dysfunction, LS may also lead to squamous cell carcinoma. Disseminated extragenital LS and oral LS are also reported. The diagnosis is usually clinical; however, a skin biopsy should be performed in case of an unclear clinical picture, treatment failure or suspicion of a neoplasm. The gold-standard therapy is the long-term application of ultrapotent or potent topical corticosteroids and, alternatively, topical calcineurin inhibitors such as pimecrolimus or tacrolimus. Collectively, LS is a common dermatological disease with a so far incompletely understood pathogenesis and only limited treatment options. To foster translational research in LS, we provide here an update on its clinical features, pathogenesis, diagnosis and (emerging) treatment options.

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“…In line with this, a study by Virgilli et al in Italy highlighted that LS patients exhibited a higher prevalence of overweight and obesity compared to the general Italian population [44,45]. Similarly, American research reinforcing earlier data demonstrated that autoimmune thyroid disease was more prevalent among LS patients, with significant increases in the odds of thyroiditis, autoimmune thyroiditis, hypothyroidism, and hyperthyroidism [11,42,43,46,47]. While one study did not establish a significant connection between thyroiditis and LS, particularly in women [42], our findings indicate an increased risk for both hyperthyroidism and thyroiditis in LS patients, aligning with the earlier mentioned studies.…”

Section: Discussionmentioning

confidence: 69%

Lichen Sclerosus—Incidence and Comorbidity: A Nationwide Swedish Register Study

Jerkovic Gulin,

Lundin,

Eriksson

et al. 2024

JCM

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Background: Data on the incidence and comorbidity of Lichen sclerosus (LS), based on validated nationwide population-based registries, remains scarce. Objective: To explore the incidence and association of comorbidities with LS in Sweden, emphasizing its potential links to malignancies and autoimmune disorders. Methods: A population-based retrospective open cohort study was conducted using the National Patient Register to identify all individuals diagnosed with LS (ICD-10 code L90.0) from 1 January 2001 to 1 January 2021. The study included 154,424 LS patients and a sex and age matched control group of 463,273 individuals to assess the incidence and odds ratios for various cancers and premalignant conditions. Results: The incidence of LS in Sweden was 80.9 per 100,000 person per year, with higher incidence in females (114.4) than in males (47.2). LS patients showed an increased odds ratio for vulvar cancer (OR = 8.3; 95% CI = 7.5–9.0), penile cancer (OR = 8.9; 95% CI = 7.3–11.0), prostate cancer (OR = 1.2; 95% CI = 1.1–1.2), testicular cancer (OR = 1.4; 95% CI = 1.1–1.7), bladder cancer (OR = 1.1; 95% CI = 1.1–1.2), breast cancer (OR = 1.4; 95% CI = 1.3–1.4), leukoplakia of the vulva (OR = 253.5; 95% CI = 221.9–289.6), and leukoplakia of the penis (OR = 5.1; 95% CI = 4.9–5.4). Conclusions: This study underscores the significantly increased association of various cancers and premalignant conditions in LS patients, highlighting the critical need for efficacious treatment and diligent follow-up. The association between LS and autoimmune diseases further necessitates comprehensive investigation to understand the underlying mechanisms and clinical management implications. Future research is essential to confirm these findings and elucidate the role of LS in cancer development.

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Thyroid disorders associated with lichen sclerosus: a case–control study in the All of Us Research Program

Cited by 11 publications

References 8 publications

Comorbidity in patients with Lichen sclerosus: a retrospective cohort study

Comorbidity in patients with Lichen sclerosus: a retrospective cohort study

Lichen sclerosus: The 2023 update

Lichen Sclerosus—Incidence and Comorbidity: A Nationwide Swedish Register Study

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