Volume 28, Issue 154, December 2024

Concomitant psoriasis with lichen planus in single patient: A systematic review

Sultan Aqeel Jaafari^1♦, Mohammed Ibrahim Alsaeed², Ali Ahmed Al-Abdullah³, Hussein Adel Al-Sakkak⁴

¹Consultant Dermatology, King Fahad Central Hospital, Jazan, Saudi Arabia
²MBBS, King Abdulaziz Hospital, Eastern province, Al-Ahsa, Saudi Arabia
³Dermatology senior registrar, Al-Ahsa Health Cluster, Saudi Arabia
⁴MBBS, Al-Ahsa, Eastern Province, Saudi Arabia

^♦Corresponding Author
Consultant Dermatology, King Fahad Central Hospital, Jazan, Saudi Arabia

ABSTRACT

Background: Lichen planus and psoriasis are separate chronic inflammatory dermatoses with different clinical and pathological characteristics. The reports of coexisting of this two conditions is rare in the literature as mostly as case studies. The overlap of lichen planus and psoriasis is due to shared immunologic mechanisms. The current study aimed to review the available literature of case studies reporting the coexisting of lichen planus and psoriasis to analyze the demographics, clinical features, histopathology, immunological findings, and management outcomes. Methodology: This is a systematic review of published cases aimed to assess demographics, clinical appearances, findings from histopathological examinations, immune characteristics, and treatment approaches. Synthesis and data analysis aimed to identify patterns and outcomes common to each case. Results: The results of this systematic review showed a wide range of ages of patients with coexisting of lichen planus and psoriasis including pediatric and adult population. The clinical features involved hyperpigmented plaques, papules, mucosal involvement, nail dystrophy, and psoriatic lesions, usually triggered by extrinsic factors such as the Koebner phenomenon. Histopathology, thus confirming the diagnosis, showed combined features of both diseases: Hyperkeratosis, parakeratosis, and band-like lymphocytic infiltrates. Immunologically, both inflammatory pathways involve T cells and cytokines, including TNF-α and IFN-γ. Conclusion: The overlap of lichen planus and psoriasis is rarely seen but is clinically essential and requires multidisciplinary approaches. The coexistence of these two conditions would draw upon immunopathological mechanisms, which afford them insights into possible therapeutic targets. Individualized systemically and topically-focused treatments appear to be effective in this overlap syndrome.

Keywords: Psoriasis, Lichen planus, Dermatitis, Coexistance, Histopathology

Medical Science, 2024, 28, e161ms3493

PDF

DOI: https://doi.org/10.54905/disssi.v28i154.e161ms3493

Published: 30 December 2024