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CORRESPONDENCE
Year : 2021  |  Volume : 66  |  Issue : 1  |  Page : 101-103
Lichen planus and alopecia areata co-localization


Department of Dermatology, Venereology and Leprology, Government Medical College, Jammu, Jammu and Kashmir, India

Date of Web Publication1-Feb-2021

Correspondence Address:
Sabha Mushtaq
Department of Dermatology, Venereology and Leprology, Government Medical College, Jammu, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.IJD_210_19

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How to cite this article:
Mushtaq S. Lichen planus and alopecia areata co-localization. Indian J Dermatol 2021;66:101-3

How to cite this URL:
Mushtaq S. Lichen planus and alopecia areata co-localization. Indian J Dermatol [serial online] 2021 [cited 2021 Feb 28];66:101-3. Available from: https://www.e-ijd.org/text.asp?2021/66/1/101/308491




Sir,

Lichen planus (LP) has been associated with a number of autoimmune diseases including alopecia areata (AA). Although the co-occurrence of LP and AA has commonly been reported, there is a paucity of literature on the co-localization of the two conditions.[1]

A 30-year-old man presented with a 2-month history of a mildly itchy violaceous plaque over the occiput. After about 4 weeks, the patient had noticed an area of hair loss surrounding the initial lesion but without any symptoms or surface changes. The patient was otherwise well with no systemic complaints. Past medical and family history was unremarkable.

Cutaneous examination revealed a patch of non-scarring alopecia about 5 × 4 cm in size over the occipital area of the scalp. A single well defined round violaceous plaque of about 2 × 1.5 cm was present at the center of the alopecic patch [Figure 1]. There was no skin lesion or loss of hair over other body sites. Mucosal and nail examinations were normal. Two punch biopsies were taken. Histopathology of the violaceous plaque revealed hyperkeratosis, wedge-shaped hypergranulosis, irregular acanthosis, basal cell liquefaction, and a band-like lymphocytic infiltrate and pigment? incontinence suggestive of a diagnosis of LP and that of alopecic patch revealed a perifollicular “swarm of bees”-type lymphocytic infiltrate consistent with the diagnosis of AA [Figure 2] and [Figure 3]. Based on clinical and histopathology findings, the diagnosis of co-localization of LP and AA was made.
Figure 1: Non-scarring alopecic patch with a violaceous plaque at the center

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Figure 2: Basal cell degeneration with band-like lymphocytic infiltrate at the dermoepidermal junction and pigment incontinence (H and E, 100Ö)

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Figure 3: Perifollicular lymphocytic infiltrate with the typical “swarm of bees” appearance (H and E, 400×)

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Both LP and AA have frequently been described in association with other autoimmune disorders such as thyroid disease, diabetes mellitus, vitiligo, pernicious anemia etc. About 25% of patients with one autoimmune disease have a tendency to develop additional autoimmune disease. Multiple autoimmune syndrome (MAS) is the coexistence of three or more autoimmune diseases. In MAS, patients often have at least one dermatological condition.[2] There are reports on anatomic co-habitation of autoimmune skin diseases like vitiligo and LP, vitiligo, and AA.[1],[3] There have been many reports on the co-occurrence of LP and AA, however, their anatomical co-localization remains scarcely reported. The co-localization of LP and AA can possibly be explained based on a common T-cell mediated pathogenesis in the two conditions.[1],[4]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Kar BR, Ebenezer G, Job CK. Co-localisation of alopecia areata and lichen planus. Indian J Dermatol Venereol and Leprol 2004;70:242-3.  Back to cited text no. 1
    
2.
Cojocaru M, Cojocaru IM, Silosi I. Multiple autoimmune syndrome. Maedica 2010;5:132.  Back to cited text no. 2
    
3.
Kumar S, Mittal J, Mahajan BB. Colocalization of vitiligo and alopecia areata: Coincidence or consequence? Int J Trichology 2013;5:50.  Back to cited text no. 3
    
4.
Hassan I, Anwar P, Sajad P. Co-localisation of alopecia areata and lichen planus: Rare presentation. NJDVL 2014;12:45-7.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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