Histopathological Profile of Lichen Planus and Its Variants in a Tertiary Care Hospital of Chitwan, Nepal

Abstract

Background
Lichen planus (LP) is a subacute or chronic inflammatory dermatoses that can involve skin, mucous membranes, hair follicles and nails. Though, classical LP has characteristic presentation, variations exist which are rare and may have atypical presentation, rendering their diagnosis difficult and delay in management. Hence, biopsy of the lesion and histological examination remains important. This study was undertaken to study the histopathological profile of LP and its variants and describe their histological features.
Methods
This cross-sectional study was conducted in Department of Pathology, College of Medical Sciences-Teaching Hospital on 70 cases of LP and its variants in a study duration of 2 years from August 2023 to July 2025. The statistical analysis was performed using SPSS 16. For the categorical variables, percentages and frequencies were computed.
Results
Of the total 70 cases, age ranged from 9 to 79 years with mean 44.5 years. Female male ratio was 1.5:1. Most common lesions were cutaneous comprising, 51 (72.9%) cases followed by 16 (22.9%) mucosal cases. Most common histological diagnosis was classical LP in 38 (54.3%) cases followed by Oral lichen planus in 14 (20.0%) cases, Lichen planus pigmentosus (LPP) in 7 (10.0%) cases, Lichen planopilaris in 5 (7.1%) cases, Hypertrophic LP in 4 (5.7%) cases and Bullous LP and LP pemphigoides in 1 (1.4%) case each. Most common histological feature was band shaped dermal lymphocytic infiltrate observed in 64 (91.4%) cases.
Conclusions
Variants of LP need to be kept in mind while evaluating lesions of skin. Histopathological examination in suspected cases of LP help in finding the correct diagnosis.