Laboratory and Biochemical Work-up of Lichen Planus in Qatar
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A prospective study of 29 Qatari lichen planus patients over a period of two months was conducted at Hamad Medical Corporation, Doha, Qatar. Of the studied group 23 patients (79.31%) had different endocrinal and metabolic disoorders, 10 of them (43.48%) had the combination of more than one disorder. For the biochemical work-up of each system per se, 11 patients (37.93%) had significant elevation of free cortisol in urine FCU (p <0.05). There was no clear explanation for such elevation. No association was observed between elevated FCU, diabetes, hypertension, or stress in our patients. Six normotensive patients (20.69%) had slight elevation of serum aldosterone, seven (24.14%) had abnormal liver enzymes, seven (24.14%) were diabetic and five (17.24%) had thyroid disorders. It would be interesting to know if alteration of immune mechanisms in lichen planus has any relation with such abnormalities; or is lichen planus a disease expression of an autoimmune antigenic stimulus influencing different body systems. Lichen planus patients should not be treated as a sole dermatological disorder. Full biochemical work-up for the patients is required to exclude and treat other associated systemic disorders. Introduction Lichen planus is a chronic inflammatory disease of the skin and mucous membranes. It is one of the common skin disorders in Qatar. Many reports have been published about the association of lichen planus with glucose interolance(1), and with immune-mediated diseases such as chronic active hepatitis(2), primary biliary cirrhosis(3), myathesnia gravis with thymoma(4), bullous pemphigoid(5), ulcerative colitis(6) and systemic lupus erythematosus(7). The present study was undertaken with the objectives of finding the incidence of different endocrinal and metabolic abnormalities associated with lichen planus in Qatar, including the biochemical work-up for the suprarenal gland, which, to our knowledge, had not been conducted before.