Study of Clinical Variants of Lichen Planus and Its Association with Histopathological Findings in a Tertiary Care Centre

Background: Lichen Planus (LP) is a chronic, immune-mediated papulosquamous disorder with multiple clinical variants. Accurate diagnosis requires taking into account both clinical and histological features and acquire an association between them. Objective: To evaluate clinical variants of lichen planus and associate them with histopathological findings. Methods: A hospital-based observational study was conducted over 18 months at a tertiary care centre. A total of 70 patients with clinically diagnosed lichen planus were included. Clinical examination and lesional biopsies were performed. Histopathological findings were recorded and compared with clinical diagnoses. Results: The study found the highest incidence of LP in the age group of 31-40 years (30%). Females predominated the sample with a male to female ratio of 1:1.56. Most patients presented with lesions of 6–11 months’ duration. Histopathological association with clinical diagnosis showed an 83% concordance. Classical LP was the most prevalent form (45%), primarily affecting the lower limbs. Frequently observed histopathological features included inflammatory infiltrate at the dermo-epidermal junction (DEJ) (70%), irregular acanthosis (64%), melanin incontinence (64%), hyperkeratosis (57%), and basal cell vacuolation (53%). Conclusion: LP exhibits a varied age-related prevalence with a complex clinical spectrum. This study highlighted the importance of clinical presentation along with histopathological characteristics in order to arrive at a diagnosis, indicating the need for an appropriate diagnostic approach, so as to effectively understand the aspects of LP.