Plain language summary
Lichen planus is a rare, chronic, inflammatory skin condition affecting the mucous membranes. It is immunological, sometimes regarded as autoimmune, and associated with some autoimmune disorders and infectious diseases. The presence of an autoimmune disorder increases the likelihood of the co-occurrence or development of other autoimmune conditions, and such is the case in Coeliac disease (CD). CD is an autoimmune condition leading to damage to the gastrointestinal tissue. CD can remain undetected in many patients, yet skin manifestations can occur long before or together with gastrointestinal damage. Hence the authors of this study were interested in how CD and Lichen planus related to each other and whether Lichen planus can be an early marker for CD. For this 2389 studies were assessed, with the inclusion of nine in the final assessment - a mix of case reports, observational studies, and systematic and traditional reviews. The authors could identify a correlation between lichen planus and CD but could not establish causation or a clear relationship between the two conditions. In conclusion, the authors advocated for more studies on larger population groups. Of clinical interest is the author's suggestion that in LP patients with signs of mouth ulcers and skin eruptions testing for CD and a gluten-free diet is warranted and could help manage disease progression.
Abstract
Celiac disease is receiving much attention due to the gluten-free diet trend. Many health-conscious individuals practice a gluten-free diet, even if they do not have celiac disease. As it is an autoimmune disorder, it is associated with many other autoimmune diseases. We were interested in one skin condition, another autoimmune disorder lichen planus as a correlative factor for celiac disease. The following systematic review may give some clues. We searched online resources including PubMed, PubMed Central, Cochrane library, and Google scholar for systematic reviews, traditional reviews, randomized controlled trials, and meta-analysis on celiac disease and lichen planus. We included human studies published in peer-reviewed journals in the English language. After reviewing 2389 initial results of our search, we excluded 1250 duplicates, 1108 abstracts, 42 irrelevant articles. We assessed the remaining 26 articles for their quality using various quality assessment tools. After the quality assessment, we included nine final articles in our systematic review. Out of these nine studies, there were four systematic reviews, one traditional review, two case reports, and two observational studies. Only two articles had exclusively studied the specific association between celiac and lichen planus. The remaining studies included data that gave an overall association between other skin manifestations of celiac disease. From our study, we could not establish the relationship between celiac disease and lichen planus. We need more case-control studies and clinical trials with a larger population to get conclusive data. From current data, we can conclude that both immunological processes correlate but there is no causation. There is also a need for clinical trials to explore the exacerbation of lichen planus due to celiac disease.
Methodological quality
Jadad score
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Not applicable
Allocation concealment
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