All Variants of Lichen Planus are a Possible Triggering Factors for Squamous Cell Carcinoma

Background: Lichen planus is a common dermatological disorder where oral lichen planus is the most commonly incriminated to have the possible risk to change into squamous cell carcinoma.

Objective: To realize squamous cell carcinoma as a possible complication of all variants of lichen planus and to raise dermatologists̛ awareness about this complication.

Patients and Methods: All patients with lichen planus who developed squamous cell carcinoma during the period from July 2012 –July 2021 were collected and included in this case series descriptive observational study. Full history and clinical, systemic and cutaneous, examinations were performed .Lymph nodes were inspected and palpated and biopsy was carried out to confirm the diagnosis.

Results: The data of eight patients were evaluated with 5 (62.5%) males and 3 (37.5%) females, and their ages at presentation were ranged from 45-71 years with mean 58.3±8.3 years. All patients were suffering from squamous cell carcinoma complicating previously diagnosed lichen planus during nine years time period. The variants of lichen planus that observed in the present study were as follow: 3 (37.5%) classic lichen planus, 2 (25%) oral lichen planus, 2 (25%) lichen planus actinicus and one(12.5%) with hypertrophic lichen planus. Also this study revealed that the sites of squamous cell carcinoma were observed in oral in 5 (62.5%) patients ,nose in 1 (12.5%)patient, penis in 1(12.5%) patient, and dorsal foot in1 (12.5%) patient.

Conclusion: Squamous cell carcinoma as a complication of lichen planus in its mucosal and cutaneous variant is a rare and non-documented issue but according to daily clinical practice, it can present and can complicate all variants of lichen planus on contrary to previous reports where the main site was oral cavity. This observation should be kept in mind while evaluating longstanding non-healed or poorly responding lesions of all varieties of lichen planus.