Lichen planus in children in Kaduna, North-west Nigeria: A 20-year experience

Abstract

Background: Lichen planus (LP) is a chronic inflammatory disease which mainly affects the skin but may affect mucous membranes and nails. The disease is rare in children.

Methods: Retrospective review of records of patients aged < 18 years diagnosed with LP in two dermatology clinics in Kaduna, northwest Nigeria between September 2001 and November 2021.

Results: Children constituted 11.3% (38/335) of patients diagnosed with LP: Mean age 10.3 years (range 5 – 16), 44.7% < 10 years, 63.2% male, median duration at presentation - 8 weeks. The legs (68.4%) and lower arms (50%) were the most frequently affected parts of the body. Others were: upper back (34.2%), abdomen (34.2%), lower back (27.2%), chest (23.7%), upper arms (23.7%), elbows/knees (21.1%) and flexural wrists (18.4%). The oral mucosa and genitalia were affected in one patient each. All patients presented with itching while 31.6% and 28.9% of patients presented with post-inflammatory hyperpigmentation and Koebner’s phenomenon, respectively. Classic LP was diagnosed in 90% of patients. Other variants were: hypertrophic (7.9%), annular (6.3%) and on lines of Blaschko (5.3%). There was no significant gender or agerelated difference in presentation. One patient was positive for hepatic C virus infection. Most patients were treated with topical corticosteroids with complete resolution of lesions in 80.8%. During follow-up, recurrence occurred in 3 patients.

Conclusion: Lichen planus is more common in Nigerian children than has been reported from many parts of the world. Its presentation is similar to that of adults, although oral and genital involvement is infrequent.