Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies
Abstract
:1. Introduction
1.1. Pathogenic Traits of LP/OLP
1.2. The Thyroid Gland: A Player in the Field of Dermatologic Conditions
1.3. Aim
2. Methods
3. Results
3.1. LP/OLP: Delve into Thyroid Conditions
3.1.1. LP/OLP and Thyroid Dysfunction
3.1.2. LP/OLP and Positive Thyroid Autoimmunity
3.1.3. LP/OLP Patients under Levothyroxine Replacement
3.1.4. LP/OLP and the Co-Presence of Thyroid Nodules/Malignancy
3.2. Subjects with Thyroid Conditions: LP/OLP Analysis
4. Discussion
4.1. Study-Based Investigation
4.2. Connecting the Dots between LP/OLP and Thyroid Anomalies
4.2.1. Immune and Autoimmune Elements
4.2.2. Genetic Factors
4.2.3. Environmental Elements
Smoking
Nutrients
Vitamin D
Infectious Diseases
4.2.4. (Non-Thyroid) Hormonal and Metabolic Potential Contributors to LP/OLP and Thyroid Conditions
4.3. From Key Findings to Current Limits of This Topic and Future Research
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
ATD | autoimmune thyroid diseases |
GD | Graves’ disease |
HT | Hashimoto’s thyroiditis |
HLA | human leukocyte antigen |
IFN-γ | interferon-gamma |
IL | interleukin |
LP | lichen planus |
N | number of patients |
n | number of studies |
OLP | oral lichen planus |
OLL | oral lichenoid lesion |
TNF-α | tumour necrosis factor-alpha |
TPOAb | anti-thyroperoxidase antibodies |
TgAb | anti-thyroglobulin antibodies |
TRAb | Thyroid-Stimulating Hormone receptor antibodies |
TSH | Thyroid-Stimulating Hormone |
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Authors Year of Publication Reference Number | Type of Study Country | Studied Subgroups | Outcomes |
---|---|---|---|
LP/OLP and thyroid dysfunction: confirmatory studies | |||
Piloni 2023 [43] | Retrospective, case-control study (#) Italy | N = 307 patients 158 (51.47%) F + 149 (48.53% M) (age > 18 y; range: 49–75 y, mean age of 63 y) N1 = 76 OLP patients N2 = 133 OLL patients N3 = 98 controls | Patients with hypothyroidism: N1′ = 17/76 patients (22.37%) N2′ = 19/133 patients (14.29%) N3′ = 7/98 patients (7.14%) N1′ vs. N3′: p = 0.0059 N2′ vs. N3′: p = 0.09 |
Amato-Cuartas 2019 [44] | Cross-sectional study Colombia | N = 860 patients N1 = 14 OLP patients (representing 1.6% of N, mean age of 59.6 y, F = 11/16) | Patients with hypothyroidism: N′ = 34/860 patients (3.9%) N1′ = 5/14 patients (35.7%) N′ vs. N1′: p = 0.0001 |
Kumar 2019 [45] | Case-control study India | N = 75 LP patients (adults with at least 3-month disease duration) 43 (57.33%) F and 32 (42.66%) M age: 16–45 y (mean age of 35.2 y) 17.3% with metabolic syndrome N1 = 12 OLP patients N2 = 75 controls | Patients with hypothyroidism: N′ = 8/75 patients (10.76%) N1′ = 4/12 patients (33%) N2′ = 3/75 patients (4%) N′ vs. N1′: p = 0.005 N′ vs. N2′: p = 0.117 |
Robledo-Sierra 2018 [46] | Case-control study Sweden (*) | N = 110 OLP+/LT4− 99 (90%) F (mean age of 65.6 y) N1 = 657 healthy controls | Patients with hypothyroidism: N′ = 62/108 patients (58.1%) N1′ = 21/58 patients (37.3%) N′ vs. N1′: p = 0.0179 |
Robledo-Sierra 2015 [47] | Case-control study Sweden (#,#) | N = 1611 OLP patients (data collection from general population: standardized registration method) N1 = 1615 controls | Patients with hypothyroidism: N′ = 180/1611 patients (11%) N1′ = 40/1615 patients (2.5%) multivariate OR = 2.99 (95% CI: 2.03–4.44; p < 0.0001) |
Siponen 2010 [48] | Retrospective case-control study Finland (#,#,#) | N = 222 OLP/OLL patients N1 = 222 controls | Patients with hypothyroidism: N′ = 21/222 patients (10%) N1′ = 10 /222 patients (5%) OR = 2.19 (95% CI: 1.03–4.90) |
LP/OLP and thyroid dysfunction: non-confirmatory studies | |||
Tang 2020 [49] | Cross-sectional study China (#,#,#,#) | N = 585 OLP patients 167 (87.97%) F + 23 (12.1% M) (age > 18 y; mean age of 52.85 ± 13.15 y) N1 = 10.441 controls | Patients with hypothyroidism: N′ = 7/585 patients (1.2%) N1′ = 430/10.441 patients (4.1%) N′ vs. N1′: p < 0.05 Patients with hyperthyroidism: N″ = 6/585 patients (1%) N1″ = 48/10.441 patients (0.5%) N” vs. N1”: p > 0.05 |
Kats 2019 [50] | Retrospective, case-control study Israel (#,#,#,#,#) | N = 102 OLP patients 70.6% F (mean age of 55.7 ± 13.2 y) N1 = 102 controls | Patients with hypothyroidism: N′ = 13/102 patients (12.7%) N1′ = 10/102 patients (9.8%) N′ vs. N1′: p = 0.65 |
Zhou 2018 [51] | Case-control study China (#,#,#,#,#,#) | N = 192 OLP patients 75.5% F + 24.45% M (mean age of 49.53 ± 9.93 y) N1 = 123 OLL patients N2 = 163 controls | Patients with hypothyroidism: N′ = 10/192 patients (5.2%) N1′ = 6/123 patients (4.87%) N′ vs. N1′: p = 0.565 N2′ = 8/163 patients (4.9%) N′ vs. N2′: p = 0.225 Patients with hyperthyroidism: N″ = 3/192 patients (1.56%) N1″ = 1/123 patients (0.81%) N″ vs. N1″: p = 0.845 N2″ = 1/163 patients (0.61%) N″ vs. N2″: p = 0.402 |
Lavaee 2016 [52] | Retrospective, comparative study Iran | N = 523 OLP patients 387(74%) F + 136 (26.2%) M (age > 18 y; mean age of 48.43 ± 13.82 y) N1 = 523 controls | Patients with hypothyroidism: N′ = 35/523 patients (6.7%) N1′ = 21/523 patients (4%) OR = 1.714 (95% CI: 0.984–2.987) Chi-square test showed no significant association between hypothyroidism and OLP |
LP/OLP and positive thyroid autoimmunity: confirmatory studies | |||
Piloni 2023 [43] | Retrospective, case-control study (#) | N = 307 patients N1 = 76 OLP patients N2 = 133 OLL patients N3 = 98 controls | Patients with HT: N1′ = 15/76 patients (19.74%) N2′ = 15/133 patients (11.28%) N3′ = 5/98 patients (5.1%) N1′ vs. N3′: p = 0.005 N2′ vs. N3′: p = 0.1075 |
Anttonen 2023 [53] | Retrospective study Northern Finland | N = 619 LP patients 58.3% F (mean age of 54.2 y) N1 = 258 LP males (41.7%) N2 = 361 LP females (58.3%) | Patients with ATD: N′ = 12.44% patients N1′ = 5% patients N2′ = 17.7% patients N1′ vs. N2′: p < 0.001 |
Zhang 2022 [56] | Cross-sectional study China | N = 247 OLP patients 186 (75.3%) F + 61 (24.7%) M (mean age of 45.21 ± 12.72 y) N1 = 61 OLP males (24.70%) N2 = 186 OLP females (75.30%) | Patients with HT: N′ = 98/247 patients (39.67%) N1′ = 12/61 patients (19.67%) N2′ = 86/186 patients (46.24%) N1′ vs. N2′: p = 0.000 |
Tang 2020 [49] | Cross-sectional study (#,#,#,#) | N = 585 OLP patients N1 = 10,441 controls | Patients with HT: N′ = 71/585 patients (12.1%) N1′ = 638/10.441 patients (6.1%) N′ vs. N1′: p < 0.05 |
Zhou 2018 [51] | Case-control study (#,#,#,#,#,#) | N = 192 OLP patients N1 = 123 OLL patients N2 = 163 controls | Patients with HT: N′ = 40/192 patients (20.83%) N1′ = 23/123 patients (18.69%) N′ vs. N1′: p = 0.011 N2′ = 16/163 patients (9.81%) N′ vs. N2′: p = 0.000 |
Alikhani 2017 [59] | Case-control study Iran | N = 92 OLP patients 34 (74%) F (mean age of 45 y, ranges: 17–68) N1 = 44 EOLP patients N2 = 48 non-EOLP patients | Patients with TPOAb + ve status: N1′ = 30/44 patients (68%) N2′ = 33/48 patients (33%) N1′ vs. N2′: p = 0.023 |
Robledo-Sierra 2015 [47] | Case-control study (#,#) | N = 108 OLP patients N1 = 40 controls | Patients with HT: N′ = 19/108 patients (22.1%) N1′ = 1/40 patients (2.5%) N′ vs. N1′: p = 0.0037 |
Lo Muzio 2013 [64] | Cross-sectional study Italy | N = 105 OLP patients N′ = 15/105 patients with OLP + HT (14/15 F + 1/15 M; age ranges: 33–63 y) | Patients with HT: N′ = 15/105 patients (14.3%) N′ vs. general population: p < 0.0003 (general population with a HT-related hypothyroidism prevalence of 1%) |
LP/OLP and positive thyroid autoimmunity: non-confirmatory studies | |||
Robledo-Sierra 2018 [46] | Case-control study (*) | N = 110 OLP+/LT4− N1 = 657 controls N2 = 108 OLP+/LT4+ N3 = 58 OLP−/LT4+ | Increased levels of TPOAb: N′ = 9/110 patients (9.4%) N1′ = 99/657 patients (15%) N′ vs. N1′: p = 0.024 |
LP/OLP and levothyroxine replacement for an endocrine condition: confirmatory studies | |||
Garcia-Pola 2016 [71] | Case-control study Spain | N = 215 OLP patients N1 = 215 controls | Patients with levothyroxine usage: N′ = 21/215 patients (9.7%) N1′ = 7/215 patients (3.3%) N′ vs. N1′: p = 0.006 |
Robledo-Sierra 2015 [47] | Case-control study (#,#) | N = 1611 OLP patients N1 = 1615 controls | N′ = 170/1611 patients (10.6%) N1′ = 40/1615 patients (2.5%) N′ vs. N1′: p < 0.0001 |
Robledo-Sierra 2013 [72] | Case-control study Sweden | N = 956 OLP patients N1 = 1029 controls | Patients with levothyroxine usage: N′ = 85/956 patients (8.9%) N1′ = 26/1029 patients (2.5%) N′ vs. N1′: p < 0.001 |
LP/OLP and levothyroxine replacement for an endocrine condition: non-confirmatory studies | |||
Kats 2019 [50] | Retrospective, case-control study (#,#,#,#,#) | N = 102 OLP patients N1 = 102 controls | Patients with levothyroxine usage: N′ = 13/102 patients (12.7%) N1′ = 10/102 patients (9.8%) N′ vs. N1′: p = 0.659 |
Siponen 2010 [48] | Retrospective case-control study (#,#,#) | N1 = 222 OLP/OLL patients N = 222 controls | Patients with levothyroxine usage: N′ = 21/222 patients (10%) N1′ = 11/222 patients (5%) OR = 0.94 (95% CI: 0.37–5.2) |
LP/OLP and thyroid nodules/cancer | |||
Tang 2020 [49] | Cross-sectional study (#,#,#,#) | N = 585 OLP patients N1 = 10,441 controls | Patients with thyroid nodules: N′ = 62/585 patients (10.6%) N1′ = 5.183 /10,441 patients (49.6%) N′ vs. N1′: p < 0.05 Patients with thyroid cancer: N″ = 11/585 patients (1.9%) N1″ = 117/10.441 patients (1.1%) N” vs. N1”: p > 0.05 |
Zhou 2018 [51] | Case-control study (#,#,#,#,#,#) | N = 192 OLP patients N1 = 123 OLL patients N2 = 163 controls | Patients with thyroid nodules: N′ = 47/192 patients (24.47%) N1′ = 28/123 patients (22.76%) N′ vs. N1′: p = 0.156 N2′ = 33/163 patients (20.24%) N′ vs. N2′: p = 0.004 |
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Radu, A.-M.; Carsote, M.; Nistor, C.; Dumitrascu, M.C.; Sandru, F. Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies. Biomedicines 2024, 12, 77. https://doi.org/10.3390/biomedicines12010077
Radu A-M, Carsote M, Nistor C, Dumitrascu MC, Sandru F. Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies. Biomedicines. 2024; 12(1):77. https://doi.org/10.3390/biomedicines12010077
Chicago/Turabian StyleRadu, Andreea-Maria, Mara Carsote, Claudiu Nistor, Mihai Cristian Dumitrascu, and Florica Sandru. 2024. "Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies" Biomedicines 12, no. 1: 77. https://doi.org/10.3390/biomedicines12010077
APA StyleRadu, A.-M., Carsote, M., Nistor, C., Dumitrascu, M. C., & Sandru, F. (2024). Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies. Biomedicines, 12(1), 77. https://doi.org/10.3390/biomedicines12010077