Pandhi Deepika, Singal Archana, Bhattacharya Sambit N
Department of Dermatology and Sexually Transmitted Diseases, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
Pediatr Dermatol. 2014 Jan-Feb;31(1):59-67. doi: 10.1111/pde.12155. Epub 2013 Apr 29.
Lichen planus (LP) is infrequently seen in children and the clinical presentation is often atypical. We conducted a retrospective analysis of clinical features and treatment response in childhood LP to date. The clinical profile and treatment response data of patients younger than 14 years old with LP (entered in a predesigned pro forma study) from January 1997 to June 2011 were analyzed. The treatment was administered according to a predetermined departmental protocol and was comprised of topical steroids with or without oral dapsone or corticosteroids. Patients were evaluated for response, adverse effects, and relapse. The study population consisted of 316 children (166 boys, 150 girls), or 18.7% of the total registered patients in the LP clinic. The mean age was 10.28 years (range 2-14 years). Cutaneous lesions were seen in 96.2%. Involvement of the oral mucosa was detected in 18%, nails in 13.9%, scalp in 8.2%, and genitalia in 4.4%. Classic LP was most prevalent (53.8%), followed by eruptive (16.5%), hypertrophic (8.2%), linear (6.9%), and lichen planopilaris (6.3%). LP pigmentosus, annular, and atrophic variants were encountered infrequently. Topical corticosteroids were the most common treatment used in 69.5% of patients, 28.8% of whom had excellent response at 6 months, although 38.8% failed to follow up. Dapsone was prescribed in 20% and systemic steroids in 9.8% of patients. We report the largest series to date of LP in childhood, with a more varied clinical presentation than in previous series. The course and response to treatment were similar to those in adults.
扁平苔藓（LP）在儿童中并不常见，临床表现往往不典型。我们对迄今为止儿童LP的临床特征和治疗反应进行了回顾性分析。分析了1997年1月至2011年6月期间14岁以下LP患者（纳入预先设计的格式研究）的临床资料和治疗反应数据。治疗按照预定的科室方案进行，包括使用或不使用口服氨苯砜或皮质类固醇的局部类固醇。对患者的反应、不良反应和复发情况进行了评估。研究人群包括316名儿童（166名男孩，150名女孩），占LP诊所登记患者总数的18.7%。平均年龄为10.28岁（范围2 - 14岁）。96.2%的患者出现皮肤病变。18%的患者口腔黏膜受累，13.9%的患者指甲受累，8.2%的患者头皮受累，4.4%的患者生殖器受累。经典型LP最为常见（53.8%），其次是发疹型（16.5%）、肥厚型（8.2%）、线状型（6.9%）和扁平毛发苔藓（6.3%）。色素沉着型、环状型和萎缩型LP变体很少见。69.5%的患者最常使用局部皮质类固醇治疗，其中28.8%的患者在6个月时反应良好，尽管38.8%的患者未能随访。20%的患者使用了氨苯砜，9.8%的患者使用了全身性类固醇。我们报告了迄今为止最大规模的儿童LP系列病例，其临床表现比以往系列更为多样。病程和治疗反应与成人相似。
