Lichen Planus – Hepatitis

Liver disease is a major trigger for patients to develop Lichen Planus and I frequently encounter hepatitis associated lichenoid rashes in both my The Woodlands dermatology and Conroe dermatology offices.  The three main liver diseases responsible for Lichen Planus are Hepatitis C, Hepatitis B immunizations, and Primary Biliary Cirrhosis.  Patients with Hepatitis C have typical Lichen Planus skin findings but are more likely to have Ulcerative Lichen Planus in their oral mucosa.  The treatment of Hepatitis C is with interferon and at the beginning of the treatment course a patient may experience worsening of their Lichen Planus.  Towards the end of interferon treatment many patients do note that their Lichen Planus has improved but usually not resolved. Patients developing Lichn Planus from Hepatitis B immunizations does occur but is rare.  In these patients, Lichen Planus usually arises about one month after the second immunization.  Fortunately, this form of Lichen Planus resolves in most patients.  In patients with Pirmary Biliary Cirrhosis, Lichen Planus may arise and can be found mixed with xanthomatous skin lesions.