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30 rev port estomatol med dent cir maxilofac. 2021;62(1):29-34

Líquen Plano e abordagem terapêutica: um estudo retrospetivo

r e s u m o

Palavras-chave: Objetivos: Caracterizar epidemiologicamente a patologia Líquen Plano e sua abordagem
Corticoesteróides terapêutica.
Dermatologia Métodos: Neste estudo retrospetivo, foram incluídos 174 pacientes, de um hospital público
Epidemiologia português, com diagnóstico de Líquen Plano entre os anos 2008 e 2017. Os registos médicos
Líquen plano permitiram a recolha de informação relativa a género, idade, distribuição topográfica das
Terapêutica lesões de Líquen Plano, terapêutica prescrita (princípio ativo, via de administração e esque-
ma terapêutico), duração média da doença, episódios de cura e recidiva. A análise estatísti-
®
ca foi realizada com recurso ao software IBM SPSS Statistics, versão 25.
®
Resultados: Nesta população, a doença afetou ambos os géneros com a mesma probabilida-
de (p=0,820), no entanto, com maior prevalência na 4.ª e 5.ª décadas de idade. As lesões de
Líquen Plano manifestaram-se na pele (em 75,9% dos doentes), nas mucosas (5,2%), ou em
ambos (19,0%). Os fármacos mais prescritos foram os corticosteróides, seguidos dos anti-
-histamínicos e dos imunossupressores. Os corticosteróides tópicos foram os mais comu-
mente administrados, nomeadamente o Propionato de Clobetasol (37,4%). Dentro dos cor-
ticosteróides sistémicos, a Prednisolona foi o fármaco mais utilizado (12,3%). A duração
média das lesões e sintomas foi de aproximadamente 6,5 meses. Para a população que re-
cidivou (12%), o período médio de remissão dos sintomas foi de 513 dias.
Conclusões: Os parâmetros epidemiológicos desta amostra de pacientes portugueses com
Líquen Plano partilham semelhanças com outras populações descritas. Nenhuma terapêu-
tica baseada em evidência provou ser eficaz para o tratamento do Líquen Plano. No entanto,
os corticosteróides tópicos continuam a apresentar-se como a solução terapêutica de pri-
meira linha para esta patologia. (Rev Port Estomatol Med Dent Cir Maxilofac. 2021;62(1):29-34)
© 2021 Sociedade Portuguesa de Estomatologia e Medicina Dentária.
Published by SPEMD. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).

virus) or HPV (human papillomavirus) infection. 3,6,16,17 More-
Introduction
over, the association between stress/anxiety and OLP is well
Lichen planus (LP) is an inflammatory, immunologically me- established. 18
diated, chronic disease. 1-3 It represents a mucocutaneous en- As in all autoimmune diseases, LP treatment is not cura-
tity present in about 0.5 to 5% of the adult population and can tive but aims to reduce/eliminate lesions and the associated
19
affect any age or gender. 4 -6 However, some studies report a symptomatology. Topical corticosteroids represent the first
preferential occurrence of LP in female individuals aged 30 to current line treatment for both CLP and OLP. However, their
60 years, being rare among children. 4,7,8 effectiveness has not yet been proved by studies of strong
Clinically, its lesions can appear in several body locations, scientific evidence. 1,2,19-22 Thus, it is urgent to find the most
such as the skin, nails, scalp, oral and genital mucosa, and, less favorable therapeutic regimen for better treatment of our
frequently, ocular, tear, and gastrointestinal tract mucosa. (6,9,10) patients. 2
Cutaneous lichen planus (CLP) commonly manifests as small Therefore, this investigation aims to study the epidemio-
polygonal violet papules, although it can take several forms logical distribution of LP and its therapeutic management in
depending on the disease’s subtype. 6,8,11 Oral lichen planus a sample of the Portuguese public healthcare population.
(OLP) occurs as the only manifestation of the disease in 15-25%
of patients and is associated with skin lesions in 60-70% of the
cases. It has several subtypes, and the most common is the Material and Methods
3,4
5
reticular one, which is usually asymptomatic. OLP deserves
careful consideration from health professionals, as the latest This investigation consists of a retrospective, observational,
studies confirm the possibility of malignancy, especially in the case series study. It was carried out at the Dermatology Ser-
erosive subtype. 12,13 vice of one of Portugal’s biggest public hospitals: Hospital de
The etiopathogenesis of this disease is not fully clarified. Santa Maria, Lisbon. This study included patients with a clin-
However, the literature suggests the occurrence of an autoim- ical and histological diagnosis of LP, observed from 2008 to
mune process mediated by deregulated T cells that compro- 2017. Of 340 patients, 174 were included in this study; the re-
mise basal keratinocytes of the epithelium. (4,14,15) Some factors maining were excluded due to lack of information or incon-
were associated with this pathology, such as HCV (hepatitis C clusive diagnosis. The data was blindly collected from the pa-