Short report Viti/igo and lichen planus Colocalization qf vitiligo and lichen planus in a patient with autoimmune thyroiditis C. Veller Fomasa, S. Rosin, M. Lazzaro and M. Tarantello SUMMARY A case of a 63 years old woman with autoimmune thyroiditis and the presence of papules of lichen planus strictly within pre-existing depigmented areas of vitiligo is described. To the art of our knowledge there are no case like this previously published in the literature. Vitiligo and lichen planus (LP) are two immune-re- lated diseases reported in association with processes mediated by altered immunoregulation or with disor- ders of autoimmune origin (1 ,2,3,4,5,6,7,8). The coexistence of vitiligo and LP is also described with (9,10,11,12,13,14,15) orwithout (10,11,16,17,18,19) the presence of other autoimmune diseases, but the studies of large series of patients have not yet provided evidence of an association of LP with vitiligo (20,21). We describe a case of a patient affected by vitiligo, lichen planus and autoimmune thyroiditis. Case report A 63 years old Caucasian woman was admitted to the clinic due to the presence of purplish, itchy, po- Iygonal papules which had appeared 1 year previously strictly within pre-existing depigmented areas of viti- ligo. The patient had suffered from vitiligo for 25 years and had never been treated. Furthermore, the patient had a 3-year history of autoimmune thyroiditis and for this reason she had been treated with thyroxin sodium (EutiroxR, Bracco). The papules were situated on the face, arms, hands, lower Iegs and feet. A biopsy of one papule was performed and the histological examina- tion revealed the diagnosis oflichen planus (LP). Char- acteristically, the papules of LP were confined to the areas of vitiligo, and no papules ofLP were observed in non vitiligineous skin. Discussion To our knowledge, this is the first case of coloca- lization of LP and vitiligo associated with autoimmune thyroiditis. One case of LP in areas of vitiligo bas been reported by Anstey (16) , but in that case the thyropathy was not associated. Anstey and Marks suggested that the colocalization of LP and vitiligo is determined by the fact that both condition are Iymphocyte mediated. In contrast Porten et al. speculated that coexistence of LP and vitiligo is a coincidence as an autoimmune patho- genesis in LP bas not bween proved. Acta Dermatoven APA Vol 11, 2002, No 3 ------------------Jf_J Vitiiigo and lichen planus In conclusion, we report the first the association of vitiligo, LP and autoimmune thyroiditis; if this associa- tion is the result of a common underlying pathogen- esis, it remains to be elucidated. Lastly there are no data in the literature indicating that the drugs used by a pa- tient for the treatment of thyropathy may be involved in the development of LP. 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Parter SR, Scully C, Everson JW Coexistence of lichen planus and vitiligo is coinciclental. Ciin Exp Dennatol.1994; 19: 366. 21. Gruppo Italiano Studi Epidemiologici in Dermatologia. Epiclemiological evidence of the association be- tween lichen planus ancl two immune-relatecl cliseases. Arch Dermatol 1991; 127: 688-91. A U T H O R S ' C leto Veller Fornasa, MD, Projessor and Chairman, C linica A D D R ES SE S Dermatologica, Via Cesare Battisti, 206, 35126 Padova-Italia, E-mail: vellerc @uxl. unipd. it, corresponding author Stefana Rosin, MD, same address Michela Lazzaro, MD, same address Marco Tarantello, MD, same address Short report .f .f 4 ----------------------------------Acta Dermatoven APA Vol 11, 2002, No 3