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. 
REFEJ{EjVCE8 
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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 
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