Mucosal (oral and vulval) lichen planus in women: are angiotensin-converting enzyme inhibitors protective, and beta-blockers and non-steroidal anti-inflammatory drugs associated with the condition?
OBJECTIVE
To determine whether there is an association between the use of angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and nonsteroidal anti-inflammatory drugs (NSAIDS) in women with mucosal (oral and vulval) lichen planus (LP) compared with a control population.


METHODS
This was a retrospective review of medical records in dedicated vulval and oral clinics in hospitals. The study population comprised 141 women with vulval LP and 106 women with oral LP. Medications taken at the time of diagnosis were recorded.


RESULTS
Patients with mucosal LP were more likely to be on NSAIDS and beta-blockers, but less likely to be on ACE inhibitors compared with controls. All three groups were found to have an inverse relationship with ACE inhibitors, but no association was found between patients with oral LP and beta-blockers.


CONCLUSIONS
Beta-blockers and NSAIDS are associated with LP, suggesting that withdrawal of these drugs should be considered. Further studies are needed to confirm or refute the inverse relationship between mucosal LP and use of ACE inhibitors.
Clayton
R
R
Department of Dermatology, Royal Berkshire Hospital, Reading, UK. r.clayton@doctors.org.uk
Chaudhry
S
S
Ali
I
I
Cooper
S
S
Hodgson
T
T
Wojnarowska
F
F
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008010:Lichen Planus / Q000139:chemically induced* / Q000517:prevention & control; D017676:Lichen Planus, Oral / Q000139:chemically induced / Q000517:prevention & control; D008875:Middle Aged; D012189:Retrospective Studies; D014845:Vulvar Diseases / Q000139:chemically induced / Q000517:prevention & control
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal